Displaying publications 1 - 20 of 32 in total

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  1. Zahari Z, Ishak A, Justine M
    J Back Musculoskelet Rehabil, 2020;33(2):245-254.
    PMID: 31356191 DOI: 10.3233/BMR-181305
    OBJECTIVES: This study aimed to gain an overview of patient education and the effects of patient education for older people with low back pain (LBP).

    METHODS: The search strategies were performed via EBSCO MEDLINE, EBSCO CINAHL, Science Direct, PubMed, and PEDro databases from 2006 to 2016. The keywords "patient education", "low back pain", "elderly", "older adults", "older persons" and "older people" were used during the literature search. Boolean operators were used to expand or limit the searching scope and manual exclusion was performed to choose articles eligible for this study.

    RESULTS: A total of 2799 articles were retrieved but only five articles were related with patient education for older people with LBP. Findings suggest that patient education for older people may differ in terms of its contents such as health education, self-management, video education, and postural education. The high methodological quality of the studies revealed that patient education showed improvement in terms of pain, disability and quality of life among older people with LBP.

    CONCLUSIONS: Patient education improved pain and had positive effects on disability and quality of life among older people with LBP. However, due to the limited number of RCTs more studies are needed to provide evidence for its effectiveness.

  2. Vikram M, Sundaraganesh K, Justine M, Kurup M, Leonard JH
    Clin Ter, 2012;163(5):383-6.
    PMID: 23099965
    The main objective of the study was to investigate postural control impairment in athletes with history of ankle injury by using Balance Error Scoring System (BESS) and to compare with the controls.
  3. Tajuddin K, Justine M, Mohd Mustafah N, Latif L, Manaf H
    Malays J Med Sci, 2021 Apr;28(2):63-71.
    PMID: 33958961 DOI: 10.21315/mjms2021.28.2.6
    Background: Stroke survivors depend on the unaffected leg during walking and standing. The presence of diabetic peripheral neuropathy (DPN) affecting both legs may further affect the postural balance and gait instability and increase the risk for falls in such patients. Thus, this study was conducted to investigate the effect of dual taskings on the gait and turning performance of stroke survivors with DPN.

    Methods: Forty stroke survivors were recruited (20 with DPN and 20 without DPN) in this cross-sectional study design. Instrumented timed up and go (iTUG) tests were conducted in three different tasking conditions (single task, dual motor and dual cognitive). APDM® Mobility Lab system was used to capture the gait parameters during the iTUG tests. A two-way mixed analysis of variance was used to determine the main effects of gait performance on three taskings during the iTUG test.

    Results: Spatiotemporal gait parameters and turning performance (turning time and turning step times) were more affected by the tasking conditions in stroke survivors with DPN compared to those without DPN (P < 0.05).

    Conclusion: Stroke survivors with DPN had difficulty walking while turning and performing a secondary task simultaneously.

