• Title/Summary/Keyword: Outcome measures

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Comparison of ultrasound-guided subacromial corticosteroid and ozone (O2-O3) injections in the treatment of chronic rotator cuff tendinopathy: a randomized clinical trial

  • Merve Orucu Atar;Nurdan Korkmaz;Sefa Gumruk Aslan;Ozge Tezen;Sinem Uyar Koylu;Yasin Demir;Serdar Kesikburun
    • The Korean Journal of Pain
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    • v.36 no.1
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    • pp.128-136
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    • 2023
  • Background: The authors aimed to compare the effects of a one-time ultrasound (US)-guided subacromial corticosteroid injection and three-time ozone (O2-O3) injection in patients with chronic supraspinatus tendinopathy. Methods: Participants were randomly assigned to the corticosteroid group (n = 22) or ozone group (n = 22). Injections in both groups were administered into subacromial bursa with an US-guided in-plane posterolateral approach. Primary outcome measure was the change in the Western Ontario Rotator Cuff Index (WORC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale and Shoulder Pain and Disability Index scores. Assessments were recorded at baseline, and 4-weeks and 12-weeks post-injection. Results: Forty participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both the groups showed clinically significant improvements in shoulder pain, quality of life, and function. Baseline, 4-week post-injection, and 12-week post-injection WORC scores (mean ± standard deviation) were 57.91 ± 18.97, 39.10 ± 20.50 and 37.22 ± 27.31 in the corticosteroid group, respectively and 69.03 ± 15.89, 39.11 ± 24.36, and 32.26 ± 24.58 in the ozone group, respectively. However, no significant group × time interaction was identified regarding all outcome measures. Conclusions: Three-time ozone injection was not superior to a one-time corticosteroid injection in patients with chronic supraspinatus tendinopathy. It might be as effective as corticosteroid injection at 4-weeks and 12-weeks post-injection in terms of relieving pain and improving quality of life and function.

Evaluating the effects of age on the long-term functional outcomes following anatomic total shoulder arthroplasty

  • Troy Li;Akiro H. Duey;Christopher A. White;Amit Pujari;Akshar V. Patel;Bashar Zaidat;Christine S. Williams;Alexis Williams;Carl M. Cirino;Dave Shukla;Bradford O. Parsons;Evan L. Flatow;Paul J. Cagle
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.231-237
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    • 2023
  • Background: In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA. Methods: Among the patients who underwent TSA, 119 shoulders were retrospectively analyzed. Preoperative and postoperative clinical outcome data were collected. Linear regression analysis (univariate and multivariate) was conducted to evaluate the associations of clinical outcomes with age. Kaplan-Meier curves and Cox regression analyses were performed to evaluate implant survival. Results: At final follow-up, patients of all ages undergoing aTSA experienced significant and sustained improvements in all primary outcome measures compared with preoperative values. Based on multivariate analysis, age at the time of surgery was a significant predictor of postoperative outcomes. Excellent implant survival was observed over the course of this study, and Cox regression survival analysis indicated age and sex to not be associated with an increased risk of implant failure. Conclusions: When controlling for sex and follow-up duration, older age was associated with significantly better patient-reported outcome measures. Despite this difference, we noted no significant effects on range of motion or implant survival. Level of evidence: IV.

Daily Physical Functioning and Quality of life for Stroke (뇌졸중 환자의 일상적인 신체적 기능과 삶의 질 수준)

  • Kwon, Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.19 no.5
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    • pp.87-96
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    • 2007
  • Purpose: It remains controversial for the effect of daily functioning and quality of life on therapeutic exercise after stroke. The purpose of this study was to describe the effects on daily functioning and QOL. Methods: Outcome measures of daily functioning included, such as the Functional Independence Measure (FIM), Barthel index. Outcome measures of QOL included, such as Stroke Impact Scale(SIS) and the Medical Outcomes Study short-form 36-item questionnaire(SF-36). Results: 125 stroke patients were recruited, who were in or outpatients. The average age was 55.4 years. 64.8% were male. The mean Bathel index and FIM score was 63.7 and 87.5. The mean SIS score were higher in communication and mean SF-36 score were higher in physical pain. In/out patients are associated with SIS (communication, emotion) and SF-36(social function, energy or fatigue). Sex are associated with SF-36 (physical function). Other disease state are associated with SIS(hand function) and SF-36 (physical function). Paralysis portion are associated with SIS(communication, daily activity). Barthel index are associated with SIS(communication, mobility) and SF-36(social function, physical function, role limits due to emotional problems). Conclusion: These findings may provide the useful with rehabilitation professionals, who specilalized in the importance of QOL in designing treatment modalities.

