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Dai ACK, Mackenzie L. Falls experienced by adult cancer survivors: a scoping review. Disabil Rehabil 2024:1-21. [PMID: 38946208 DOI: 10.1080/09638288.2024.2362399] [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: 08/06/2023] [Accepted: 05/28/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Accidental falls among adult cancer survivors are a health concern. Falls impose economic burdens and detrimental consequences to cancer survivors. This review aimed to synthesize findings from published research to explore the relationship between falls and cancer diagnosis and treatment among cancer survivors. MATERIALS AND METHODS A scoping review was conducted using four databases (Medline, EMBASE, CINAHL, and Scopus) for the years 2001-2021. A total of 425 abstracts were identified after removing duplicates. A second search for the years 2022-2023 was completed where 80 abstracts were identified. Abstract screening, full-text review, and data extraction were conducted. Study characteristics and key findings were extracted from full texts. Descriptive numerical summaries were presented, and narrative analyses were performed. RESULTS AND CONCLUSIONS A total of 42 articles were included in the scoping review which demonstrated (1) an increased prevalence of falls among cancer survivors, (2) the presence of cancer-specific fall risk factors, (3) a lack of cancer-specific fall prediction tools, and (4) few fall prevention interventions as part of usual care among cancer survivors. Younger cancer survivors were underrepresented. Cancer survivors should be aware of their risk of falls, and health professionals should ensure that fall prevention is part of usual care.
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Affiliation(s)
- Anson Chuk Kwan Dai
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Tsekoura M, Matzaroglou C, Xergia S, Dionyssiotis Y, Tsepis E, Sakellari V, Billis E. The Feasibilty of the Motor Control Home Ergonomics Elderlies' Prevention of Falls (McHeELP) Programme in Patients with Sarcopenia: A Pilot Study. J Frailty Sarcopenia Falls 2024; 9:89-95. [PMID: 38835618 PMCID: PMC11145092 DOI: 10.22540/jfsf-09-089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 06/06/2024] Open
Abstract
Objectives The objective of this pilot study was to investigate the feasibility of a three month 'Motor control Home ergonomics Elderlies' Prevention of falls' (McHeELP) programme on muscle mass, muscle strength, functionality, balance and fear of falling among older adults with sarcopenia. Methods A feasibility study of the McHeELP programme was performed in patients with sarcopenia. Primary outcome measures included number of participants; number of participants that showed engagement with the programme; adherence rates; data loss in questionnaires and secondary outcome measures; any adverse events, related or not to the intervention programme. All participants received a home-based motor control exercise programme combined with an ergonomic home modification for 12 weeks. Secondary outcome measures included Hand Grip Strength, Bioimpendance Analysis, Muscle Mass, Functionality and Fear of Falling. Results Twelve participants, (74.9±5 years), completed the pilot study. Significant differences were recorded before and after the programme on participants' functionality (p < 0.001), balance (p < 0.05) and fear of falling (p < 0.001). Conclusions The present study revealed that the McHeELP programme is fesasible and that it is possible to implement the programme in clinical practice. The McHeELP programme positively affects functionality, balance and fear of falling. Thus, it seems feasible to conduct a full-scale randomised controlled trial.
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Affiliation(s)
- Maria Tsekoura
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| | - Charalampos Matzaroglou
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| | - Sofia Xergia
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| | - Yannis Dionyssiotis
- 2 Physical Medicine and Rehabilitation Department, National Rehabilitation Center EKA, Athens, Greece
| | - Elias Tsepis
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
| | - Vassiliki Sakellari
- Physiotherapy department, Faculty of Health and Care Sciences, University of Western Attica, Greece
| | - Evdokia Billis
- Physiotherapy department, School of Health Rehabilitation Sciences, University of Patras, Greece
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Sideridou M, Kouidi E, Hatzitaki V, Chouvarda I. Towards Automating Personal Exercise Assessment and Guidance with Affordable Mobile Technology. SENSORS (BASEL, SWITZERLAND) 2024; 24:2037. [PMID: 38610249 PMCID: PMC11013996 DOI: 10.3390/s24072037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024]
Abstract
Physical activity (PA) offers many benefits for human health. However, beginners often feel discouraged when introduced to basic exercise routines. Due to lack of experience and personal guidance, they might abandon efforts or experience musculoskeletal injuries. Additionally, due to phenomena such as pandemics and limited access to supervised exercise spaces, especially for the elderly, the need to develop personalized systems has become apparent. In this work, we develop a monitored physical exercise system that offers real-time guidance and recommendations during exercise, designed to assist users in their home environment. For this purpose, we used posture estimation interfaces that recognize body movement using a computer or smartphone camera. The chosen pose estimation model was BlazePose. Machine learning and signal processing techniques were used to identify the exercise currently being performed. The performances of three machine learning classifiers were evaluated for the exercise recognition task, achieving test-set accuracy between 94.76% and 100%. The research methodology included kinematic analysis (KA) of five selected exercises and statistical studies on performance and range of motion (ROM), which enabled the identification of deviations from the expected exercise execution to support guidance. To this end, data was collected from 57 volunteers, contributing to a comprehensive understanding of exercise performance. By leveraging the capabilities of the BlazePose model, an interactive tool for patients is proposed that could support rehabilitation programs remotely.