  4. Razak S, Justine M, Mohan V
    J Exerc Rehabil, 2021 Feb;17(1):52-58.
    PMID: 33728289 DOI: 10.12965/jer.2142026.013
    This cross-sectional study evaluated the relationships between anthropometric and aerobic fitness (rate of perceived exertion [RPE] and predicted maximal oxygen uptake [VO2max]) among 228 participants (age: 23.78±4.42 years). RPE and predicted VO2max were determined during the cycle ergometer exercise test. Data were also obtained for height, weight, body mass index (BMI), hip and waist (WC) circumferences. Data analysis revealed VO2max is correlated with WC (r=-0.571), weight (r=-0.521), waist-to-height ratio (WHtR) (r=-0.516), waist-to-hip ratio (WHR) (r=-0.487), and BMI (r=-0.47) in men, while, in women with WC (r=-0.581), weight (r=-0.571), WHtR (r=-0.545), BMI (r=-0.545), WHR (r=-0.473), and height (r=-0.287) (all P<0.05). Regression analysis showed WC was a significant predictor for VO2max in men and women (r2=32.6% vs. 33.7%). The receiver operating characteristic curve of WC showed 0.786 and 0.831 for men and women, respectively. WC or abdominal obesity is the strongest predictor for VO2max, which is an indicator of aerobic fitness in Malaysian adults.
  5. Nor R, Justine M, Joanny A, Zolkafli AA
    J Exerc Rehabil, 2021 Aug;17(4):247-255.
    PMID: 34527636 DOI: 10.12965/jer.2142412.206
    This study determined the effectiveness of a 3-month group-based multicomponent exercise program in the mobility, balance confidence, and muscle performance of older adults. A total of 40 participants (mean age=70.60±6.25 years completed pre- and posttest clinical intervention measures of mobility using the Timed Up and Go (TUG) test, balance confidence using the Activities-specific Balance Confidence scale, upper limb strength (handgrip dynamometer), and lower limb function (30-sec chair rise test). Data were analyzed using paired t-test and based on TUG criteria for risk of fall (low- and high-risk groups). Significant improvements were found in all measures (All P<0.05) following the 3-month program. Measures according to the risk of fall categories were also significantly improved (P<0.01), except the left handgrip strength (P>0.05). The low-risk group showed a higher improvement in mobility (14.87% vs. 11.74%), balance confidence (34.21% vs. 26.08%), and lower limb function (96.87% vs. 21.20%) but was not significantly different from the high-risk group (P>0.05). A group-based multicomponent exercise program benefited the physical functions of older adults at low- or high risk of falls.
  6. Mustapa A, Justine M, Mohd Mustafah N, Jamil N, Manaf H
    Biomed Res Int, 2016;2016:9305025.
    PMID: 27525281
    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.
  7. Mustapa A, Justine M, Mustafah NM, Manaf H
    Rehabil Res Pract, 2017;2017:5280146.
    PMID: 28491477 DOI: 10.1155/2017/5280146
    Purpose. The aim of this present study was to investigate the ground reaction forces (GRFs) alterations in stroke survivors with diabetic peripheral neuropathy (DPN). Methods. Ten stroke survivors with DPN, 10 stroke survivors without DPN, and 10 healthy controls with matched body weight between groups participated in this case-control cross-sectional study. Three-dimensional GRFs (anterior-posterior, medial-lateral, and vertical) were collected at a comfortable walking speed using the Nexus Vicon motion analysis system and force plate. The Kruskal-Wallis test was used to analyze GRFs parameters. Results. We found significant alterations of medial-lateral forces of the nonparetic side and vertical forces of the paretic side in stroke survivors with DPN compared to stroke survivors without DPN and healthy controls. In addition, there were smaller braking and lower propulsion peak in anterior-posterior forces, smaller magnitude of medial-lateral forces, and lower first and second peak of vertical forces in stroke survivors with DPN compared to stroke survivors without DPN and healthy controls. Conclusion. The study findings identified that GRFs were affected in stroke survivors with DPN on both the paretic and the nonparetic sides. Further investigations are warranted to explore the impact of DPN on the kinematics and muscle activity related to the gait performance in stroke survivors with DPN.
  8. Mustapa A, Justine M, Latir AA, Manaf H
    Ann Rehabil Med, 2021 Oct;45(5):345-358.
    PMID: 34743478 DOI: 10.5535/arm.21102
    To promote optimal healthcare delivery in type 2 diabetes mellitus (T2DM) following the outbreak of coronavirus disease 2019, adopting home-based physical activity (PA) is being seriously considered. Therefore, this study aims to outline the characteristics of exercise protocols for home-based PA and the challenges and limitations in implementing home-based PA in patients with T2DM. This scoping review was carried out by identifying eligible studies in six different databases (Scopus, Cochrane Library, SpringerLink, ProQuest, Science Direct, and Google Scholar). The keywords used in the search strategies were: home-based physical activity, home-based exercise therapy, home-based physical exercise, home-based exercise, home-based exercise training, diabetes mellitus, and T2DM. Two reviewers independently screened all full-text articles to find articles that met the eligibility requirements. A total of 443 articles were identified in the search. Approximately 342 articles were excluded by screening titles and abstracts, which led to the selection of 44 articles relevant to the current study. Further screening of the full-text led to the subsequent removal of 34 other articles, leading to 10 studies that were eligible for data extraction. This review suggested that the exercise protocols for home-based PA include resistance exercise using free weight and own body weight with a frequency of two to three sessions per week at moderate intensity, along with aerobic exercise (particularly walking) with a frequency of three to five times per week at moderate intensity. A combination of resistance and aerobic exercise showed more significant benefits of PA in patients with T2DM. More studies regarding home-based PA in T2DM patients with metabolic disorders are warranted.
  9. Mustapa A, Justine M, Manaf H
    Malays Fam Physician, 2022 Nov 30;17(3):22-32.
    PMID: 36606173 DOI: 10.51866/rv.208
    INTRODUCTION: Patient education is an integral component of diabetes mellitus care. The emergence of different methods and characteristics of patient education has led to varying outcomes of quality of life (QoL). Herein, we systematically searched for published studies reporting patient education and its methods and characteristics for improving the QoL of patients with type 2 diabetes mellitus (T2DM).

    METHOD: In this scoping review, eligible studies from six databases (PubMed, Scopus, Cochrane Library, Springer Link, Science Direct and Google Scholar) were identified. The keywords used in the search strategies were as follows: health education, health promotion, patient education, diabetes care, QoL, diabetes mellitus and type 2 diabetes mellitus. Two reviewers independently screened all references and full-text articles retrieved to identify articles eligible for inclusion.

