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Bégin D, Janecek M, Macedo LG, Richardson J, Wojkowski S. The relationship between fear of falling and functional ability following a multi-component fall prevention program: an analysis of clinical data. Physiother Theory Pract 2024; 40:1121-1132. [PMID: 36305706 DOI: 10.1080/09593985.2022.2137384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The first objective was to evaluate clinical data from a multi-component fall prevention program. The second objective was to explore the relationship between physical function and fear of falling (FoF). METHODS Adults (N = 287, mean age = 76 years) who participated in the Building Balance Program between 2011-2020 were assessed with five physical function measures and two FoF measures. Repeated measures ANOVA controlling for age and sex were performed to assess change from baseline. Linear regressions were conducted to evaluate how physical function explained variations in FoF. RESULTS There were significant improvements between pre and post-program Berg Balance Scale (BBS) scores (p < .001), Timed-Up and Go (TUG) times (p < .001), 30 second Chair-Stand (30 CST repetitions) (p < .001), Functional Reach (FR) distance (p < .001), gait speed (p < .001), single item-FoF score (p < .001), and short Falls Efficacy Scale-International (FES-I score) (p < .001). After controlling for sex on all regression analyses, age, and pre-program gait speed explained variations in pre-program short FES-I scores (Adjusted R2 = 0.19). Age, pre-program BBS and 30 CST repetitions explained variations in pre-program level of FoF (Adjusted R2 = 0.25). Variations in post-program short FES-I scores (Adjusted R2 = 0.17) were explained by age, post-program TUG times and FR distance after controlling for age and sex. Robust regressions indicated variations in post-program level of FoF explained by age, post-program TUG and FR distance with a two-way interaction between age and FR. CONCLUSION A multi-component fall prevention program improved physical function and decreased FoF. A small association between physical function and FoF similar between pre- and post-program conditions was identified.
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Affiliation(s)
- Diane Bégin
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
| | - Marci Janecek
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
| | - Luciana G Macedo
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
| | - Sarah Wojkowski
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
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Pitluk Barash M, Elboim-Gabyzon M, Shuper Engelhard E. Investigating the emotional content of older adults engaging in a fall prevention exercise program integrated with dance movement therapy: a preliminary study. Front Psychol 2023; 14:1260299. [PMID: 37790228 PMCID: PMC10543662 DOI: 10.3389/fpsyg.2023.1260299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023] Open
Abstract
Fall prevention interventions for older adults have primarily focused on the physical aspects, overlooking the emotional aspects inherent in falls. This qualitative study presents a novel fall prevention intervention that integrates physical therapy exercise (PTE) based on the Otago Exercise Program with Dance Movement Therapy (DMT) to address the emotional experience during PTE. The aim of this study is to explore the emotional content expressed by older adults during balance-focused exercises and the unique emotional content expressions following the PTE + DMT intervention compared to the PTE intervention. Eleven older adults (aged 81-91 years) from a day center were randomly assigned to either the PTE + DMT group (n = 6) or the PTE group (n = 5). Interpretative phenomenological analysis of the instructors' observations and process diary identified three themes that emerged during the sessions: (1) self-image and self-worth, (2) the individual in relation to others, and (3) past memories. These themes highlight both similarities and differences between the groups. These findings provide valuable insights into the emotional experiences encountered by older adults, particularly in the context of falls prevention practices. Recognizing, understanding, and facilitating the expression of these experiences can enhance the effectiveness of fall prevention interventions and contribute to the overall health of older adults.
