ABSTRACT
PURPOSE: To understand the role of camptocormia (increased kyphosis) and postural alteration in Parkinson's disease in the development of shoulder pathology, with a special concern for adhesive capsulitis and shoulder stiffness. METHODS: A preliminary online search was carried out, with combination of keywords including "Parkinson," "Shoulder stiffness," "Frozen shoulder," "Adhesive capsulitis," "Postural alteration," "Camptocormia". The retrieved papers were screened by title and abstract and those considered relevant to the aim of the review were read in full text and included. Relevant information were extracted and reported into text. RESULTS: Due to a severe impairment of posture, patients affected by PD show an increased thoracic kyphosis (camptocormia) and decreased mobility of the trunk that can yield a humeroacromial impingement syndrome and capsulitis, resulting in inflammation of the bursa, shoulder pain and reduction of movement. Furthermore, kinematic of the shoulder is allowed by the combined movement of the humerus, the scapula, the clavicle, the thoracic wall and thoracic spine. The thoracic spine and wall mobility are severely impaired in the parkinsonian patient, thus limiting the shoulder motion. CONCLUSION: The postural alteration observed in PD is the primum movens for shoulder pathology, since anterior tilt of the scapula, which occurs with the increment of thoracic kyphosis, yields to a subacromial impingement. A closed loop is then created, as the rigidity of the shoulder causes further alteration in the posture, which worsens the impingement syndrome and so on.
Subject(s)
Bursitis/diagnosis , Parkinson Disease/complications , Shoulder Impingement Syndrome/diagnosis , Bursitis/etiology , Diagnosis, Differential , Humans , Inflammation , Kyphosis/etiology , Movement , Posture , Rotator Cuff Injuries/etiology , Shoulder Impingement Syndrome/etiology , Shoulder Impingement Syndrome/physiopathology , Shoulder Pain/etiologyABSTRACT
Rugby is a popular contact sport worldwide. Collisions and tackles during matches and practices often lead to traumatic injuries of the shoulder. This review reports on the epidemiology of injuries, type of lesions and treatment of shoulder injuries, risk factors, such as player position, and return to sport activities. Electronic searches through PubMed (Medline), EMBASE, and Cochrane Library retrieved studies concerning shoulder injuries in rugby players. Data regarding incidence, type and mechanisms of lesion, risk factors and return to sport were extracted and analyzed. The main reported data were incidence, mechanism of injury and type of lesion. Most of the studies report tackle as the main event responsible for shoulder trauma (between 50% and 85%), while the main lesions reported were Bankart lesions, Superior Labral tear from Anterior to Posterior (SLAP tears), anterior dislocation and rotator cuff tears. Open or arthroscopic repair improve clinical outcomes. Shoulder lesions are common injuries in rugby players. Surgical treatment seems to be effective in for rotator cuff tears and shoulder instability. More and better designed studies are needed for a higher Level of Evidence analysis of this topic.
ABSTRACT
OBJECTIVE: To determine the efficacy over 12 months of the educational programme on self-care of the elderly (PECA), which covers quality of life, nutritional status, and perceived social support of people over 65 living in their own homes. DESIGN: Pre-test/post-test experimental study with control group. SETTING: Urban population in the Manso Health District (Example, Barcelona), Spain. PARTICIPANTS: Persons over 65 living in their own homes, healthy or with chronic illnesses characteristic of their age, who had a normal score in the Pfeiffer test. A total of 70 subjects (35 per group) were selected and 5 of the control group left the study. INTERVENTION: Programme on self-care of the elderly, including education on physical activity, nutrition, and social support. MEASUREMENTS: Dependent variables were quality of life, measured by the Nottingham Health Profile; nutritional status, measured by the Mini-Nutritional Assessment (MNA); and social support, measured by the Duke-Unk Functional Social Support Scale. RESULTS: The study sample had an average age of 70.9 (SD, 3.1); 88.2% had self-perception of good health; and 21% lived alone. We only found statistically significant differences between pre- and post-intervention observations in nutritional status (P=.001). CONCLUSION: Despite a statistically significant difference in the variable of nutritional status, the difference was not "clinically" relevant. The ineffectiveness of the intervention is due to our starting from a very homogeneous sample, which had good health status and well-established social networks.