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Immediate Effect of Foot Drop Stimulator in Outpatients with Chronic Stroke: A Mixed Method Study

  • Park, Jaeyoung;Lee, Dooho;Oh, Donghwan
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.1
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    • pp.1992-1998
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    • 2020
  • Background: The foot drop stimulator is designed to improve the walking ability of foot drop in patients after stroke, however, studies on clinical effects are still lacking. Objective: To investigate the effect of a foot drop stimulator on the walking and balancing abilities of foot drop patients after a stroke. Design: One-Group (Pretest-Posttest) Design. Methods: All subjects walked in all three conditions: foot drop stimulator (FDS) ankle foot orthosis (AFO) and barefoot. Primary outcome measures were assessed for walking and balance using a 10-m walking test (10MWT) and a timed up and go test (TUG). Secondary outcome measures consisted of a brief user interview, and the patients recorded the advantages and disadvantages of each condition. Results: FDS, AFO, and barefoot conditions showed a statistically significant difference in 10MWT and TUG (P<.001) as a result of comparing three conditions. FDS and AFO were significantly different from the barefoot condition as post-hoc results; however, there was no significant difference between the two conditions (P>.05). Conclusion: In this study, the foot drop stimulator contributed to improving the balance ability, and the walking ability was similar to the effect of the ankle-foot orthosis.

The Motor-cognitive Training on Cognition and Physical Performance in the Older Adults with Mild Cognition Impairment : A Literature Review

  • Jung, Jihye;Kim, Yong-Seong;Lee, Seungwon
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.493-502
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    • 2021
  • Objective: Older adults with mild cognitive impairment (MCI) are more likely to progress to dementia. Motor-cognitive training is applied as a dual-task to improve the cognitive and physical functions of older adults with MCI. The purpose of the study was to know the recent trends in motor training types and outcome measures used for motor-cognitive training in older adults with MCI. Design: Aliterature review Methods: This literature review was conducted in Pubmed, MEDLINE® and Google Scholar with the following key words: older adults, mild cognitive impairment, motor-cognitive training, cognition, and dual-task. The 7 studies were found with the search tool and all studies were randomized controlled trials. Results: In motor-cognitive training in older adults with MCI, 6 studies applied aerobic exercise. And 3 out of 6 studies also applied strengthening exercises. One study applied dual tasks without aerobic exercise. In the 6 studies, overall cognitive and executive function were used as outcome measures, and physical function was evaluated as gait performance. Memory and physical frailty were also used as measurement tools. As a result of all studies, when motor-cognitive training was applied, cognition and physical performance showed significant results. Conclusions: A recent five-year study applied mainly aerobic exercise and strength training to older adults with MCI and found it to improve cognitive and physical performance.

Effectiveness of Electroacupuncture in Patients with Chronic Fatigue Syndrome: A Systematic Review and Meta-analysis

  • Yang, Jaewoo;Shin, Donghoon;Oh, Jihoon;Lim, Jinwoong
    • Journal of Acupuncture Research
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    • v.39 no.3
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    • pp.170-181
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    • 2022
  • This review evaluated the efficacy of electroacupuncture (EA) for chronic fatigue syndrome. Randomized controlled trials (RCTs) using EA as an intervention for patients with chronic fatigue syndrome were identified in 6 databases (PUBMED, EMBASE, CNKI, J-STAGE, KMBASE, OASIS). Fatigue indicators were used as the primary outcome measures. The quality-of-life index, efficiency rate, and level of pain were used as secondary outcome measures. There were 408 patients from seven RCTs included in this study. Meta-analysis showed that EA was significantly associated with fatigue relief compared with the control group (n = 141 SMD = -1.55, 95% CI; -2.58 - -0.52, p = 0.003, I2 = 92%). In addition, EA had a statistically significant improvement in quality of life compared with the control group (n = 176, SMD = -2.29, 95% CI; -3.68 - -0.90, p = 0.001, I2 = 96%). One study reported ten cases of bleeding, however, no serious adverse events were reported in any of the included studies. This review determined that EA may have a greater clinical effect than the control group for fatigue relief and improved quality of life. However, there were several risks of bias identified. Not all of the RCTs accurately reported the research method, all studies were conducted in 1 country (China), and the number of studies included were small.

