Search Results (687)

Background/Objectives: Malnutrition in older adults is both preventable and treatable, yet its detection and etiology remain complex. Therefore, the aim of this study was to evaluate the prevalence of malnutrition and various factors involved in the etiology of malnutrition in community-dwelling individuals aged 65 years and older. Methods: This cross-sectional study was conducted with community-dwelling individuals aged 65 years and older in a health center in Ağrı, Türkiye. The nutritional status of older adults was measured using the Mini Nutritional Assessment (MNA). Data were collected through face-to-face interviews and a series of validated instruments, including the Standardized Mini Mental Examination (MMSE), body composition measurements (BIA), dietary intake records, and physical performance tests such as hand grip strength, chair stand, and Timed ‘Up & Go’ (TUG) Test. Statistical analyses included chi-square and Mann-Whitney U tests for group comparisons and logistic regression to investigate independent factors associated with risk of malnutrition. Results: A total of 182 participants were included in the study. The mean age of the participants was 72.1 ± 6.0 years. Of the participants, 59.3% were male. 1.6% of the participants were malnourished, and 25.3% were at risk of malnutrition. Perceived health status compared to peers (OR: 1.734, 95% CI: 1.256–2.392, p = 0.001), lower appetite status (OR: 1.942, 95% CI: 1.459–2.585, p < 0.001) and lower waist circumference (OR: 1.089, 95% CI: 1.040–1.140, p < 0.001) were independent predictors of malnutrition risk. Conclusions: The risk of malnutrition was higher among individuals with lower appetite, poorer self-perceived health status compared to peers, and smaller waist circumference. Reduced physical function and strength were also associated with an increased risk of malnutrition. Full article

The mental and physical health of college students, especially in urban environments like Shanghai, is crucial given the high academic and urban stressors, which were intensified by the COVID-19 lockdown. Prior research has shown gender differences in health impacts during public health crises, with females often more vulnerable to mental health issues. Objective: This study aimed to comprehensively assess the physical and psychological health of Chinese college students post-lockdown, focusing on the relationship between stress, anxiety, depression, sleep patterns, and physical health, with a particular emphasis on gender differences. Methods: We conducted a cross-sectional study involving 116 students in Shanghai, utilizing psychological scales (HAMA, IPAQ, PSQI, SDS, FS 14, PSS, SF-36) and physical fitness tests (resting heart rate, blood pressure, hand grip, forced vital capacity, standing long jump, sit-and-reach, one-minute sit-up test and the one-minute squat test, single-leg stand test with eyes closed), to analyze health and behavior during the pandemic lockdown. All students have undergone the same life habits during the pandemic. Results: The HAMA scores indicated no significant levels of physical or mental anxiety. The PSS results (42.45 ± 8.93) reflected a high overall stress level. Furthermore, the PSQI scores (5.4 ± 2.91) suggested that the participants experienced mild insomnia. The IPAQ scores indicated higher levels of job-related activity (1261.49 ± 2144.58), transportation activity (1253.65 ± 987.57), walking intensity (1580.78 ± 1412.20), and moderate-intensity activity (1353.03 ± 1675.27) among college students following the lockdown. Hand grip strength (right) (p = 0.001), sit-and-reach test (p = 0.001), standing long jump (p = 0.001), and HAMA total score (p = 0.033) showed significant differences between males and females. Three principal components were identified in males: HAMA, FS14, and PSQI, explaining a total variance of 70.473%. Similarly, three principal components were extracted in females: HAMA, PSQI, and FS14, explaining a total variance of 69.100%. Conclusions: Our study underscores the complex interplay between physical activity (PA), mental health, and quality of life, emphasizing the need for gender-specific interventions. The persistent high stress, poor sleep quality, and reduced PA levels call for a reorganized teaching schedule to enhance student well-being without increasing academic pressure. Full article

