View clinical trials related to Disability.
Filter by:This study is to determine whether accelerometry can be used to measure physical activity occurring during routine clinical care in a diverse population of patients with medical or surgical critical illness.
According to the recent World Report on Disability, around 15% of the world population lives with a disability and 80% of people with disabilities (PWD) live in developing countries. More and more evidence show that PWD are more likely to be poor, vulnerable to physical and sexual violence, and to have less access to education. Therefore, PWD are likely to have an increased risk for HIV infection, potentially being a key population in regard to this epidemic. The vulnerability of PWD was recognized in 2007 by the United Nations Convention on the Rights of Persons with Disabilities. However, data on the extent how PWD are affected by HIV is still very limited. As a result, PWD are usually overlooked by National AIDS Control Programmes and few projects specifically targeting them have been developed. Recognizing the need for appropriate and reliable data to help protect the rights of PWD and achieve a better inclusion of disability in National AIDS Control Programmes, the Institute of Research for Development (IRD), the Institut de Formation et Recherche Demographique (IFORD) and Handicap International (HI) propose this study that aims to provide quantitative and qualitative data on the vulnerability of PWD to HIV infection in Cameroon and Burkina Faso, in order to define if this vulnerable population is also a Key Population in relation to the HIV epidemic. This study adopts a multidisciplinary approach (quantitative and qualitative methods). Quantitative data are collected only in Cameroon. Only the quantitative study is described here.
Background to main study question: Cardiac complications are a common cause of morbidity after non-cardiac surgery. Patients with perioperative myocardial injury (both MI, and lower levels of cardiac troponin elevation) experience higher short-term and long-term mortality. They are also at substantially increased risk of additional cardiac and non-cardiac complications. It is therefore plausible that myocardial injury adversely affects quality of life. This study will compare postoperative health-related quality of life of patients who did or did not experience perioperative myocardial injury (defined by troponin-I > 0.07ng/ml) after non-cardiac surgery Study Design: Pilot prospective cohort study (n = 300). Population: Consecutive patients undergoing non-cardiac, non-transplant surgery at UHN. Background to secondary study questions: 1. Clinically based risk stratification tools used in non-cardiac surgery (e.g., Revised Cardiac Risk Index) are of moderate utility and assign patients only to broad risk categories. This study will examine the usefulness of pre-operative biomarkers (BNP, HbA1c, and others) in supporting cardiac risk stratification and will address the question: Is there a set of preoperative criteria that can accurately inform the decision to monitor troponin postoperatively? 2. Intra-operative physiological derangement measured with the Surgical Apgar Score correlates with morbidity and mortality 3-months postoperatively. This study will examine the relationship between the Surgical Apgar Score; continuous non-invasively monitored intraoperative metrics of hemoglobin concentration and occult hypovolemia (Pleth Variability Index) with the Masimo Radical-7 Pulse Co-Oximeter; and the primary and secondary outcomes. This aspect of the study will address the question: Can readily available intraoperative physiological data inform the decision to monitor troponin postoperatively? 3. Quality of Recovery-40 Score evaluates (in the recovery room and at 24 hours postoperatively) the patient's subjective experience of their recovery from surgery. This metric is correlated with quality of life 3-months postop. This study will evaluate correlation between Quality of Recovery-15 Score, a valid and more efficient means of measuring recovery, and the primary and secondary outcomes. 4. Approximately 2/3 of patients who have postoperative myocardial injury are asymptomatic and have no ECG changes. Diagnosis of MI requires biomarker elevation (Troponin > 0.3ng/ml) plus clinical or ECG or imaging evidence of myocardial injury. Of the latter 3 criteria, 2 are often absent. In selected patients, this study will use trans-thoracic echocardiography, CT coronary angiography, and cardiac MRI to improve diagnostic yield and define those diagnostic modalities that are most useful in the postoperative patient. Rationale: Postoperative myocardial injury may negatively impact health-related quality of life. Affected patients may experience higher levels of postoperative dependency. This possibility has implications for patient rehabilitation, provincial and personal healthcare costs, as well as patients' physical, emotional and mental well-being and relationships. The public health dimension of this problem could therefore be significant. In addition, an incomplete understanding exists of how individual patient cardiac risk factors, in combination with the perioperative environment, result in myocardial injury. The diagnostic investigations that are most useful in this setting have not yet been clearly defined. Patients who fail to be rescued after experiencing postoperative complications (as distinct from failure to avoid experiencing the complication in the first instance) plays a central role in postoperative mortality. Early recognition of such patients is therefore crucial. By prospectively observing a cohort of high-risk surgical patients, this study will provide insight into how these factors interact. This will allow us to better characterize the potential predictors and features of postoperative myocardial injury. We hope that our findings will aid in the identification of patient characteristics associated with increased risks of postoperative myocardial injury, thus helping to direct diagnosis, early treatment and rescue. This study will thus potentially yield important data that will positively impact future patient care and the rational use of healthcare resources.
This study will compare the clinical outcomes for patients undergoing a total knee replacement using a bipolar sealer, the Aquamantys® System, as compared to standard electrocautery. Total blood loss during the hospital stay and knee mobility and discharge factors will be analyzed.
Osteoporosis and falls occur with increasing frequency among the elderly. Osteoporosis and fall increases the risk of fracture. Falls in the elderly are associated with a high morbidity and mortality with potentially life-threatening consequences of falls including fractures. Besides fracture fall may cause long term problems such as disability fear of falling and loss of independence. Today osteoporosis is diagnosed by bone scan of the hip and spine. The investigators want to investigate whether other more accessible and less expensive testing methods can be used to diagnose osteoporosis. Additionally, the investigators will examine the incidence of osteoporosis among the elderly in the municipality of Odense. Finally, the investigators would like to investigate the association between factors that can lead to falls and to investigate the performance of older and whether there are changes in functional ability over time.
Innovative advances in rehabilitation technology have created a split-belt treadmill capable of providing a much needed intervention aimed at limiting mobility disability. When desynchronized, the split-belt treadmill imposes demands on each leg such that the central nervous system must adapt to the challenge. Based on preliminary data from our lab utilizing the split-belt treadmill, the investigators hypothesize this intervention can challenge the locomotor processes required for safe, efficient gait while concurrently providing an aerobic stimulus will produce favorable changes in physical function in older adults at risk for mobility disability.
The study hypothesis is that caudal epidural steroid injections provides short term relief to patients with persistent low back pain and sciatica due degenerative disc disease or lumbar spinal stenosis. Patients will be evaluated wiht clinical examination and radiological examinations before injections. They will be followed up with questionnaires on pain and disability up to 6 months postinjection.
The purpose of this study is to determine whether myofascial release techniques are effective in the improvement of pain, disability and electromyography response of lumbar muscles in patients with chronic low back pain.
In Western Countries, stroke and dementia are the main causes of long-term disability, dependency, and nursing home admission. Due to demographic trends a continuous increase of patient numbers can be expected. There is growing evidence that vascular risk factors which are implicated in the etiology of stroke also play important etiologic roles in both vascular dementia and Alzheimer disease. The present project is aimed at the reduction of stroke and dementia by means of a systematic detection and subsequent treatment of vascular risk factors by the family doctor based on established guidelines.
A prospective study to assess the association between the change in quality of sleep and the change in intensity of pain in Spanish patients seen for subacute or chronic neck pain. The objective is to determine the prevalence of sleep alterations, the association between quality of sleep and intensity of pain, degree of disability, intensity of catastrophizing and depression.