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Affiliation(s)
- Michal Pitluk Barash
- The Graduate School of Creative Art Therapies, Faculty of Humanities & Social Sciences, Kibbutzim College of Education, Tel Aviv, Israel
- The Graduate School of Creative Art Therapies, Faculty of Social Welfare & Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Michal Elboim-Gabyzon
- Physical Therapy Department, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Einat Shuper Engelhard
- The Graduate School of Creative Art Therapies, Faculty of Humanities & Social Sciences, Kibbutzim College of Education, Tel Aviv, Israel
- The Graduate School of Creative Art Therapies, Faculty of Social Welfare & Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
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Jafari H, Gustafsson T, Nyberg L, Röijezon U. Predicting balance impairments in older adults: a wavelet-based center of pressure classification approach. Biomed Eng Online 2023; 22:83. [PMID: 37608334 PMCID: PMC10463618 DOI: 10.1186/s12938-023-01146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Aging is associated with a decline in postural control and an increased risk of falls. The Center of Pressure (CoP) trajectory analysis is a commonly used method to assess balance. In this study, we proposed a new method to identify balance impairments in older adults by analyzing their CoP trajectory frequency components, sensory inputs, reaction time, motor functions, and Fall-related Concerns (FrC). METHODS The study includes 45 older adults aged [Formula: see text] years who were assessed for sensory and motor functions. FrC and postural control in a quiet stance with open and closed eyes on stable and unstable surfaces. A Discrete Wavelet Transform (DWT) was used to detect features in frequency scales, followed by the K-means algorithm to detect different clusters. The multinomial logistic model was used to identify and predict the association of each group with the sensorimotor tests and FrC. RESULTS The study results showed that by DWT, three distinct groups of subjects could be revealed. Group 2 exhibited the broadest use of frequency scales, less decline in sensorimotor functions, and lowest FrC. The study also found that a decline in sensorimotor functions and fall-related concern may cause individuals to rely on either very low-frequency scales (group 1) or higher-frequency scales (group 3) and that those who use lower-frequency scales (group 1) can manage their balance more successfully than group 3. CONCLUSIONS Our study provides a new, cost-effective method for detecting balance impairments in older adults. This method can be used to identify people at risk and develop interventions and rehabilitation strategies to prevent falls in this population.
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Affiliation(s)
- Hedyeh Jafari
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Luleå, Sweden.
| | - Thomas Gustafsson
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Luleå, Sweden
| | - Lars Nyberg
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Ulrik Röijezon
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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Pitluk Barash M, Shuper Engelhard E, Elboim-Gabyzon M. Feasibility and Effectiveness of a Novel Intervention Integrating Physical Therapy Exercise and Dance Movement Therapy on Fall Risk in Community-Dwelling Older Women: A Randomized Pilot Study. Healthcare (Basel) 2023; 11:healthcare11081104. [PMID: 37107938 PMCID: PMC10137670 DOI: 10.3390/healthcare11081104] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/15/2023] [Accepted: 04/02/2023] [Indexed: 04/29/2023] Open
Abstract
This pilot study presents a novel fall prevention intervention that integrates physical therapy exercise (PTE) and dance movement therapy (DMT) to address both physical and emotional fall risk factors, as well as factors influencing adherence to treatment. The aim of this study was to examine the feasibility and effectiveness of the intervention in a sample of eight older women (median = 86 [81.25-90.75] years) from a day center for senior citizens. The intervention, based on the Otago Exercise Program and DMT techniques, aimed to address the emotional experience during physical exercise. Participants were randomly assigned to either a PTE+DMT intervention group (n = 5) or a PTE control group (n = 3). A pre-post intervention battery of physical and emotional fall risk assessments, therapist-patient bond, and home exercise adherence was conducted. Non-parametric tests results showed significant improvement in the PTE+DMT group in measures of balance and fear of falling compared to the PTE group. However, no other significant differences were found between the groups in terms of falls-related psychological concerns, self-perceived health status, therapist-patient bond, and home exercise adherence. These findings demonstrate the feasibility and potential benefits of an intervention that integrates both physical and emotional aspects to reduce fall risk in older adults, and provide a basis for further studies and modifications in the research protocol.