Background: The Malnutrition Screening Tool (MST) is commonly used to identify malnutrition risk; however it has demonstrated poor sensitivity to detect malnutrition in inpatients with chronic kidney disease (CKD) and kidney replacement therapy (KRT) populations. Gastrointestinal symptoms, such as poor appetite, may better detect malnutrition. The accuracy of MST or other nutrition-related parameters to detect malnutrition in ambulatory patients with CKD stages 4–5 without KRT has not been evaluated. Methods: A single site retrospective audit of outpatient records from May 2020 to March 2025 was conducted. Patients with eGFR < 25 mL/min/1.73 m² without KRT who had both MST and a 7-point Subjective Global Assessment (SGA) within 7 days were included. Sensitivity, specificity, and ROC-AUC analyses compared nutritional parameters against SGA-defined malnutrition. Nutritional parameters tested included MST, hand grip strength, upper gastrointestinal symptom burden, poor appetite and a combination of some of these parameters. Results: Among 231 patients (68.8% male, median age 69 years, median eGFR 15), 29.9% were at risk of malnutrition (MST ≥ 2) and 33.8% malnourished (SGA ≤ 5). All potential screening tools had AUC ranging from 0.604 to 0.710, implying a poor-to-moderate discriminator ability to detect malnutrition. Combining HGS ≤ 29.5 kg or MST ≥2 demonstrated high sensitivity (95.5%) and negative predictive value (93.3%), but low specificity (33.3%) for detecting malnutrition, indicating this approach is effective for ruling out malnutrition but may over-identify at-risk individuals. Conclusions: MST and other tested tools showed limited overall accuracy to identify malnutrition. Using combined nutritional markers of HGS or MST score was the most sensitive tool for detecting malnutrition in this advanced CKD without KRT population. Full article

This study explores the application of Eye-Tracking technology for the ergonomic evaluation of assistive device usability. Sixty-four participants evaluated six jar-opening devices in a two-phase study. First, the participants’ gaze was recorded while they viewed six rendered pictures of assistive devices, each shown in two different versions: with and without rubber in the grip area. Second, the participants physically interacted with the devices in a hands-on usability task. In both phases, participants rated the devices according to six usability affordances: robustness, comfort, easiness to grip, lid slippery, effort level, and easiness to use. Eye-Tracking metrics (fixation duration, number of fixations, and visit duration) correlated with the on-screen ratings, which aligned with ratings after using the physical devices. High ratings in comfort and effort level correlated with more visual attention to the grip area, where the rubber acted as key signifier. Heatmaps revealed the grip area as important for comfort and easiness to use and the lid area for robustness and slipperiness. These findings demonstrate the potential of Eye Tracking in usability studies, providing valuable insights for the ergonomic evaluation of assistive devices. Moreover, they highlight the suitability of Eye Tracking for early-stage design evaluation, offering objective metrics to guide design decisions and improve user experience. Full article

Objective: A self-management telehealth program to improve hand strength and function in systemic sclerosis (SSc) patients may improve their quality of life, so we investigated its efficacy. Methods: A 6-week prospective randomized controlled study was conducted in adults with SSc with a hand mobility in scleroderma (HAMIS) score > 1 or a limited range of motion in at least one hand joint. Participants were randomly allocated into three groups for six weeks of health education: (a) typical education, (b) watching video guides as needed, in addition to typical education, and (c) watching video guides and receiving weekly telephone notifications, in addition to typical education. The endpoints were the differences in self-management behavior, HAMIS scores, hand grip strength (HGS), and quality of life (QoL) using the European Quality of Life-5 Dimensions between groups, as well as the changes in these parameters compared to baseline. Results: A total of 24 patients per group were enrolled, with the majority diagnosed with diffuse cutaneous SSc (79.2%). Six weeks post-intervention, HGS improved significantly in both the video guide and telephone notification groups compared to typical education in both hands (p = 0.028, p = 0.044). Pincer grip differed between the groups in the non-dominant hand. Household modifications were more frequent in the video guide and telephone notification groups than in the typical education group (p = 0.023). All groups showed significant improvements in HGS and HAMIS scores in both hands, as well as in self-management behaviors, compared to baseline. QoL, as measured using a visual analog scale, improved significantly after the intervention in both the video guide and telephone notification groups, but not in the typical education group. Conclusions: Self-management telehealth programs effectively enhance hand strength, function, and self-management behaviors in patients with SSc with limited hand function. Weekly telephone notifications further reinforced continuity and engagement in these patients. Full article

Background: Cirrhosis is responsible for a large proportion of mortality worldwide. Despite having multiple scoring systems, organ allocation for end-stage liver disease remains a major problem. Since anthropometric indices play important roles in predicting the prognosis of patients with cirrhosis, these variables were used in establishment of a novel scoring system. Methods: In order to evaluate a machine learning approach for predicting the probability of three-month mortality in cirrhotic patients awaiting liver transplantation, the clinical and anthropometric information of 64 patients referred to Abu-Ali-Sina Transplantation Center were collected and followed for three months. A LASSO logistic regression model was used to devise and validate a new machine learning approach and compare it to the Model for End-Stage Liver Disease (MELD) regarding the three-month mortality of cirrhotic patients. Hand grip, skeletal muscle mass index, average mean arterial pressure, serum sodium, and total bilirubin were assessed with this new machine learning approach to predict the prognosis of patients with cirrhosis, which we named the Sina score. Results: Sixty-four patients were enrolled, with a mean age of 46.50 ± 12.871 years. Like the MELD score, the Sina score is a precise prognostic tool for predicting the three-month mortality probability in cirrhotic patients [area under the curve (AUC) = 0.753 and p = 0.005 vs. AUC = 0.607 and p = 0.238]. Our machine learning approach, the Sina score, was shown to be a precise prognostic tool, like the MELD, for the prediction of the three-month mortality probability of cirrhotic patients awaiting liver transplantation. Conclusions: The Sina score, given that its level of precision is on par with the MELD, can be recommended for the prediction of three-month mortality in cirrhotic patients awaiting liver transplantation. Full article