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Affiliation(s)
- Maria Sideridou
- Lab of Computing, Medical Informatics, and Biomedical-Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Evangelia Kouidi
- School of Physical Education and Sport Science, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.K.); (V.H.)
| | - Vassilia Hatzitaki
- School of Physical Education and Sport Science, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.K.); (V.H.)
| | - Ioanna Chouvarda
- Lab of Computing, Medical Informatics, and Biomedical-Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Zanghelini F, Xydopoulos G, Fordham R, Rodgers G, Khanal S. Early economic evaluation of the digital gait analysis system for fall prevention-Preliminary analysis of the GaitSmart system. Aging Med (Milton) 2024; 7:74-83. [PMID: 38571670 PMCID: PMC10985772 DOI: 10.1002/agm2.12290] [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: 12/21/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 04/05/2024] Open
Abstract
Objective To develop an early economics evaluation (EEE) to assess the cost-effectiveness of the GS in reducing the RoF and FoF. Methods A cost-effectiveness analysis (CEA) with a return on investment (RoI) estimation was performed. CEA used the most relevant parameters, such as increased gait speed and decreased FoF, to estimate the reduction in the RoF, the impact on health care resources used and financial implications for the National Health System in the United Kingdom. Outcomes were measured as incremental cost-effectiveness ratio per quality-adjusted life years (QALYs) gained based on the reduction of the RoF and FoF. Uncertainties around the main parameters used were evaluated by probabilistic sensitivity analysis. Results The CEA results showed that the GS is a dominant strategy over the standard of care to improve the movements of older persons who have suffered a fall or are afraid of falling (incremental QALYs based on FoF = 0.77 and QALYs based on RoF = 1.07, cost of FoF = -£4479.57 and cost of RoF = -£2901.79). By implementing the GS, the ROI results suggest that every pound invested in the GS could result in cost savings of £1.85/patient based on the RoF reduction and £11.16/patient based on the FoF reduction. The probability of being cost saving based on the number of iterations were 79.4 percent (based on FoF) and 100 percent (based on RoF). Conclusion The EEE supports the main hypothesis that the GS is an effective intervention to avoid falls and is potentially cost saving.
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Affiliation(s)
- Fernando Zanghelini
- Health Economics Consulting, Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Georgios Xydopoulos
- Health Economics Consulting, Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Richard Fordham
- Health Economics Consulting, Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | | | - Saval Khanal
- Health Economics Consulting, Norwich Medical SchoolUniversity of East AngliaNorwichUK
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Pan H, Liu TW, Ng SSM, Tsoh J, Wong TWL, Lam SSL, Li CSK, Chan CCC, Lai CYY. Testing the psychometric properties of the Chinese (Cantonese) version of SATIS-Stroke in people with chronic stroke. Disabil Rehabil 2024; 46:159-169. [PMID: 36476081 DOI: 10.1080/09638288.2022.2153179] [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: 04/25/2022] [Accepted: 11/05/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE To culturally adapt and examine the psychometric properties of the Chinese (Cantonese) version of SATIS-Stroke (C-SATIS-Stroke) in people with chronic stroke. MATERIALS AND METHODS Forward and backward translations were performed in accordance with available guidelines. We administered the C-SATIS-Stroke to 101 people with stroke and 50 healthy older adults. We assessed the test-retest and internal reliability, measurement error, known-group validity, correlations with other outcome measures, optimal cut-off score and ceiling and floor effects. RESULTS C-SATIS-Stroke demonstrated excellent internal consistency (Cronbach's α = 0.959) and good test-retest reliability (intraclass correlation coefficient3,1 = 0.913). Compared with healthy controls, people with chronic stroke had lower C-SATIS-Stroke scores. The mean C-SATIS-Stroke score was significantly correlated with the mean scores of the Activities-specific Balance Confidence Scale, Stroke Impact Scale, Community Integration Measure and Survey of Activities and Fear of Falling in the Elderly. The cut-off score to distinguish the levels of satisfaction with activity and participation between people with chronic stroke and healthy older adults was 80 out of 108 (sensitivity: 77%; specificity: 72%). C-SATIS-Stroke exhibited ceiling effects but not floor effects. CONCLUSIONS C-SATIS-Stroke is a reliable and valid measure for assessing satisfaction with social participation among Chinese people with chronic stroke.IMPLICATIONS FOR REHABILITATIONSatisfactory semantic, idiomatic, cultural, and conceptual equivalence of the C-SATIS-Stroke are in line with those of the original English version of the SATIS-StrokeExcellent reliability and validity of the C-SATIS-Stroke are also in line with those of the original English version of the SATIS-StrokeThe C-SATIS-Stroke can be used to assess the subjective satisfaction feeling in terms of social participation among Chinese people with chronic stroke.