The Net Promoter Score with Friends and Family Test applied to arthroscopic shoulder surgery

  • Jabbal Monu;Sharma Sunil
    • Clinics in Shoulder and Elbow
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    • v.26 no.1
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    • pp.20-24
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    • 2023
  • Background: The Friends and Family Test (FFT) developed by the UK National Health Service evaluates whether patients are satisfied with a service provided, where improvements are needed, and how likely patients are to recommend the intervention. Calculated from the FFT, the Net Promoter Score (NPS) creates a recommendation metric for treatment. The primary aim of this prospective study is to evaluate NPS for arthroscopic subacromial decompression (ASD) and rotator cuff repair (RCR). Secondary aims are to postoperatively evaluate 1-year changes in patients' Oxford Shoulder Scores (OSSs) in terms of the proportion of patients satisfied with their surgery and correlation with FFT. Methods: During a 2-year period, all patients undergoing ASD or RCR completed questionnaires prospectively. Collected preoperatively and postoperatively at 1 year. Results: NPSs were 31 for ASD (n=32) and 52 for RCR (n=39). OSSs increased by 4.3 and 6.9 for ASD and RCR, respectively (P<0.001). Overall, 75% of ASD and 77% of RCR patients were either "satisfied" or "very satisfied," respectively, with procedure outcomes. Scores from FFT had a positive correlation with improvement in OSS and satisfaction scores among patients undergoing arthroscopic shoulder surgeries (P<0.001). Conclusions: The current study shows positive NPS outcomes in patients with ASD and RCR. Scores from FFT correlate well with both satisfaction and OSS among patients. NPS can be an adjunct to traditional patient-reported outcome measures to provide global evaluation of patient experiences to aid in determining the clinical value of common procedures in shoulder orthopaedics. Level of evidence: III.

Mapping between Musculoskeletal Patient-Reported Outcome Measures and KCF: Physical Therapy Perspective (근육뼈대계 환자보고식 결과 측정과 KCF의 연결: 물리치료 중심으로)

  • Ju-Min Song
    • Journal of the Korean Society of Physical Medicine
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    • v.19 no.1
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    • pp.143-154
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    • 2024
  • PURPOSE: The present study was conducted to improve the understanding of the Korean Standard Functional, Disability, and Health Classification (KCF) and its ease of use in the clinical domain of the musculoskeletal system by comparing, analyzing, and linking the KCF codes with items from patient-reported outcome measures (PROMs), which are currently mainly used to evaluate patients with neck, shoulder, waist, and knee pain. METHODS: The items of the most widely used PROMs, the Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Oswestry Disability Index (ODI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the codes of the KCF were linked by two experts according to the linking rules. RESULTS: The concordance between the items of each of the PROMs and the KCF code linked by the two experts was NDI,86.4%86.4%, DASH 83.3%, ODI 92.0%, and WOMAC 80.7%. The NDI, DASH, and WOMAC indexes were found to comprise items corresponding to physical function, activity, and participation areas, and were linked to 22, 43, and 31 KCF codes, respectively. In addition to these two areas, the ODI included items related to environmental factors and was linked to 25 codes (duplicated codes are treated as one). CONCLUSION: This research can be used by adding the KCF code to the questions of the currently used evaluation tool. This coding can be easily applied and will contribute to the easy understanding of the KCF.

Statistical Methods for Repeated Measures Data with Three Repeat Factors (반복요인이 3개인 반복측정자료에 대한 통계적 분석방법 -양평 주민 혈압자료를 이용하여-)

  • 강성현;박태성;이성곤;김창훈;김명희;최보율
    • The Korean Journal of Applied Statistics
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    • v.17 no.1
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    • pp.1-12
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    • 2004
  • In this paper, we consider choosing the appropriate covariance structure for analyzing repeated measures data with three repeat factors from a study of blood pressure data, which is collected from the local residents of Yangpyeong, Gyeonggi-do (2001) and fitted linear mixed models to find the significant covariates on outcome variable(Blood Pressure)

Comparison of Multiple Chronic Obstructive Pulmonary Disease (COPD) Indices in Chinese COPD Patients

  • Zhang, Jinsong;Miller, Anastasia;Li, Yongxia;Lan, Qinqin;Zhang, Ning;Chai, Yanling;Hai, Bing
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.116-122
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    • 2018
  • Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.