Background: Cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb, and it is characterized by ulnar nerve compression at the elbow. Traditional surgical options, including simple decompression and anterior transposition, have limitations in addressing ulnar nerve instability. This study introduces and evaluates the short-term outcomes of a novel surgical technique, the fascio-aponeurotic epicondylar flap (FAEF), for stabilizing the ulnar nerve and managing its instability. Materials and methods: A retrospective study was conducted on ten patients with longstanding cubital tunnel syndrome and confirmed ulnar nerve dislocation or instability. All patients underwent surgical intervention using the FAEF technique, which involves creating a quadrangular fascial flap from the epicondylar fascia to stabilize the ulnar nerve within the retrocondylar groove. Outcomes were assessed using clinical follow-ups, the Michigan Hand Outcomes Questionnaire (MHQ), VAS, and qDASH scores over a 90-day postoperative period. Results: All ten patients experienced complete resolution of neurological symptoms, including paresthesia, pain, and nerve clicking, by the final follow-up. Postoperative recovery was uneventful, with no complications such as infections or hematomas. Grip strength and hand functionality were fully restored, with significant improvements in MHQ scores (mean: 94). Dynamic elbow mobilization initiated on the first postoperative day resulted in full recovery of elbow range of motion. No recurrence of ulnar nerve dislocation was observed. Discussion: The FAEF technique effectively stabilizes the ulnar nerve, alleviates symptoms, and restores function while minimizing risks associated with traditional procedures, such as nerve trauma and elbow instability. By preserving the anatomical integrity of the medial epicondyle and enhancing nerve mobility, this approach represents a less invasive alternative to anterior transposition and medial epicondylectomy. Conclusions: The FAEF technique is a viable and effective surgical option for managing ulnar nerve instability in cubital tunnel syndrome. It offers a less invasive solution with excellent short-term outcomes, making it a promising addition to the surgical armamentarium for this condition. Further studies are warranted to evaluate long-term efficacy and broader applicability. Full article

Cerebral palsy generates an elevated burden on both patients and health-care systems. Cost-effective therapies such as action observation therapy (AOT), have been proposed to enhance motor performance in these patients. Objective: This systematic review with meta-analysis aimed to evaluate the effectiveness of AOT in children and adolescents with CP and describe its prescription parameters. Results: Fourteen studies involving a total of 393 patients with CP were included. Most studies presented some concerns on risk of bias. Meta-analyses compared AOT to placebo (no motor content) observation and found inconclusive results for the following: unilateral upper limb function (g = 0.565; 95% CI −0.174, 1.305), assisting hand function during bimanual activities (g = 0.200; 95% CI −0.742, 1.143), manual function daily activities (g = −0.022; 95% CI −3.134, 3.090), and hand grip strength (MD (kg) = 1.175; 95% CI −0.280, 2.630). Meta-analysis comparing AOT and physical therapy also yielded inconclusive findings for standing (g = 0.363; 95% CI −5.172, 5.898), as well as the combined dimension of walking, standing, and jumping (g = 0.798; 95% CI −8.821, 10.417) within gross motor function. Conclusions: Current evidence is imprecise and does not support definitive conclusions regarding the effectiveness of AOT over placebo observation, or over physical therapy, on functional outcomes including upper limb, hand, and lower limb functioning parameters. Current findings prevent recommending AOT for its employment in clinical practice. Further evidence is required to draw precise conclusions. Full article