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Affiliation(s)
- Michal Pitluk Barash
- The Graduate School of Creative Art Therapies, Faculty of Social Welfare & Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
| | - Einat Shuper Engelhard
- The Graduate School of Creative Art Therapies, Faculty of Social Welfare & Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
- The Graduate School of Creative Art Therapies, Faculty of Humanities & Social Sciences, Kibbutzim College of Education, Tel Aviv 6250769, Israel
| | - Michal Elboim-Gabyzon
- Physical Therapy Department, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 3498838, Israel
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Xie H, Chen E, Zhang Y. Association of walking pace and fall-related injury among Chinese older adults: Data from the SAGE survey. Complement Ther Clin Pract 2023; 50:101710. [PMID: 36455493 DOI: 10.1016/j.ctcp.2022.101710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Falls are an important public health issue that poses a threat to the health of senior people and reduces their ability to maintain independence, which in turn reduces poor quality of life. Several studies have demonstrated a positive relationship between physical function and fall, it remains unclear whether there is an association between gait speed and fall-related injuries among the aging population, which represent the largest proportion of older adults in China. Therefore, the aim of this study was to examine the association between gait speed and fall-related injuries among older Chinese adults. METHODS Data from the Global Ageing and Adult Health Survey (2007-2010) were analyzed. A stratified multi-stage cluster sampling design was used to collect the survey data. A total of 7558 Chinese adults aged 60 or older were included in this study. A 4-m walking test was used to assess gait speed. Fall-related injuries were self-reported by study participants. The binary logistic regression model was employed to examine the association between gait speed and fall-related injuries while controlling for age, sex, education years, smoking, alcohol consumption, and chronic diseases. RESULTS The mean age of the sample of older Chinese adults was 69.70 ± 7.10 years (females accounted for 52.6%). The results showed that a normal gait speed was negatively correlated with fall-related injury (odds ratio = 1.20) when adjusting for all covariates. Moreover, a binary regression analysis showed that a normal gait speed was only negatively correlated with fall-related injury in male participants (odds ratio = 1.32). There were no significant results in rapid gait speed and fall-related injuries. CONCLUSION The results suggest that a slow gait speed may predict a higher risk of fall-related injuries among older Chinese adults, especially older male adults. Further studies are needed to verify our findings.
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Affiliation(s)
| | - Erle Chen
- Shenzhen College of International Education, China.
| | - Yanjie Zhang
- Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong-Shenzhen, Shenzhen, China.
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Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults. J Clin Med 2023; 12:jcm12020450. [PMID: 36675379 PMCID: PMC9864613 DOI: 10.3390/jcm12020450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
This study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical falls (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively.
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Salihu D, Wong EML, Kwan RYC, Ho GWK, Chutiyami M, Surajo KS, Bello UM, Ibrahim AA, Ali MU, Wang S, Bashir K, Jalo HA, Haddad MM, Suleiman AD, Ajio DK, Ali GM, Leung DYP. Anxiety, depression and stress among internally displaced persons and host community in an armed conflict region: A comparative study. Psychiatry Res 2022; 315:114700. [PMID: 35803168 DOI: 10.1016/j.psychres.2022.114700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 12/29/2022]
Abstract
This study compares the psychological profile of Internally Displaced Persons (IDPs) and individuals living in host communities in the war-affected setting. We conducted a cross-sectional survey from October-November 2019. Subjects were recruited from six IDPs camps and the surrounding host communities within the metropolis of Maiduguri, Nigeria by convenience sampling. Data were collected using the Hausa version of Depression Anxiety Stress Scale-21, and analysed by logistic regression using adjusted odds ratio (AOR) at 95% Confidence Interval (CI). A total of 562 subjects were recruited. Living in IDP camp was the most significantly predictor of depression, anxiety, and stress. The common predictors were living in an IDP camp, and marital status (separated). Aged 18-29years was a protective factor compared to those ≥50years. Living in IDP camps, separated from partners, lack of education and pre-conflict employment were significant predictors of depression, anxiety and stress.
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Affiliation(s)
- D Salihu
- School of Nursing, The Hong Kong Polytechnic University, HKSAR, China.
| | - E M L Wong
- School of Nursing, Tung Wah College, HKSAR, China
| | - R Y C Kwan
- School of Nursing, Tung Wah College, HKSAR, China.