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Affiliation(s)
- Hong Pan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China (SAR)
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital and Shatin Hospital, Hong Kong, China (SAR)
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Stefanie S L Lam
- Physiotherapy Department, Shatin Hospital, Hong Kong, China (SAR)
| | - Carol S K Li
- Physiotherapy Department, Shatin Hospital, Hong Kong, China (SAR)
| | - Charles C C Chan
- Physiotherapy Department, Shatin Hospital, Hong Kong, China (SAR)
| | - Cynthia Y Y Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
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Thiamwong L, Xie R, Park JH, Lighthall N, Loerzel V, Stout J. Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e51899. [PMID: 37788049 PMCID: PMC10582821 DOI: 10.2196/51899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The lack of health care coverage, low education, low motivation, and inconvenience remain barriers to participating in fall prevention programs, especially among low-income older adults. Low-income status also contributes to negative aging self-perceptions and is associated with a high perceived barrier to care. Existing fall prevention intervention technologies do not enable participants and practitioners to interact and collaborate, even with technologies that bring viable strategies to maintain independence, prevent disability, and increase access to quality care. Research is also limited on the use of technology to enhance motivation and help individuals align their perception with physiological fall risk. We developed a novel, 8-week Physio-Feedback Exercise Program (PEER), which includes (1) technology-based physio-feedback using a real-time portable innovative technology-the BTrackS Balance Tracking System, which is reliable and affordable, allows for home testing, and provides feedback and tracks balance progression; (2) cognitive reframing using the fall risk appraisal matrix; and (3) peer-led exercises focusing on balance, strength training, and incorporating exercises into daily activities. OBJECTIVE This study consists of 3 aims. Aim 1 is to examine the effects of the technology-based PEER intervention on fall risk, dynamic balance, and accelerometer-based physical activity (PA). Aim 2 is to examine the effects of the PEER intervention on fall risk appraisal shifting and negative self-perceptions of aging. Aim 3 is to explore participants' experiences with the PEER intervention and potential barriers to accessing and adopting the technology-based PEER intervention to inform future research. METHODS This is an intention-to-treat, single-blinded, parallel, 2-arm clustered randomized controlled trial study. We will collect data from 340 low-income older adults at baseline (T1) and measure outcomes after program completion (T2) and follow-up at 3 months (T3) and 6 months (T4). Participants will be enrolled if they meet all the following inclusion criteria: aged ≥60 years, cognitively intact, and able to stand without assistance. Exclusion criteria were as follows: a medical condition precluding exercise or PA, currently receiving treatment from a rehabilitation facility, plan to move within 1 year, hospitalized >3 times in the past 12 months, and does not speak English or Spanish. RESULTS As of August 2023, the enrollment of participants is ongoing. CONCLUSIONS This study addresses the public health problem by optimizing a customized, technology-driven approach that can operate in low-resource environments with unlimited users to prevent falls and reduce health disparities in low-income older adults. The PEER is a novel intervention that combines concepts of physio-feedback, cognitive reframing, and peer-led exercise by motivating a shift in self-estimation of fall risk to align with physiological fall risk to improve balance, PA, and negative aging self-perception. TRIAL REGISTRATION ClinicalTrials.gov NCT05778604; https://www.clinicaltrials.gov/ct2/show/study/NCT05778604. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51899.