Objectives: The aims of the presented study were to investigate and compare the effectiveness of Low-Level Laser Therapy (LLLT) and therapeutic ultrasound (US) on pain, function, emotional status, and sleep disturbances in patients with rotator cuff tendinopathy (RCT). Method: A total of 84 patients with RCT were included in the study and randomly divided into the US group (n = 42) and the LLLT group (n = 42). Hot-pack, transcutaneous electrical nerve stimulation, and a home-based exercise program were also administered to patients in each group. The patients were evaluated at baseline, and at 1st, 4th, and 12th weeks after treatment by Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), Constant Murley Score (CMS), Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), Hand Grip Strength (HGS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36). Results: Significant improvements in VAS, SPADI, CMS, DASH, BDI, BAI, PSQI, and SF-36 scores were observed over time in both groups (p < 0.05 for all). The improvements in HGS scores were significantly greater in the US group compared to the LLLT group (p < 0.05 for all). There were no statistically significant differences between the groups in VAS, SPADI, CMS, DASH, BDI, BAI, PSQI, and SF-36 scores at each time point (p > 0.05 for all). Conclusions: Both therapeutic US and LLLT are effective and safe in the treatment of patients with RCT. However, our findings indicate no superiority of one treatment over the other in terms of pain relief or improvements in function, emotional status, sleep disturbances, or quality of life. Full article

Background/Objectives: Dupuytren’s disease (DD) presents significant challenges in hand function due to the progressive contracture of the palmar fascia. This study evaluates the impact of Percutaneous Needle Aponeurotomy (PNA) on grip strength before and after intervention. Methods: A prospective pilot study included patients with DD over 18 years of age who underwent PNA. Grip strength was measured at baseline, six weeks, and three months post-procedure using a Jamar Dynamometer. The median time to return to work or normal activities was recorded. Results: The study included a total of 29 participants. There was a recorded difference in one kilogram of baseline grip strength between the treatment and non-treatment hands. Patients reported improved hand function and recorded an average increase of 5.8 kg in grip strength at the three-month follow-up. Improvements were demonstrated in active extension, averaging 26 degrees at the metacarpophalangeal joint and 27 degrees at the proximal interphalangeal joint. Nine minor skin tears occurred, and there was no recorded recurrence. Conclusions: This study adds to the literature, confirming PNA is a safe and effective intervention for DD, offering rapid recovery and functional improvement. A larger study of a longer duration will help to establish whether grip strength gains are maintained following PNA. Full article

Background: Humans interacting with virtual objects is becoming common due to the popularity of the devices adopting the mixed reality (MR) techniques. Assessing hand functions using these devices for medical purposes provides alternatives in addition to the traditional hand function assessment techniques. Objectives: The objectives were to compare the movement time (MT) of handing a real and a virtual object between post-surgery wrist fracture patients and healthy adults and to determine the correlation between the MT and commonly adopted hand function indicators. Methods: An experiment was performed. A total of 29 participants, including 17 patients and 12 healthy adults, joined. All the participants moved a real or a virtual tube from an origin to a destination. A set of MR device was adopted to generate the virtual object. The MTs were analyzed to compare differences between the patients and the healthy adults. Regression models were developed to predict the MT under experimental conditions. Results: The MT of the surgical hand was significantly longer than that of the nonsurgical hand of the patients and was significantly longer than that of the left hand of the healthy adults. The MT was negatively correlated with the commonly adopted hand function indicators, including grip strength, range of motion, hand dexterity score, and Modified Mayo Wrist Score. Conclusions: The anticipation that the MT of interacting with virtual objects for patients may reveal hand function characteristics for post-surgery patients was supported. The regression models developed could reveal the progression of hand function recovery for these patients. Having patients interact with virtual objects could be a supplemental approach in assessing their hand functions. Full article

Background and Objectives: This cross-sectional study investigates the association between fatigue and upper limb (UL) function in people with Multiple Sclerosis (PwMS). Methods: Adult PwMS were recruited from five Italian MS centers. Fatigue was evaluated using the Modified Fatigue Impact Scale (MFIS), while UL function was assessed through the Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and Hand-Grip Strength (HGS). Data analysis included Spearman rank correlations and Mann–Whitney U tests. Results: A total of 261 participants were involved. Significant correlations were found between fatigue severity, UL function, and patient-reported manual ability. Physical and cognitive aspects of fatigue were independently related to functional impairments. Participants with clinically relevant fatigue demonstrated lower subjective UL function, poorer BBT and HGS performance, and greater HGS asymmetry. Discussion: The study underscores the complex relationship between fatigue and functional impairments in MS. The findings suggest both strength and dexterity contribute to the perception of clinically relevant fatigue in PwMS, highlighting the importance of incorporating both domains to complement neurological assessment. Conclusion: Fatigue in PwMS is linked to both subjective and objective measures of UL function. Assessing strength and dexterity alongside fatigue may enhance clinical understanding and inform targeted rehabilitation strategies. Full article