Subject(s)
Health Education , Health Status , Program Evaluation , Quality of Life , Self Care , Social Support , Aged , Female , Humans , MaleABSTRACT
Objetivo. Determinar la eficacia, a lo largo de 12 meses, del programa Educativo de Autocuidado del Anciano (PECA) sobre la calidad de vida, el estado nutricional y el apoyo social percibido de personas mayores de 65 años que viven en su propio domicilio. Diseño. Ensayo clínico aleatorizado. Emplazamiento. Área básica de salud (ABS) de Manso. Barcelona. Participantes. Personas mayories de 65 años que viven en sus propios domicilios, sanas o con enfermedades crónicas propias de la edad y que obtienen una puntuación normal en el test de Pfeiffer. Se seleccionó a un total de 70 sujetos (35 por grupo) y abandonaron 5 del grupo control. Intervención. Programa PECA que incluyeeducación sobre la actividad física, la nutrición y el apoyo social. Mediciones. Las variables dependientes son la calidad de vida, medida con el Perfil de Salud de Nottinham (PSN); el estado nutricional, medido con el Mini Nutritional Assessment (MNA), y el apoyo social, medido con la escala de Apoyo Social Funcional Duke-UnK. Resultados. La muestra tenía una edad media ± desviación estándar de 70,9 ± 3,1 años, tenía una buena percepción de su salud (88,2 por ciento) y el 21 por ciento vivía solo. Únicamente se observaron diferencias estadísticamente significativa s entre las observaciones preinterveción y postintervención en la variable estado nutricional (p = 0,001). Conclusión. La diferencia observada en la variable estado nutricional no es clinicamente relevante. La ausencia de efecto de la intervención podría deberse a que la muestra es muy homogénea, con un buen estado de salud y con una red social bien estabelecida.(AU)
Subject(s)
Humans , Aged , Aged , Quality of LifeABSTRACT
Objetivo. Determinar la eficacia, a lo largo de 12 meses, del programa Educativo de Autocuidado del Anciano (PECA) sobre la calidad de vida, el estado nutricional y el apoyo social percibido de personas mayores de 65 años que viven en su propio domicilio. Diseño. Ensayo clínico aleatorizado. Emplazamiento. Área básica de salud (ABS) de Manso. Barcelona. Participantes. Personas mayores de 65 años que viven en sus propios domicilios, sanas o con enfermedades crónicas propias de la edad y que obtienen una puntuación normal en el test de Pfeiffer. Se seleccionó a un total de 70 sujetos (35 por grupo) y abandonaron 5 del grupo control. Intervención. Programa PECA que incluye educación sobre la actividad física, la nutrición y el apoyo social. Mediciones. Las variables dependientes son la calidad de vida, medida con el Perfil de Salud de Nottingham (PSN); el estado nutricional, medido con el Mini Nutritional Assessment (MNA), y el apoyo social, medido con la escala de Apoyo Social Funcional Duke-UnK. Resultados. La muestra tenía una edad media ± desviación estándar de 70,9 ± 3,1 años, tenía una buena percepción de su salud (88,2%) y el 21% vivía solo. Únicamente se observaron diferencias estadísticamente significativas entre las observaciones preintervención y postintervención en la variable estado nutricional (p = 0,001). Conclusión. La diferencia observada en la variable estado nutricional no es «clínicamente» relevante. La ausencia de efecto de la intervención podría deberse a que la muestra es muy homogénea, con un buen estado de salud y con una red social bien establecida
Objective. To determine the efficacy over 12 months of the educational programme on self-care of the elderly (PECA), which covers quality of life, nutritional status, and perceived social support of people over 65 living in their own homes. Design. Pre-test/post-test experimental study with control group. Setting. Urban population in the Manso Health District (Eixample, Barcelona), Spain. Participants. Persons over 65 living in their own homes, healthy or with chronic illnesses characteristic of their age, who had a normal score in the Pfeiffer test. A total of 70 subjects (35 per group) were selected and 5 of the control group left the study. Intervention. Programme on self-care of the elderly, including education on physical activity, nutrition, and social support. Measurements. Dependent variables were quality of life, measured by the Nottingham Health Profile; nutritional status, measured by the Mini-Nutritional Assessment (MNA); and social support, measured by the Duke-Unk Functional Social Support Scale. Results. The study sample had an average age of 70.9 (SD, 3.1); 88.2% had self-perception of good health; and 21% lived alone. We only found statistically significant differences between pre- and post-intervention observations in nutritional status (P=.001). Conclusion. Despite a statistically significant difference in the variable of nutritional status, the difference was not "clinically" relevant. The ineffectiveness of the intervention is due to our starting from a very homogeneous sample, which had good health status and well-established social networks
Subject(s)
Male , Female , Aged , Humans , Quality of Life , Health of the Elderly , Nutritional Status , Geriatric Assessment , Social Support , Self-Help Groups , Clinical TrialABSTRACT
The time nurses spend on two activities is measured; one being the time spent in consulting offices by Primary Assistance Health Care Team members; and the second being the total time dedicated to house calls. This distribution time study has three focuses: observational, cross-sectional and descriptive. This study showed that more than one fourth of a nurse's time is spent carrying out technical procedures on patients, another fourth part is used filling out administrative documents, another fourth part corresponds to preventative medicine and health education activities, all of which leaves very little time for an independent professional role as compared to an interdependent role.
