Hon K. Yuen

Using Wii Fit to reduce fatigue among African American women with systemic lupus erythematosus: A pilot study:

Fatigue and physical deconditioning are common, difficult to treat conditions among patients with systemic lupus erythematosus (SLE). The aim of this pilot study was to evaluate the effectiveness of a home-based exercise program using the Wii Fit system in patients with SLE. Fifteen sedentary African American women with SLE experiencing moderate to severe fatigue participated in a home exercise program using the Wii Fit 3 days a week for 30 minutes each for 10 weeks. A one-group pretest–post test design was used to evaluate the effectiveness of this program. Primary outcome measure was severity of fatigue. Secondary outcome measures were body weight, waist circumference, fatigue-related symptoms of distress, activity level, and physical fitness. At the completion of the 10-week Wii Fit exercise program, participants perceived fatigue severity as measured by the Fatigue Severity Scale to be significantly decreased (p = 0.002), and body weight and waist circumference were significantly reduced (p = 0.01). In addition, anxiety level, as measured by Hospital Anxiety and Depression Scale, and overall intensity of total pain experience, as measured by Short-form of the McGill Pain Questionnaire, were also significantly reduced (p < 0.05). Findings provide preliminary evidence that the Wii Fit motivates this population to exercise, which leads to alleviation of fatigue and reduced body weight, waist circumference, anxiety level, and overall intensity of total pain experience.

Oral health knowledge and behavior among adults with diabetes.

The purpose of this study was to determine levels of oral health knowledge and factors associated with adequate oral health knowledge in adults with diabetes. A convenience sample of 253 adult US residents with diabetes completed an oral health survey to assess their knowledge. Results showed that only 47% of the participants answered five or more (out of a maximum of seven) oral health knowledge items related to diabetes correctly. Participants who received oral health information related to diabetes have 2.9 times the odds of possessing adequate oral health knowledge (i.e., answered five or more items correctly) compared to participants who did not received that information controlling for education and race (OR=2.86, 95% CI 1.31-6.24, P=0.008). Given that oral health information provided by health professionals (dental and/or medical) contributes to improve oral health knowledge among adults with diabetes, health professionals should take the opportunity to educate patients with diabetes about the oral manifestations (e.g., dry mouth) and complications (e.g., periodontitis and oral candidiasis) of diabetes and to promote proper oral health behaviors.

Activities of daily living performance in dementia

Objective –  To explore the activities of daily living ADL performance profile of community‐living people with dementia and to investigate its relationship with dementia severity.

Body image and exercise in people with and without acquired mobility disability

Purpose : This study was conducted to determine whether differences existed in self-perceived body image between adults with and without Acquired Mobility Disability (AMD), and whether a relationship existed between exercise and self-perceived body image in adults with AMD. Method : Thirty adults with AMD were paired with 30 able-bodied controls and matched on gender, age, ethnicity and exercise level. Both groups completed the Multidimensional Body-Self Relations Questionnaire (MBSRQ) which measures body image on 10 subscales related to appearance, fitness, health/illness, body-areas satisfaction and weight-related attitude. Results : A 2 2 2 two-way ANOVA, with disability (AMD vs able-bodied) and exercise (active vs non-active) serving as the main factors, was used to examine group differences of each on the 10 subscales of the MBSRQ separately. Results indicated that there was a significant interaction between disability and exercise on Health Orientation [F(1, 56)=22.46, p=0.000]. Post-hoc analysis indicated that active able-bodied individuals scored higher on the health orientation subscale than the other three subgroups. No other comparisons on health orientation were significant. There was a significant main effect of disability on appearance orientation [F(1, 56)=10.44, p=0.002] and health evaluation [F(1, 56)=10.48, p=0.002], and a significant main effect of exercise on appearance evaluation [F(1, 56)=10.75, p=0.002] and fitness orientation [F(1, 56)=40.96, p=0.000]. The AMD group scored higher on appearance orientation than the able-bodied group, whereas the able-bodied group scored higher on health evaluation. The physically active group scored higher than the non-active group on appearance evaluation and fitness orientation. Conclusions : The present study indicated that individuals with AMD rated their body image comparable to the able-bodied controls except in the attention paid to appearance and perceptions about physical health. When taking the effect size of the main effect of exercise into consideration, the members of the active mobility disability group appear to evaluate their physical appearance (appearance evaluation) and health (health evaluation) better, are more concerned with fitness (fitness orientation) and more satisfied with different body parts (body areas satisfaction) when compared to their nonactive mobility disability counterparts. The potential role of exercise on improving body image in individuals with mobility disabilities should be systematically investigated.