    RESULTS: A total of 203 articles were identified in the initial search. Of them, 166 were excluded after screening the titles and abstracts. Further full-text screening led to the subsequent removal of 22 articles, leaving 15 articles eligible for data extraction.

    CONCLUSION: There is a broad array of methods of patient education for improving the QoL of patients with T2DM. Self-management education with supplementary supervision and monitoring effectively improves QoL. Future studies must emphasise the application of holistic education covering psychological distress, diet plan, and physical health.

  10. Mullins N, Kang J, Campos AI, Coleman JRI, Edwards AC, Galfalvy H, et al.
    Biol Psychiatry, 2022 Feb 01;91(3):313-327.
    PMID: 34861974 DOI: 10.1016/j.biopsych.2021.05.029
    BACKGROUND: Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders.

    METHODS: We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors.

    RESULTS: Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged.

    CONCLUSIONS: Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.

  11. Mohd Said A, Manaf H, Bukry SA, Justine M
    Biomed Res Int, 2015;2015:385269.
    PMID: 26583104 DOI: 10.1155/2015/385269
    This study determines (1) the correlation between mobility and balance performances with physiological factors and (2) the relationship between foot postures with anthropometric characteristics and lower limb characteristics among elderly with neutral, pronated, and supinated foot. A cross-sectional observational study was conducted in community-dwelling elderly (age: 69.86 ± 5.62 years). Participants were grouped into neutral (n = 16), pronated (n = 14), and supinated (n = 14) foot based on the foot posture index classification. Anthropometric data (height, weight, and BMI), lower limb strength (5-STS) and endurance (30 s chair rise test), mobility (TUG), and balance (FSST) were determined. Data were analyzed using Spearman's correlation coefficient. Body weight was negatively and moderately correlated (r(s) = -0.552, P < 0.05) with mobility in supinated foot; moderate-to-high positive linear rank correlation was found between lower limb strength and mobility (r(s) = 0.551 to 0.804, P < 0.05) for pronated and neutral foot. Lower limb endurance was negatively and linearly correlated with mobility in pronated (r(s) = -0.699) and neutral (r(s) = -0.573) foot. No correlation was observed in balance performance with physiological factors in any of the foot postures. We can conclude that muscle function may be the most important feature to make movement possible in older persons regardless of the type of foot postures.
  12. Mohan V, Justine M, Jagannathan M, Aminudin S, Johari SH
    J Orthop Sci, 2015 Mar;20(2):410-7.
    PMID: 25542222 DOI: 10.1007/s00776-014-0682-4
    BACKGROUND: Research has been conducted on the prevalence and physical risk factors of work-related musculoskeletal disorders (WMSDs) among occupations such as agriculture workers, office workers, school teachers, and health care professionals. However, a paucity of research exists on the patterns and physical risk factors of WMSDs among the academicians in a higher learning institution. This study was conducted to determine the patterns and physical risk factors of WMSDs among the academicians.
    METHODS: A cross-sectional study was conducted among 228 subjects with a mean age of participants of 32.3 ± 7.8 for a period of 1 year from December 2011 until December 2012. An extended neordic musculoskeletal questionnaire (NMQ-E) was used to assess the patterns of work-related musculoskeletal disorders. The short version of the Dutch musculoskeletal questionnaire (DMQ) was used to determine the physical risk factors of WMSDs among the academicians. Descriptive statistics and Pearson Chi square test were used for data analysis.
    RESULTS: The 1-year pattern of WMSDs among the academicians were neck pain (44.7 %), followed by shoulder pain (40.4 %), upper and lower back pain (33.3 %), and the least common region was elbow pain (3.5 %). Among 20 common physical activities in DMQ, 15 physical activities performed by the academicians in their workplace were considered as a physical risk factors for neck, shoulder, and back pain at p < 0.05.
    CONCLUSION: The preliminary study demonstrated that neck pain, shoulder pain, and back pain were the most common WMSDs among the academicians in a higher learning institution.
  13. Mirza FT, Jenkins S, Justine M, Cecins N, Hill K
    Respirology, 2018 Jul;23(7):674-680.
    PMID: 29446206 DOI: 10.1111/resp.13262
    BACKGROUND AND OBJECTIVE: There is increased use of the 2-min walk test (2MWT) to assess functional exercise capacity. However, the distance achieved during this test may be difficult to interpret in the absence of reference values from a local population. Regression equations to estimate the 2-min walk distance (2MWD) only exist for American and Brazilian populations. The objective of this study was to develop regression equations to estimate the 2MWD in Malaysian adults who were free from major health problems.