| | - G W K Ho
- School of Nursing, The Hong Kong Polytechnic University, HKSAR, China
| | - M Chutiyami
- School of Nursing, Institute of Health and Management, Sydney, Australia
| | - K S Surajo
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - U M Bello
- Department of Physiotherapy and paramedicine, Glasgow Caledonian University, Glasgow, United Kingdom
| | - A A Ibrahim
- Department of Physiotherapy, Muhammad Abdullahi Wase Teaching Hospital, Hospitals Management Board, Kano, Nigeria
| | - M U Ali
- Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, HKSAR, China
| | - S Wang
- School of Nursing, The Hong Kong Polytechnic University, HKSAR, China
| | - K Bashir
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - H A Jalo
- State Specialist Hospital, Damaturu, Damaturu, Yobe State, Nigeria
| | - M M Haddad
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - A D Suleiman
- Shehu Sule College of Nursing and Midwifery, Damaturu, Damaturu, Yobe State, Nigeria
| | - D K Ajio
- Department of Nursing Science, Faculty of Medical Sciences University of Jos, Jos, Plateau State, Nigeria
| | - G M Ali
- 461 Nigerian Air Force Hospital, Kaduna, Kaduna State, Nigeria
| | - Doris Y P Leung
- School of Nursing, The Hong Kong Polytechnic University, HKSAR, China
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Falk J, Strandkvist V, Pauelsen M, Vikman I, Nyberg L, Röijezon U. Increased co-contraction reaction during a surface perturbation is associated with unsuccessful postural control among older adults. BMC Geriatr 2022; 22:438. [PMID: 35585517 PMCID: PMC9118814 DOI: 10.1186/s12877-022-03123-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/03/2022] [Indexed: 11/21/2022] Open
Abstract
Background As a strategy to maintain postural control, the stiffening strategy (agonist-antagonist co-contractions) is often considered dysfunctional and associated with poor physical capacity. The aim was to investigate whether increased stiffening is associated with unsuccessful postural control during an unpredictable surface perturbation, and which sensory and motor variables that explain postural stiffening. Methods A sample of 34 older adults, 75.8 ± 3.8 years, was subjected to an unpredicted surface perturbation with the postural task to keep a feet-in-place strategy. The participants also completed a thorough sensory- and motor test protocol. During the surface perturbation, electromyography was measured from tibialis anterior and gastrocnemius to further calculate a co-contraction index during the feed-forward and feedback period. A binary logistic regression was done with the nominal variable, if the participant succeeded in the postural task or not, set as dependent variable and the co-contraction indexes set as independent variables. Further, the variables from the sensory and motor testing were set as independent variables in two separate Orthogonal Projections of Latent Structures (OPLS)-models, one with the feed-forward- and the other with the feedback co-contraction index as dependent variable. Results Higher levels of ankle joint stiffening during the feedback, but not the feed-forward period was associated with postural task failure. Feedback stiffening was explained by having slow non-postural reaction times, poor leg muscle strength and being female whereas feed-forward stiffening was not explained by sensory and motor variables. Conclusions When subjected to an unpredicted surface perturbation, individuals with higher feedback stiffening had poorer postural control outcome, which was explained by poorer physical capacity. The level of feed-forward stiffening prior the perturbation was not associated with postural control outcome nor the investigated sensory and motor variables. The intricate causal relationships between physical capacity, stiffening and postural task success remains subject for future research. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03123-2.
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Affiliation(s)
- Jimmy Falk
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
| | - Viktor Strandkvist
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Mascha Pauelsen
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Irene Vikman
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Lars Nyberg
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Ulrik Röijezon
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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MacKay S, Ebert P, Harbidge C, Hogan DB. Fear of Falling in Older Adults: A Scoping Review of Recent Literature. Can Geriatr J 2021; 24:379-394. [PMID: 34912493 PMCID: PMC8629501 DOI: 10.5770/cgj.24.521] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Fear of falling (FOF) is prevalent among older adults and associated with adverse health outcomes. Over recent years a substantial body of research has emerged on its epidemiology, associated factors, and consequences. This scoping review summarizes the FOF literature published between April 2015 and March 2020 in order to inform current practice and identify gaps in the literature. Methods A total of 439 articles related to FOF in older adults were identified, 56 selected for full-text review, and 46 retained for data extraction and synthesis. Results The majority of included studies were cross-sectional. Older age, female sex, previous falls, worse physical performance, and depressive symptoms were the factors most consistently associated with FOF. Studies that measured FOF with a single question reported a significantly lower prevalence of FOF than those using the Falls Efficacy Scale, a continuous measure. FOF was associated with higher likelihoods of future falls, short-term mortality, and functional decline. Conclusions Comparisons between studies were limited by inconsistent definition and measurement of FOF, falls, and other characteristics. Consensus on how to measure FOF and which participant characteristics to evaluate would address this issue. Gaps in the literature include clarifying the relationships between FOF and cognitive, psychological, social, and environmental factors.
