Sex differences in independence in activities of daily living early in stroke rehabilitation.

BACKGROUND: Current stroke research suggests that there are differences between females and males regarding incidence, stroke risk factors, stroke severity, outcome, and mortality. The few studies that have investigated sex differences in rehabilitation 8-12 months poststroke found that males are more independent, compared to females. OBJECTIVES: To investigate if there is a difference in the improvement of independence in activities of daily living (ADL) between females and males in the acute phase (first 2 weeks) of stroke rehabilitation in a Danish population. METHODS: A prospective cohort study enrolling patients admitted to the hospital's rehabilitation ward with a stroke diagnosis from January 1, 2016, to March 17, 2017. Baseline and follow-up data regarding the primary outcome, Barthel-100 index, were analyzed using an adjusted linear mixed model. RESULTS: The study included 206 patients (83 females). Females were older at admission and more males lived with a partner. No differences in stroke severity or any of the risk factors were found. There were no differences between female and male scores at baseline. In the adjusted linear mixed model, quantifying the difference between follow-up and baseline Barthel-100 score, females increased their Barthel-100 score by 20.8 points (95% confidence interval (CI) 15.4-26.3) and males with 29.0 points (95% CI 24.6-33.4). CONCLUSION: In a homogeneous sample of stroke survivors undergoing specialized 24-h stroke rehabilitation for 11-14 days, females were more dependent in ADL than males.

Walking ability in patients with glioblastoma: prognostic value of the Berg Balance Scale and the 10 meter walk test.

Primary brain tumors frequently cause considerable functional impairments and the survival time when diagnosed with glioblastoma is 14.6 months. The aim of this study was to examine if baseline postural control and walking ability in patients with glioblastoma could predict long term walking ability and 1 year mortality. Data were gathered from prospective recordings in a brain cancer database supplemented by retrospective review of electronic patient records. We included 109 patients with glioblastoma, 47 women and 62 men with mean age 65 years. At admission 84 patients were tested with Berg Balance Scale and 57 were tested with 10 meter walk test. Binary logistic regression analysis showed no statistical significance in favour of the 10 meter walk test. Berg Balance Scale showed an ability to predict walking ability 4-8 months after admission. The risk of dying within a year was 6.9 times higher in patients who lost their ability to walk within 4-8 months of the first admission. This study showed that Berg Balance Scale has some ability to predict the loss of walking ability 4-8 months after admission. This could be an important indicator pin pointing patients most in need of more intensive specialized neurorehabilitation efforts early in the disease course.

Benefit of physiotherapeutic treatment in children with torticollis.

INTRODUCTION: The incidence of torticollis, which is often accompanied by some degree of plagiocephaly in infants, has remained increased since the introduction of the supine sleeping position to prevent sudden infant death. Recently, instruments allowing quantitative measurement of torticollis and related pathology have been developed and validated. The aim of the present study was to monitor a cohort of children with torticollis using a standardised protocol including valid and reliable measurements. METHODS: A total of 136 infants diagnosed with torticollis and referred to physiotherapeutic treatment in four paediatric departments were included (October 2009-April 2011). Trained and calibrated physiotherapists assessed their cervical range of motion (ROM), cervical muscle function and severity of plagiocephaly prior to and after the treatment period. RESULTS: The infants' median age was three months at inclusion and seven months at the end of the treatment period that comprised a median of five treatment sessions. Initially, 52% and 54% presented with ROM deficits in rotation and lateral flexion, respectively. After treatment, these parts were reduced to 6% and 14%, and the magnitudes of the remaining ROM deficits were substantially reduced. Plagiocephaly improved in 82, remained unchanged in 18 and deteriorated in five of 105 infants with complete follow-up. Symmetrical or almost symmetrical muscle function was achieved in 93% (n = 101). CONCLUSION: A successful outcome was achieved in the majority (90%) of children with torticollis with less than ten physiotherapeutic treatment sessions. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.

The graded cycling test combined with the talk test is reliable for patients with ischemic heart disease.

PURPOSE: To assess relative reliability and measurement error of the Graded Cycling Test (GCT) with the Talk Test (TT) for patients with cardiac disease. METHODS: Patients (N = 64; women, n = 30) with ischemic heart disease performed the GCT with the TT twice in 1 day. Every minute the patient recited a text passage of 30 words. The question "Are you still able to speak comfortably?" was then answered: "Yes" (TT+), "Not sure" (TT±), or "No" (TT-). Two physiotherapists (PTs) rated when the speaking ability was affected by ventilation. Relative reliability: intraclass correlation coefficient (ICC)2.1 and absolute reliability: standard error of measurement with 95% CI (SEM95) and smallest real difference (SRD) were calculated. RESULTS: Intraclass correlation coefficient values of 0.90, 0.91, and 0.90 were observed for TT+, TT±, and TT-, respectively. Physiotherapist ICCs ranged between 0.81 and 0.88. SEM95 ranged between 17.2 and 18.3 watts (W), with corresponding SRD values between 24.4 and 25.9 W for the patient ratings. The PT ratings ranged between 15.8 and 21.4 W (SEM95) and between 22.3 and 30.3 W (SRD). CONCLUSIONS: The TT, combined with the GCT, was well tolerated by patients with cardiac disease in clinical settings with small measurement error and an excellent relative reliability. These results apply to both patient-rated and PT-rated TT.

[Positional plagiocephaly in infants can be prevented]. / Lejringsbetingede skæve hoveder hos spædbørn kan forebygges.

The prevalence of positional plagiocephaly is increasing. A systematic database search (Cochrane, MEDLINE, Embase, Cinahl and PEDro), critical appraisal and systematic evaluation of the quality of 14 selected studies show that the following are certain risk factors for the development of positional plagiocephaly: supine sleeping position, positional preference, one-sided handling of the child, male sex, delayed motor development, reduced neck mobility, too little "tummy time", firstborn, multiple births and premature children. Recommendations for prevention are provided.