BACKGROUND: Up to 33% of the general population over 50 years of age are affected by nocturnal leg cramps. Currently there are no generally accepted clinical characteristics, which identify nocturnal leg cramps. This study aims to identify these clinical characteristics and to differentiate between them and the characteristics of restless leg syndrome and periodic limb disorder.METHOD: A systematic literature study was executed from December 2015 to May 2016. This study comprised of a systematic literature review of randomized clinical trials, observational studies on nocturnal and rest cramps of legs and other muscles, and other systematic and narrative reviews. Two researchers independently extracted literature data and analyzed this using a standardized reviewing protocol. Modified versions of the Cochrane Collaboration tools assessed the risk of bias. A Delphi study was conducted to assess agreement on the characteristics of nocturnal leg cramps.RESULTS: After systematic and manual searches, eight randomized trials and ten observational studies were included. On the basis of these we identified seven diagnostic characteristics of nocturnal leg cramps: intense pain, period of duration from seconds to maximum 10 minutes, location in calf or foot, location seldom in thigh or hamstrings, persistent subsequent pain, sleep disruption and distress.CONCLUSION: The seven above characteristics will enhance recognition of the condition, and help clinicians make a clear distinction between NLC and other sleep-related musculoskeletal disorder among older adults.
DOCUMENT
QUESTION: In adults who experience nocturnal leg cramps, does stretching of the calf and hamstring muscles each day just before sleep reduce the frequency and severity of the cramps?DESIGN: A randomised trial with concealed allocation and intention-to-treat analysis.PARTICIPANTS: Eighty adults aged over 55 years with nocturnal leg cramps who were not being treated with quinine.INTERVENTION: The experimental group performed stretches of the calf and hamstring muscles nightly, immediately before going to sleep, for six weeks. The control group performed no specific stretching exercises. Both groups continued other usual activities.OUTCOME MEASURES: Participants recorded the frequency of nocturnal leg cramps in a daily diary. Participants also recorded the severity of the pain associated with nocturnal leg cramps on a 10-cm visual analogue scale. Adverse events were also recorded.RESULTS: All participants completed the study. At six weeks, the frequency of nocturnal leg cramps decreased significantly more in the experimental group, mean difference 1.2 cramps per night (95% CI 0.6 to 1.8). The severity of the nocturnal leg cramps had also decreased significantly more in the experimental group than in the control group, mean difference 1.3 cm (95% CI 0.9 to 1.7) on the 10-cm visual analogue scale.CONCLUSION: Nightly stretching before going to sleep reduces the frequency and severity of nocturnal leg cramps in older adults.
LINK
Stroke is the second most common cause of death and the third leading cause of disability worldwide,1,2 with the burden expected to increase during the next 20 years.1 Almost 40% of the people with stroke have a recurrent stroke within 10 years,3 making secondary prevention vital.3,4 High amounts of sedentary time have been found to increase the risk of cardiovascular disease,5–11 particularly when the sedentary time is accumulated in prolonged bouts.12–15 Sedentary behavior, is defined as “any waking behavior characterized by an energy expenditure ≤1.5 Metabolic Equivalent of Task (METs) while in a sitting, reclining or lying posture”.16,17 Studies in healthy people, as well as people with diabetes and obesity, have shown that reducing the total amount of sedentary time and/or breaking up long periods of uninterrupted sedentary time, reduces metabolic risk factors associated with cardiovascular disease.6,9,10,12–15 Recent studies have shown that people living in the community after stroke spend more time each day sedentary, and more time in uninterrupted bouts of sedentary time compared to age-matched healthy peers.18–20 Reducing sedentary time and breaking up long sedentary bouts with short bursts of activity may be a promising intervention to reduce the risk of recurrent stroke and other cardiovascular diseases in people with stroke. To develop effective interventions, it is important to understand the factors associated with sedentary time in people with stroke. Previous studies have found associations between self-reported physical function after stroke and total sedentary time, but inconsistent results with regards to the relationship of age, stroke severity, and walking speed with sedentary time.20,21 These results are from secondary analyses of single-site observational studies, not powered to address associations, and inconsistent in the methods used to determine waking hours; thus making direct comparisons between studies difficult.20,21 Individual participant data pooling, with consistent processing of wake time data, allows novel exploratory analyses of larger datasets with greater power. By pooling all available individual participant data internationally, this study aimed to comprehensively explore the factors associated with sedentary time in community-dwelling people with stroke. Specifically, our research questions were: (1) What factors are associated with total sedentary time during waking hours after stroke? (2) What factors are associated with time spent in prolonged sedentary bouts during waking hours?
DOCUMENT
Daylight has been associated with multiple health advantages. Some of these claims are associations, hypotheses or beliefs. This review presents an overview of a scientific literature search on the proven effects of daylight exposure on human health. Studies were identified with a search strategy across two main databases. Additionally, a search was performed based on specific health effects. The results are diverse and either physiological or psychological. A rather limited statistically significant and well-documented scientific proof for the association between daylight and its potential health consequences was found. However, the search based on specific health terms made it possible to create a first subdivision of associations with daylight, leading to the first practical implementations for building design.
