Maria Justine

Patterns of work-related musculoskeletal disorders among workers in palm plantation occupation

This study investigated the patterns of ongoing work-related musculoskeletal disorders (WRMDs) and exposure risk to musculoskeletal injuries for various body regions among palm plantation workers. Standard Nordic Musculoskeletal Questionnaire (SNMQ) was used to assess the prevalence of musculoskeletal disorders symptoms. The Quick Exposure check (QEC) was used to assess the exposure risk of farmers to WRMDs. The common pattern of WRMDs was back pain (40%), followed by shoulder pain (19%). The QEC revealed high exposure risk for neck (56%), followed by back (45.6%). The results from the SNMQ showed that 58% reported pain in 1 region, followed by 2 regions (10.7%) and 3 regions (3.6%). Back pain and shoulder pain were found to be common among workers in palm plantation occupation. Nevertheless, the neck region appeared to have the highest risk of exposure to injuries.

Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review

Purpose. The aim of this paper is to review the published studies on the characteristics of impairments in the postural control and gait performance in diabetic peripheral neuropathy (DPN). Methods. A review was performed by obtaining publication of all papers reporting on the postural control and gait performance in DPN from Google Scholar, Ovid, SAGE, Springerlink, Science Direct (SD), EBSCO Discovery Service, and Web of Science databases. The keywords used for searching were “postural control,” “balance,” “gait performance,” “diabetes mellitus,” and “diabetic peripheral neuropathy.” Results. Total of 4,337 studies were hit in the search. 1,524 studies were screened on their titles and citations. Then, 79 studies were screened on their abstract. Only 38 studies were eligible to be selected: 17 studies on postural control and 21 studies on the gait performance. Most previous researches were found to have strong evidence of postural control impairments and noticeable gait deficits in DPN. Deterioration of somatosensory, visual, and vestibular systems with the pathologic condition of diabetes on cognitive impairment causes further instability of postural and gait performance in DPN. Conclusions. Postural instability and gait imbalance in DPN may contribute to high risk of fall incidence, especially in the geriatric population. Thus, further works are crucial to highlight this fact in the hospital based and community adults.

Functional balance and motor impairment correlations with gait parameters during timed up and go test across three attentional loading conditions in stroke survivors

The aim of this study was to determine whether stroke survivors gait performance during dual-task Timed Up and Go (TUG) test is correlated with the level of functional balance and motor impairment. Thirty stroke survivors (22 men, 8 women) were recruited for this study. The level of functional balance (Berg Balance Scale) and motor impairment (Fugl-Meyer assessment lower extremity) were assessed prior to the TUG test. TUG test was conducted under three attentional loading conditions (single, dual motor, and dual-cognitive). The time and number of steps were used to quantify gait parameters. The Spearmens rank correlation coefficient was used to evaluate the relationship between these variables. There was moderate to strong negative correlation between functional balance and gait parameters (range −0.53 to −0.73, P < 0.05). There was a weak negative correlation observed between the time taken to complete the single task and motor impairment (r s = −0.43; P = 0.02) dual motor task and motor impairment (r s = −0.41; P = 0.02). However, there were no significant correlations between lower limb motor impairment and the number of steps in all conditions. These findings suggest that functional balance may be an influential domain of successful dual-task TUG in stroke.

Effects of Multicomponent Exercise Training on Physical Functioning among Institutionalized Elderly

This quasiexperimental study aimed to measure the effects of 12-week multicomponent exercise training on physical functioning among institutionalized elderly. Forty-three participants (age = 70.88 ± 7.82 years) were self-assigned to an intervention (𝑛=23) or control (𝑛=20) group. Before and after training, cardiorespiratory endurance, arm curl strength, grip strength, lower limb strength, upper and lower limb flexibility, balance, and mobility were assessed. The training included aerobic, resistance, balance and flexibility exercises, performed 3 times per week. Significant increases (𝑃 0.05). The control group did not show any significant changes (𝑃>0.05) in any variables. The data suggested that 12-week multicomponent exercise training may improve physical functioning among institutionalized elderly.

Health-related quality of life, lung function and dyspnea rating in COPD patients.

BACKGROUND AND AIM COPD is a progressive and irreversible disease, thus assessing the impact of the disease on health-related quality of life (HRQOL) is important in the management of COPD. The aim of this study was to examine the relationship between HRQOL, lung function and dyspnea rating in patients with stable COPD. METHODS One hundred COPD patients (mean age = 64.76 +/- 11.43 years) were recruited for this cross-sectional study. Lung function test was measured using a FlowScreen portable spirometry. Dyspnea rating was measured using the baseline dyspnea index (BDI). HRQOL was assessed using the SF-36v2 which summarized two components; physical health component summary (PHCS) and mental health component summary (MHCS). THE RESULTS The mean value of lung function (Forced expiratory volume in 1 second, FEV1% predicted) was 58.19 +/- 30.24 and dyspnea rating was 6.85 +/- 2.68. The lung function was significantly correlated with MHCS (r=.294, p < 0.05) but not with the PHCS (p > 0.05). The dyspnea rating was significantly correlated with both PHCS (r=.730, p < 0.05) and MHCS (r = .324, p < 0.05). Regression analysis indicated that dyspnea rating emerged as the most significant predictor for PHCS and MHCS accounting for 54% and 12% of the variances respectively. CONCLUSIONS The findings show that dyspnea rating is an important factor in predicting HRQOL of patients with COPD. This indicates that dyspnea rating influences HRQOL to a greater extent than the physiological measurement of lung function. Therefore, focusing on such predictors at an early stage may provide meaningful benefits in the management of COPD.