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Affiliation(s)
- Scott MacKay
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary
| | - Patricia Ebert
- Department of Psychology, University of Calgary, Calgary.,Hotchkiss Brain Institute, University of Calgary, Calgary.,Specialized Geriatric Services, Calgary Regional Health Authority, Calgary
| | - Cathy Harbidge
- Specialized Geriatric Services, Calgary Regional Health Authority, Calgary
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB
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Nilsson E, Igelström H, Vikman I, Larsson A, Pauelsen M. Positive Self-Perceptions of Aging Play a Significant Role in Predicting Physical Performance among Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111151. [PMID: 34769667 PMCID: PMC8583078 DOI: 10.3390/ijerph182111151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/02/2022]
Abstract
Self-perceptions of aging (SPA) is associated with various health-related outcomes, including physical performance. No previous study has investigated the potential predictive influence of SPA on physical performance among Swedish community-dwelling older adults. This was a cross-sectional study using a random sample of 153 Swedish community-dwelling individuals aged 70 and older. Multiple logistic regression analysis was performed, using the subscale “Attitude Towards Own Aging” of the Philadelphia Geriatric Center Morale Scale, as a measure of SPA. The Short Physical Performance Battery (SPPB) was dichotomized and used as the outcome variable. SPA was a significant predictor (OR = 1.546, CI = 1.066–2.243) of physical performance, adjusted for age, cognitive function, and life-space mobility. Further analyses revealed significant sex differences, with SPA not being included in the model for the men whilst it was still a significant predictor (OR = 1.689, CI = 1.031–2.765) of physical performance in the group of women. SPA plays a significant role in predicting physical performance among Swedish community-dwelling older adults. To further clarify this relationship and its consequences, future longitudinal research should focus on the relationship between SPA, physical performance, and fall risk.
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Affiliation(s)
- Emma Nilsson
- Department of Health, Education and Technology, Luleå University of Technology, SE 971 87 Luleå, Sweden; (E.N.); (I.V.); (A.L.)
| | - Helena Igelström
- Department of Neuroscience, Physiotherapy, Uppsala University, SE 752 37 Uppsala, Sweden;
| | - Irene Vikman
- Department of Health, Education and Technology, Luleå University of Technology, SE 971 87 Luleå, Sweden; (E.N.); (I.V.); (A.L.)
| | - Agneta Larsson
- Department of Health, Education and Technology, Luleå University of Technology, SE 971 87 Luleå, Sweden; (E.N.); (I.V.); (A.L.)
| | - Mascha Pauelsen
- Department of Health, Education and Technology, Luleå University of Technology, SE 971 87 Luleå, Sweden; (E.N.); (I.V.); (A.L.)
- Correspondence:
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Strandkvist V, Larsson A, Pauelsen M, Nyberg L, Vikman I, Lindberg A, Gustafsson T, Röijezon U. Hand grip strength is strongly associated with lower limb strength but only weakly with postural control in community-dwelling older adults. Arch Gerontol Geriatr 2021; 94:104345. [PMID: 33497911 DOI: 10.1016/j.archger.2021.104345] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Hand grip strength is frequently used as a measurement of muscle strength, especially among older adults. Muscle strength is only one of the many components in postural control and it is currently unclear to what extent hand grip strength is associated with postural control. The aim was to analyze the association between hand grip strength and lower limb muscle strength, and postural control among older adults. METHODS Forty-five community-dwelling individuals over 70 years of age provided isometric hand grip strength and lower limb strength (including hip extension and abduction, knee flexion and extension, and ankle dorsiflexion and plantarflexion), as well as postural control measurements. In the latter, center of pressure excursions were recorded for quiet stance and limits of stability tests on a force plate. Orthogonal projection of latent structures regression models were used to analyze associations between hand grip strength and lower limb strength as well as postural control, respectively. RESULTS Lower limb strength explained 74.4% of the variance in hand grip strength. All lower limb muscle groups were significantly associated with hand grip strength. In a corresponding model, postural control measured with center of pressure excursions explained 20.7% of the variance in a statistically significant, albeit weak, model. CONCLUSIONS These results support that hand grip strength is a valid method to estimate lower limb strength among older adults on a group level. However, strength measurements seem insufficient as a substitute for measuring postural control, and therefore specific balance tests are necessary.
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Affiliation(s)
- Viktor Strandkvist
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden; Department of Public Health and Clinical Medicine, The OLIN Unit, Division of Occupational and Environmental Medicine, Umeå University, Robertsviksgatan 9, 971 89 Luleå, Sweden.