DOCUMENT
Daylight has been associated with multiple health advantages. Some of these claims are associations, hypotheses or beliefs. This review presents an overview of a scientific literature search on the proven effects of daylight exposure on human health. Studies were identified with a search strategy across two main databases. Additionally, a search was performed based on specific health effects. The results are diverse and either physiological or psychological. A rather limited statistically significant and well-documented scientific proof for the association between daylight and its potential health consequences was found. However, the search based on specific health terms made it possible to create a first subdivision of associations with daylight, leading to the first practical implementations for building design.
DOCUMENT
Light therapy for older persons with dementia is often administered with light boxes, even though indoor ambient light may more comfortably support the diverse lighting needs of this population. Our objective is to investigate the influence of indoor daylight and lighting on the health of older adults with dementia living in long-term care facilities. A systematic literature search was performed within PubMed, CINAHL, PsycINFO, Web of Science and Scopus databases. The included articles (n=37) were published from 1991 to 2020. These articles researched the influence of existing and changed indoor light conditions on health and resulted in seven categories of health outcomes. Although no conclusive evidence was found to support the ability of indoor light to decrease challenging behaviors or improve circadian rhythms, findings of two studies indicate that exposure to (very) cool light of moderate intensity diminished agitation. Promising effects of indoor light were to reduce depressive symptoms and facilitate spatial orientation. Furthermore, there were indications that indoor light improved one’s quality of life. Despite interventions with dynamic lighting having yielded little evidence of its efficacy, its potential has been insufficiently researched among this study population. This review provides a clear and comprehensive description of the impact of diverse indoor light conditions on the health of older adults with dementia living in long-term care facilities. Variation was seen in terms of research methods, (the description of) light conditions, and participants’ characteristics (types and severity of dementia), thus confounding the reliability of the findings. The authors recommend further research to corroborate the beneficial effects of indoor light on depression and to clarify its role in supporting everyday activities of this population. An implication for practice in long-term care facilities is raising the awareness of the increased lighting needs of aged residents. Original article at: https://doi.org/10.2147/CIA.S297865
MULTIFILE
Recalling that a majority of those who need assistive technology do not have access to it, and that this has a significant impact on the education, livelihood, health and well-being of individuals, and on families, communities and societies, Member States adopted a resolution on Improving access to assistive technology during the 71st World Health Assembly in May 2018. Among other mandates, Member States requested the Director-General of the World Health Organization (WHO) to prepare a global report on effective access to assistive technology in the context of an integrated approach, based on the best available scientific evidence and international experience, with the participation of all levels within the organization and in collaboration with all relevant stakeholders. In fulfilling this commitment, aiming to improve access to assistive technology, this global report: • presents the first comprehensive data set of its kind and analysis of current assistive technology access; • draws the attention of governments and civil societies to the need for, and benefits of, assistive technology, including its return on investment; • makes recommendations for concrete actions that will improve access; • supports implementation of the UN Convention on the Rights of Persons with Disabilities; and • contributes towards achieving the Sustainable Development Goals, especially in making universal health coverage (UHC) inclusive – leaving no one behind. The global report explores assistive technology from a variety of perspectives.
DOCUMENT
A Manifesto The group of some 17 participants interrupted the UDHR text in real time, infusing it with inclusive terminology, queering its binary language and expanding its gaze to other lifebeings, making it a manifesto for a new world. The newly formulated Universal Declaration of Human and More-Than-Human Rights and Responsibility for a New World would be the manifesto for an alliance of those who insisted on an end to capitalist practices and their destructive effects on the planet.
MULTIFILE
Talloze studies tonen aan dat een fysiek actieve leefstijl bloeddruk, cholesterol en gewicht verlaagt, botten en spieren versterkt en het risico van hart- en vaatziekten, darmkanker en diabetes type II vermindert. Bewegen kan dus worden gezien als een medicijn wat voor iedereen toegankelijk is.
DOCUMENT
Purpose: Elucidating the complex interactions between physical activity (PA), a multidimensional concept, and physical capacity (PC) may reveal ways to improve rehabilitation interventions. This cross-sectional study aimed to explore which PA dimensions are related to PC in people after minor stroke. Materials and methods: Community dwelling individuals >6 months after minor stroke were evaluated with a 10-Meter-Walking-Test (10MWT), Timed-Up & Go, and the Mini Balance Evaluation System Test. The following PA outcomes were measured with an Activ8 accelerometer: counts per minute during walking (CPMwalking; a measure of intensity), number of active bouts (frequency), mean length of active bouts (distribution), and percentage of waking hours in upright positions (duration). Multivariable linear regression models, adjusted for age, sex and BMI, were used to assess the relationships between PC and PA outcomes. Results: Sixty-nine participants [62.2 ± 9.8 years, 61% male, 20 months post onset (IQR 13.0–53.5)] were included in the analysis. CPMwalking was significantly associated to PC in the 10MWT (std. ß ¼ 0.409, p ¼ 0.002), whereas other associations between PA and PC were not significant. Conclusions: The PA dimension intensity of walking is significantly associated with PC, and appears to be an important tool for future interventions in rehabilitation after minor stroke
DOCUMENT