Turning Ability in Stroke Survivors: A Review of Literature

The aim of this paper is to explore the research literature on the turning ability among stroke survivors. Stroke is one of the top five leading causes of death and disability in Malaysia. Stroke survivors reported a higher rate of fall incidences with turning while walking has been the major contributor in most of the incidences. The attentional task requires stroke survivors to have higher cognitive and attention function, and sound muscle coordination in order to perform multitask activities such as driving, walking and turning while talking, carrying an object (holding a plastic bag), navigating corners and overcoming obstacles within the base of support. Most of the previous studies have focused on the kinematic and gait parameters measurement of turning ability among stroke survivors. However, studies conducted on muscle activity using electromyography to evaluate the time pattern of muscle contraction during turning event is lacking. With regards to dual-task ability among stroke survivors, there is insufficient information or research into dual task (motor and cognitive) ability during turning. Further studies are needed to understand the effects of dual-task activity on muscle activity and gait parameters and how this impairment affects the turning ability. This needs to be addressed in order to prevent falls among stroke survivors.

Effects of a behavioral program on exercise adherence and exercise self-efficacy in community-dwelling older persons.

Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons.

A multicomponent exercise program for institutionalized older adults.

This study examined the effects of a multicomponent exercise program on depression and quality of life in institutionalized older adults. A quasi-experimental pretest-posttest design was used. Participants were recruited from a publicly funded shelter home in Seremban, Negeri Sembilan Malaysia. The experimental group consisted of 23 volunteers 60 or older who performed 60 minutes of supervised exercise three times per week for 12 weeks. The control group consisted of 20 volunteers who continued with a sedentary lifestyle. At 12 weeks, the exercise group demonstrated an improvement in quality of life by 10.74% (p > 0.05) but not depression (-1.6%, p > 0.05). The control group demonstrated a decrease in both quality of life by 11.26% (p > 0.05) and level of depression by 17.7% (p > 0.05). This study suggests a multicomponent exercise program is a feasible intervention to improve quality of life in institutionalized older adults.perception of quality of life (QOL) of institutionalized older adults tend to decline with the passage of time. Depression is the most commonly reported psychological problem among institutionalized older adults, ranging in prevalence from 22.2% to 81.8% (Chow et al., 2004; Demet, Taskin, Deniz, Karaca, & Icelli, 2002; Lin, Wang, & Huang, 2007; Mohd Aznan & Samsul, 2007). Osness and Mulligan (1998) found depression might strongly affect the QOL of older adults. Previous studies have reported a moderate to strong association between functional fitness and both psychological well-being (Morala, Shiomi, & Maruyama, 2006; Penninx, Deeg, van Eijk, Beekman, & Guralnik, 2000; Penninx et al., 1998) and QOL (Karinkanta, Heinonen, Sievanen, Uusi-Rasi, & Kannus, 2005; Larson, 2001; Ozcan, Donat, Gelecek, Ozdirenc, & Karadibak 2005; Regan, 2004; Sayer et al., 2006). Therefore, participation in regular physical activity and exercise has been recommended to improve functional fitness and thus enhance the overall wellbeing of older adults (American College of Sports Medicine [ACSM], 1998a; Brach, Simonsick, Kritchevsky, Yaffe, & Newman, 2004; Mazzeo et al., 1999; McDermott & Mernitz, 2006).

Comparison of gait parameters across three attentional loading conditions during timed up and go test in stroke survivors

Abstract Background: Little is known about the effects of attentional loading on performance of turning during walking in individuals with stroke. Objective: The authors used a cross-sectional experimental design to compare gait parameters in stroke survivors across 3 attentional loading conditions (single, dual-motor, and dual-cognitive conditions) during a Timed Up and Go (TUG) test. Methods: Data were collected from 20 stroke survivors (12 males, 8 females; mean age, 60.5 ± 10.6 years). We compared the number of steps and time measured during the TUG test under 3 attentional loading conditions and 2 turning directions (nonparetic and paretic sides). We further divided the TUG test into straight walking and turning phases. Results: The number of steps and the time taken during TUG test increased significantly from single- to dual-task conditions (dual motor and dual cognitive). However, there were no significant differences in gait parameters between turning toward the nonparetic and paretic sides. Conclusions: These findings suggested that gait performance was compromised during dual-task conditions for individuals with stroke. Attentional loading may be incorporated into routine gait assessment and rehabilitation to ensure a successful recovery.

Sharp Turning and Corner Turning: Comparison of Energy Expenditure, Gait Parameters, and Level of Fatigue among Community-Dwelling Elderly

This study compares energy expenditure (EE), gait parameters (GP), and level of fatigue (LOF) between 5-minute walking with sharp turning (ST) and corner turning (CT). Data were obtained from 29 community-dwelling elderly (mean age, 62.7 ± 3.54 years). For 5 minutes, in ST task, participants walked on a 3-meter pathway with 2 cones placed at each end (180° turning), while in CT task, participants walked on a 6-meter pathway with 4 cones placed at 4 corners (90° turning). The physiological cost index, pedometer, and 10-point Modified Borg Dyspnoea Scale were used to measure EE (beats/min), GP (no of steps), and LOF, respectively. Data were analyzed by using independent t-tests. EE during ST (0.62 ± 0.21 beats/min) was significantly higher than CT (0.48 ± 0.17 beats/min) (P < 0.05). GP (434 ± 92.93 steps) and LOF (1.40 ± 1.11) in ST were found to be lower compared to GP (463 ± 92.18 steps) and LOF (1.54 ± 1.34) in CT (All, P > 0.05). Higher EE in ST could be due to the difficulty in changing to a 180° direction, which may involve agility and different turning strategies (step-turn or pivot-turn) to adjust the posture carefully. In CT, participants could choose a step-turn strategy to change to a 90° direction, which was less challenging to postural control.