    METHODS: Eighty-seven adults (43 males; mean ± SD age: 57.1 ± 9.6 years) performed two 2MWT using a standardized protocol. Heart rate (HR) was recorded every 30 s during the test. Stepwise multiple regression analysis was performed using age, gender, height, weight and change in HR (ΔHR) as independent variables, and better of the two 2MWD as the dependent variable. A second regression equation, without ΔHR, was planned if ΔHR was retained as one of the predictors of the 2MWD in the first equation.
    RESULTS: The better of the two 2MWD was 200 ± 34 m. Males walked 33 ± 6 m further than females (P < 0.001). The two regression equations were 196 - 1.1 × age, years + 1.0 × ΔHR, bpm + 31.2 × gender (R2 = 0.73) and 279 - 1.7 × age, years + 35.9 × gender (R2 = 0.47) with females = 0 and males = 1.
    CONCLUSION: The equations derived in this study may facilitate the interpretation of the 2MWD in clinical populations in Malaysia, as well as in countries with similar cultural backgrounds to Malaysia.
    Study site: volunteers from four villages in the Batu sub-district, Gombak, Malaysia
  14. Manaf H, Justine M, Goh HT
    Motor Control, 2017 Jan;21(1):42-57.
    PMID: 26595318 DOI: 10.1123/mc.2015-0040
    Attentional loadings deteriorate straight walking performance for individuals poststroke, but its effects on turning while walking remain to be determined. Here we compared turning kinematics under three attentional loading conditions (single, dual-motor, and dual-cognitive task) between stroke survivors and healthy controls. Nine chronic stroke survivors and 10 healthy controls performed the Timed Upand- Go test while their full-body kinematics were recorded. Onset times of yaw rotation of the head, thorax and pelvis segments and head anticipation distance were used to quantify turning coordination. Results showed that stroke survivors reoriented their body segments much earlier than the controls, but they preserved the similar segmental reorientation sequence under the single-task condition. For the healthy controls, attentional loading led to an earlier axial segment reorientation, but the reorientation sequence was preserved. In contrast, the dual-cognitive task condition led to a disrupted reorientation sequence in stroke. The results indicate that turning coordination was altered in individuals poststroke, especially under the dual-task interference.
  15. Manaf H, Justine M, Omar M
    Stroke Res Treat, 2014;2014:439304.
    PMID: 24757575 DOI: 10.1155/2014/439304
    The aim of this study was to determine whether stroke survivor's 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 Spearmen's 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.
  16. Manaf H, Justine M, Ting GH, Latiff LA
    Top Stroke Rehabil, 2014 Mar-Apr;21(2):128-36.
    PMID: 24710973 DOI: 10.1310/tsr2102-128
    Little is known about the effects of attentional loading on performance of turning during walking in individuals with stroke.
  17. Manaf H, Justine M, Goh HT
    PM R, 2015 Nov;7(11):1159-66.
    PMID: 25978943 DOI: 10.1016/j.pmrj.2015.05.007
    Attentional loadings have significant impacts on turning performance in individuals with stroke. Improper gait modification before turning may contribute to falls after stroke. Therefore, examination of the changes in temporal-spatial gait parameters before turning may reveal important deficits in gait control when stroke survivors are challenged by dual-tasking.
  18. Manaf H, Justine M, Hassan N
    Malays Orthop J, 2021 Mar;15(1):21-26.
    PMID: 33880144 DOI: 10.5704/MOJ.2103.004
    Introduction: Hockey is a team sport that involves running, sprinting, and making sudden changes in directions of movement to control a ball against the opposing team. Therefore, due to its nature of fast movement, hockey players may be at risk of various musculoskeletal injuries. This study aimed to identify the prevalence and pattern of musculoskeletal injuries sustained among Malaysian Hockey League players.

    Materials and Method: Data were collected from 84 field hockey players that participated in the Malaysian Hockey League competition from June 2016 until December 2016. All injuries were recorded by the participating medical team using a structured questionnaire. A descriptive statistical analysis and Chi-Square test were used to explore the prevalence of the injury.

    Result: More than half of the players were reported to have lower limb injuries (51.6%). Sprain and strain were the most prevalent injuries (63%) and mostly affected the ankle (29%). Male players sustained more injuries (50.8%) compared to female players (49.2%).

    Conclusion: This study suggests that a guideline is needed for injury prevention strategies that will benefit the hockey players in preventing injuries.

  19. Justine M, Manaf H, Sulaiman A, Razi S, Alias HA
    Biomed Res Int, 2014;2014:640321.
    PMID: 24977154 DOI: 10.1155/2014/640321
    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.
  20. Justine M, Hamid TA
    J Gerontol Nurs, 2010 Oct;36(10):32-41.
    PMID: 20438009 DOI: 10.3928/00989134-20100330-09
    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.
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