| | - Agneta Larsson
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Mascha Pauelsen
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Lars Nyberg
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Irene Vikman
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, division of Medicine, Umeå University, Robertsviksgatan 9, 971 89, Luleå, Sweden
| | - Thomas Gustafsson
- Department of Computer Science, Electrical and Space Engineering, Divison of Signals and Systems, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Ulrik Röijezon
- Department of Health Sciences, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
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Pauelsen M, Jafari H, Strandkvist V, Nyberg L, Gustafsson T, Vikman I, Röijezon U. Frequency domain shows: Fall-related concerns and sensorimotor decline explain inability to adjust postural control strategy in older adults. PLoS One 2020; 15:e0242608. [PMID: 33216812 PMCID: PMC7678972 DOI: 10.1371/journal.pone.0242608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/05/2020] [Indexed: 11/19/2022] Open
Abstract
Human postural control is a complex system and changes as we age. Frequency based analyses have been argued to be useful to identify altered postural control strategies in balance tasks. The aim of this study was to explore the frequency domain of the quiet stance centre of pressure of older adults with various degrees of fall-related concerns and sensorimotor functioning. We included 45 community dwelling older adults and used a force plate to register 30 seconds of quiet stance with eyes open and closed respectively. We also measured sensory and motor functions, as well as fall-related concerns and morale. We analysed the centre of pressure power spectrum density and extracted the frequency of 4 of its features for each participant. Orthogonal projection of latent structures-discriminant analysis revealed two groups for each quiet stance trial. Group 1 of each trial showed less sensory and motor decline, low/no fall-related concerns and higher frequencies. Group 2 showed more decline, higher fall-related concerns and lower frequencies. During the closed eyes trial, group 1 and group 2 shifted their features to higher frequencies, but only group 1 did so in any significant way. Higher fall-related concerns, sensory and motor decline, and explorative balancing strategies are highly correlated. The control system of individuals experiencing this seems to be highly dependent on vision. Higher fall-related concerns, and sensory and motor decline are also correlated with the inability to adjust to faster, more reactive balancing strategies, when vision is not available.
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Affiliation(s)
- Mascha Pauelsen
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
- * E-mail:
| | - Hedyeh Jafari
- Department of Computer Science, Electrical and Space Engineering Luleå University of Technology, Luleå, Sweden
| | - Viktor Strandkvist
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Lars Nyberg
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Thomas Gustafsson
- Department of Computer Science, Electrical and Space Engineering Luleå University of Technology, Luleå, Sweden
| | - Irene Vikman
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Ulrik Röijezon
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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Freiberger E, Sieber CC, Kob R. Mobility in Older Community-Dwelling Persons: A Narrative Review. Front Physiol 2020; 11:881. [PMID: 33041836 PMCID: PMC7522521 DOI: 10.3389/fphys.2020.00881] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/29/2020] [Indexed: 12/21/2022] Open
Abstract
Due to the demographic changes and the increasing awareness of the role of physical function, mobility in older age is becoming an important topic. Mobility limitations have been reported as increasingly prevalent in older persons affecting about 35% of persons aged 70 and the majority of persons over 85 years. Mobility limitations have been associated with increased fall risk, hospitalization, a decreased quality of life, and even mortality. As concepts of mobility are multifactorial and complex, in this narrative review, definitions, physical factors, and their age-related changes associated with mobility will be presented. Also, areas of cognitive decline and their impact on mobility, as well as neuromuscular factors related to mobility will be addressed. Another section will relate psychological factors such as Fall-related psychological concerns and sedentary behavior to mobility. Assessment of mobility as well as effective exercise interventions are only shortly addressed. In the last part, gaps and future work on mobility in older persons are discussed.
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Affiliation(s)
- Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
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Lucero RJ, Romero S, Fieo R, Cortes Y, Cimiotti JP, Poghosyan L. Language equivalence of the modified falls efficacy scale (MFES) among English- and Spanish-speaking older adults: Rasch analysis. BMC Geriatr 2020; 20:286. [PMID: 32787777 PMCID: PMC7422612 DOI: 10.1186/s12877-020-01627-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/22/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND To investigate item-level measurement properties of the Modified Falls Efficacy (MFES) Scale among English- and Spanish-speaking urban-dwelling older adults as a means to evaluate language equivalence of the tool. METHODS Secondary analysis of survey data from 170 English (n = 83) and Spanish (n = 87) speaking older adults who reported to the emergency department of a quaternary medical center in New York City between February 2010 and August 2011. The Rasch rating scale model was used to investigate item statistics and ordering of items, item and person reliability, and model performance of the Modified Falls Efficacy Scale. RESULTS The Modified Falls Efficacy Scale, for English- and Spanish-speakers, demonstrated acceptable fit to the Rasch model of a unidimensional measure. While the range of the construct is more limited for the Spanish group, the interval between tasks are much closer, reflecting little to no construct under-representation. CONCLUSION There is rationale for continued testing of a unidemsional English- and Spanish-MFES among urban community-dwelling older adults. Large-scale international studies linking the unidemsional MFES to patient outcomes will support the validity of this tool for research and practice.