Effect of orofacial exercises on oral aperture in adults with systemic sclerosis

Purpose: To examine the effect of a home orofacial exercise program on increasing oral aperture among adults with systemic sclerosis (SSc). Method: Forty-eight adults with SSc were assigned randomly to the multifaceted oral-health intervention or usual dental care control group. Participants with an oral aperture of <40 mm in the intervention group received an orofacial exercise program, which included daily manual mouth-stretching and oral-augmentation exercises twice a day with a total of 6 minutes for 6 months. The outcome measure was oral aperture which was measured at baseline, 3-months, and 6-months intervals. Results: A significantly larger increase in oral aperture for participants received the orofacial exercise program was found when compared to those in the usual care at 3 months (P = 0.01), but not at 6-months evaluation. Participants’ adherence rate to the exercise program was low (48.9%). Conclusions: The orofacial exercise program intervention for adults with SSc and microstomia did not show significant improvement at 6 months. In addition to the low exercise adherence rate, insufficient frequencies, repetitions, and durations of the orofacial exercises may contribute to these results. Implications for Rehabilitation Microstomia in adults with systemic sclerosis (SSc) has profound impacts on their quality of life. Orofacial exercise programs have the potential to improve the size of oral aperture. Brief daily orofacial home exercises for 6 months did not result in a significant increase in the size of oral aperture.

Treatment methodology. Guiding of behaviour through redirection in brain injury rehabilitation.

Confusion, agitation, and non-compliance are some of the most common behaviours exhibited by individuals with brain injury. The presence of these behaviours affects their daily functioning and social interactions with others. Management of these behaviours ranges from prevention and total ignoring to restraint, with the strategy of redirection cited most often in the literature. However, few guidelines exist on how to use redirection to manage clients who exhibit confusion and agitation beyond the acute phase of rehabilitation. This paper describes some of the intervention strategies that use guidance and redirection for individuals with brain injury in post-acute rehabilitation. Case examples are used to illustrate the various interventions.

Factors that limit access to dental care for adults with spinal cord injury.

This study investigated dental care service utilization among adults with spinal cord injury (SCI) and identified barriers and other factors affecting utilization among this population. There were 192 subjects with SCI who participated in the oral health survey assessing dental care service utilization and they were compared with subjects from the 2004 Behavioral Risk Factors Surveillance System (BRFSS). There was no significant difference in the proportion of subjects with SCI who visited the dentist for any reason in the past year compared to the general population (65.5% vs. 68.8%, p= .350). However, subjects with SCI were less likely to go to the dentist for a dental cleaning in the past year compared to the general population (54.6% vs. 69.4%, p < .001). The three most commonly reported barriers to accessing dental care were cost (40.1%), physical barriers (22.9%), and dental fear (15.1%). Multivariate modeling showed that physical barriers and fear of dental visits were the two significant factors deterring subjects from dental visits in the past year. Physical barriers preventing access to dental facilities and dental fear are prevalent and significantly impede the delivery of dental health care to adults with SCI. Dentists should undertake necessary physical remodeling of their facilities to accommodate wheelchair users and implement appropriate strategies for the management of dental fear among patients with SCI.

Driving behaviors in patients with head and neck cancer during and after cancer treatment: a preliminary report

The purpose of this study was to explore the driving behaviors of head and neck cancer patients during and after cancer therapy.

Neuroplasticity and successful cognitive aging: a brief overview for nursing.

ABSTRACT The brain remains dynamic even in older age and can benefit from mental exercises. Thus, it is important to understand the concepts of positive and negative neuroplasticity and how these mechanisms either support or detract from cognitive reserve. This article provides a brief review of these key concepts using four exemplary studies that clearly show the effects that these neurological mechanisms exert on cognitive reserve and cognitive functioning. From this review, a working knowledge of how neuroplasticity and cognitive reserve are expressed in patients will be provided along with how this information can be incorporated into nursing practice and research.

Radiation dose, driving performance, and cognitive function in patients with head and neck cancer.

Seven head and neck cancer patients participated in a driving evaluation in a driving simulator. Radiation dose on the temporal lobes was moderately associated with time to complete a cognitive test and with driving performance. Results indicated that incidental irradiation may contribute to a decrease in cognition and in unsafe driving performance, which seems to be time-dependent.