Background/Objectives: Atrophic nonunion presents a significant challenge in hand surgery, often resulting in chronic pain and functional disability. Traditional surgical treatments such as bone grafting and internal fixation may be insufficient. This study evaluates the feasibility, safety, and preliminary effectiveness of a regenerative-first surgical protocol that combines autologous bone micro-grafts with a fresh human amniotic membrane to create a biologically active regenerative chamber. Methods: A total of 8 patients (6 males, 2 females; age range: 22–56 years) with an atrophic nonunion of metacarpals and phalanges were treated using a regenerative-first surgical approach. Autologous bone was harvested from the iliac crest and mechanically disaggregated via Rigenera^® technology to obtain micro-grafts enriched with osteoprogenitor cells and extracellular matrix fragments. These were applied to the bone defect and wrapped in a fresh amniotic membrane, creating a biologically active chamber. Fixation was achieved using low-profile plates or screws, and all patients underwent early protected mobilization. Results: Radiographic consolidation was achieved in all patients within 2 months postoperatively. Functional outcomes at final follow-up demonstrated excellent or good results in Total Active Motion (TAM), with grip and pinch strength within normative ranges and minimal residual pain. Conclusions: This preliminary series suggests that combining autologous bone micro-grafts with an amniotic membrane in a regenerative surgical protocol is a promising strategy for managing atrophic nonunion in the hand. The approach was associated with rapid consolidation and excellent functional recovery. Further research with larger, controlled cohorts is warranted to validate efficacy and define standardized indications and techniques. Full article

Objectives: The global rise in dementia prevalence is escalating the socioeconomic burden, prompting efforts in prevention and treatment. This study aimed to evaluate the effects of an 8-week oral nutrition supplement (ONS) program with or without a multi-domain intervention program (MIP) in patients with mild cognitive impairment. Methods: Forty-nine patients with mild cognitive impairment were divided into three groups: (1) ONS (ONS), (2) ONS+MIP (ONS+MIP), and (3) control (CON). Korean-style dementia prevention MIP was used in the ONS+MIP group. Two packs of ONS per day were provided to the ONS group during the intervention period. Cognitive function, nutritional evaluation, body composition analysis, and physical performance were measured. The paired t-test and one-way analysis of variance were used for statistical analyses. Results: A final analysis was performed on the final 46 participants. After intervention, the cognitive function test (Repeatable Battery for the Assessment of Neuropsychological Status, RBANS) scores of the ONS+MIP group were significantly increased compared to the baseline scores. However, no significant changes were observed in the ONS and CON groups. Eating behavior and food quality also improved in the ONS+MIP group, with a significant difference among the three groups. There was no significant change in body composition in all groups; however, grip strength (left hand), muscular endurance, and the total SPPB score improved in the ONS+MIP group. The total SPPB score decreased in the CON group. Conclusions: Along with ONS intake, intensive education and continuous monitoring through multi-domain interventions are important to improve cognitive function. Trial registration: Clinical Research Information Service identifier: KCT0007253. Full article

Background and Objectives: Globally, there is a demographic transition toward an increase in the number of older adults, and with it, the comorbidities associated with aging. This requires healthcare providers to understand which variables can affect functional independence for performing activities of daily living. The general objective of this study was to determine the predictive effect of left and right handgrip strength, depression, mild to moderate dementia, and cognitive function on functional independence in older adults. Materials and Methods: This study featured a predictive cross-sectional design with n = 84 older adults with some level of physical independence; older adults with completely limited physical independence and those with severe dementia were excluded. To assess depression, the Geriatric Depression Scale was used; for dementia, the Hachinski Ischemic Scale was used; for cognitive impairment, the Folstein version of the MMSE was used; for functional independence, the Barthel Index was used; for handgrip, a 90-kg Dynatron^® professional hydraulic dynamometer (UT 84121) Number Series. 11010141, from the Dynatronics Corporation located in Salt Lake City, Utah USA, was used. Results: In total, 58.8% of the participants were female, with a mean age of 84.89 ± 7.095, with ranges from 68 to 102 years. Multiple regression analysis showed that the level of cognition, left-hand grip strength, and a low level of depression are strong predictors of independence in activities of daily living in the elderly, with an explained variance of R² = 0.34. Conclusions: Cognitive function, left-hand grip strength, and depression significantly predict the independence of older adults. Studies with larger sample sizes are recommended to confirm the veracity of the results and to design methodologically rigorous interventions that include psychological aspects such as cognitive stimulation, promoting physical activity, and addressing depressive problems to improve the functional independence of older adults. Full article