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Affiliation(s)
- Robert J Lucero
- Department of Family, Community, and Health System Science, Center for Latin American Studies, College of Nursing, University of Florida, 1225 Center Drive, Gainesville, Florida, 32610, USA.
| | - Sergio Romero
- North Florida/South Georgia Veterans Health System, Center of Innovation on Disability and Rehabilitation Research, 300 E. University Avenue, Gainesville, FL, 32601, USA
| | - Robert Fieo
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, 1225 Center Drive, Gainesville, Florida, NY, 32610, USA
| | - Yamnia Cortes
- The University of North Carolina at Chapel Hill, School of Nursing, S. Columbia Street, Chapel Hill, NC, 27599, USA
| | - Jeannie P Cimiotti
- Department of Family, Community, and Health Systems Science, Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, NE, Atlanta, GA, 30322, USA
| | - Lusine Poghosyan
- Columbia University, School of Nursing, Center for Health Policy, 560 W. 168th Street, New York, NY, 10032, USA
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Resnick B, Boltz M, Galik E, Holmes S, Fix S, Zhu S. Gender Differences in Function, Physical Activity, Falls, Medication Use, and Life Satisfaction Among Residents in Assisted Living Settings. Res Gerontol Nurs 2020; 13:31-40. [PMID: 31584687 PMCID: PMC6980912 DOI: 10.3928/19404921-20190930-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to test for gender differences among residents living in assisted living settings. This was a secondary data analysis using data from the first 64 facilities participating in the ongoing Function Focused Care for Assisted Living study using the Evidence Integration Triangle (FFC-AL-EIT). A total of 593 residents were recruited. Differences by gender with regard to function, physical activity, falls, total number of medications, and satisfaction with assisted living were tested using multivariate analysis of variance. There were 166 (28%) men and 427 (72%) women with a mean age of 88 (SD = 7.5 years). Participants had five (SD = 2) comorbidities and took on average 6.88 medications (SD = 3.47). Participants had moderate functional impairment with a mean of 64.13 (SD = 19.09) on the Barthel Index and engaged in 43.8 (SD = 76.12) minutes daily of moderate level physical activity. Women reported higher satisfaction with activities (4.32 [SD = 1.14]) than men (3.85 [SD = 1.51]), and women received more medications than men (7.09 [SD = 3.51] vs. 6.34 [SD = 3.31]). Current study findings suggest that deprescribing may be particularly important for women versus men and focusing on expanding activity options to include those preferred by men should be considered in assisted living settings. [Research in Gerontological Nursing, 13(1), 31-40.].
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Kamide N, Shiba Y, Sakamoto M, Sato H. Reliability and validity of the Short Falls Efficacy Scale-International for Japanese older people. Aging Clin Exp Res 2018; 30:1371-1377. [PMID: 29594873 DOI: 10.1007/s40520-018-0940-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The Short Falls Efficacy Scale-International (Short FES-I) has been confirmed to be a good measure with reliability and validity in a UK sample; however, the reliability and validity of the Short FES-I for Japanese older people have not yet been established. AIM The aim of this study was to determine the reliability and validity of the Short FES-I for Japanese older people. METHODS The study participants were 519 older people aged 65 years and over who were living independently in their community. The Short FES-I is composed of seven items rated on a four-point Likert scale. Lower scores indicate better fall-related efficacy. To investigate the validity of the Short FES-I, previous falls, physical function such as grip strength and scores on the Timed Up and Go (TUG) test, psychological factors such as self-rated health (SRH), cognitive function, and other confounding factors were collected. The association between the previous falls and the Short FES-I was analyzed using logistic regression analysis. Furthermore, factors related to the Short FES-I were investigated using multiple regression analysis. RESULTS Cronbach's alpha for the Short FES-I was 0.87. Short FES-I scores were significantly higher in participants with a history of falls than in those without. In addition, Short FES-I scores were significantly and independently associated with falls in logistic regression analysis, and significantly associated with grip strength, TUG time, and SRH in multiple regression analysis. CONCLUSIONS AND DISCUSSION These results suggest that the Short FES-I is a reliable and valid fall-related measurement scale for Japanese older people.
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