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Affiliation(s)
- Ladda Thiamwong
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Rui Xie
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Nichole Lighthall
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Victoria Loerzel
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Jeffrey Stout
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
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Bakırhan S, Unver B, Elibol N, Karatosun V. Fear of movement and other associated factors in older patients with total knee arthroplasty. Ir J Med Sci 2023; 192:2217-2222. [PMID: 36445627 DOI: 10.1007/s11845-022-03214-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/07/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Kinesiophobia is an important risk factor for functional activities of patients in the early stage following total knee arthroplasty (TKA). AIMS This study aimed to investigate the relationship between fear of movement and associated factors in older patients in the late stage after TKA. METHODS The study included 45 older patients (mean age:70.11 ± 0.90 years) with knee osteoarthritis who underwent TKA. Kinesiophobia was assessed with the Tampa Scale of Kinesiophobia (TSK). Pain and strength in the quadriceps femoris (QF) muscle were assessed by the Visual Analog Scale and hand-held dynamometer, respectively. Functional level was determined using the 30-s sit-to-stand test (STS) and 10-m walking test. RESULTS There were correlations between TSK and QF muscle strength (r = -0.538, p < 0.001), activity pain level (r = 0.489, p = 0.001), and 30-s STS (r = -0.306, p = 0.041). There were no correlations between TSK and age (r = 0.207, p = 0.172) and 10-m walking test (r = 0.112, p = 0.465). CONCLUSIONS Increased pain and decreased QF muscle strength and functional level on STS were related with fear of movement in TKA patients. It was concluded that kinesiophobia of older patients with TKA must be considered during the assessment and rehabilitation program in the late stage after TKA.
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Affiliation(s)
- Serkan Bakırhan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ege University, Izmir, Turkey
| | - Bayram Unver
- Department of Orthopedic Physiotherapy, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Nuray Elibol
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ege University, Izmir, Turkey.
| | - Vasfi Karatosun
- Department of Orthopedics, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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Hezel N, Sloot LH, Wanner P, Becker C, Bauer JM, Steib S, Werner C. Feasibility, effectiveness and acceptability of two perturbation-based treadmill training protocols to improve reactive balance in fall-prone older adults (FEATURE): protocol for a pilot randomised controlled trial. BMJ Open 2023; 13:e073135. [PMID: 37666555 PMCID: PMC10481747 DOI: 10.1136/bmjopen-2023-073135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/14/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Perturbation-based balance training (PBT) targets the mechanism of falls (eg, slipping, tripping) to specifically train the recovery actions needed to avoid a fall. This task-specific training has shown great promise as an effective and efficient intervention for fall prevention in older adults. However, knowledge about the dose-response relationship of PBT, as well as its feasibility and acceptability in older adults with increased risk of falling is still limited. Thus, the aim of this study is to compare the effectiveness of two different treadmill PBT protocols for improving reactive balance control in fall-prone older adults, and to evaluate the feasibility and acceptability of these protocols. METHODS AND ANALYSIS The study is designed as a pilot randomised controlled trial with a 6-week intervention and 6-week follow-up period. Thirty-six community-dwelling, fall-prone (Timed Up and Go >12 s, habitual gait speed <1.0 m/s and/or fall history) older adults will be randomised (1:1) to receive six (weeks 1-6) or two treadmill PBT sessions (weeks 1+6) plus four conventional treadmill training sessions (weeks 2-5). Training sessions are conducted 1×/week for 30 min. Each PBT will include 40 perturbations in anterior-posterior and mediolateral directions. Reactive balance after perturbations in standing (Stepping Threshold Test (STT)) and walking (Dynamic Stepping Threshold Test (DSTT)) will be assessed as the primary outcome for effectiveness. Secondary outcomes are spatiotemporal and kinematic parameters collected during STT, DSTT and PBT, maximum perturbation magnitude for each PBT session, static and dynamic balance, physical capacity, physical activity, concerns with falling and executive functions. Feasibility will be assessed via training adherence, drop-out rate, perturbations actually performed and adverse events; and acceptability via self-designed questionnaire and focus groups. ETHICS AND DISSEMINATION The study has been approved by the Ethics Committee of the Medical Faculty Heidelberg (S-602/2022). Findings will be disseminated through publications in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER DRKS00030805.
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Affiliation(s)
- Natalie Hezel
- Geriatric Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Lizeth H Sloot
- Institute of Computer Engineering, Heidelberg University, Heidelberg, Germany
| | - Philipp Wanner
- Institute for Sports and Sports Science, Heidelberg University, Heidelberg, Germany
| | - Clemens Becker
- Unit of Digital Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen M Bauer
- Geriatric Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Simon Steib
- Institute for Sports and Sports Science, Heidelberg University, Heidelberg, Germany
| | - Christian Werner
- Geriatric Center, Heidelberg University Hospital, Heidelberg, Germany
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Thiamwong L, Xie R, Park JH, Choudhury R, Malatyali A, Li W, Eckstrom E, Stout JR. Levels of Accelerometer-Based Physical Activity in Older Adults With a Mismatch Between Physiological Fall Risk and Fear of Falling. J Gerontol Nurs 2023; 49:41-49. [PMID: 37256756 PMCID: PMC10513747 DOI: 10.3928/00989134-20230512-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We examined the associations between levels of accelerometer-based physical activity and the mismatch of physiological fall risk and fear of falling (FOF) in community-dwelling older adults. We assessed 123 participants who received 7-day wrist-worn accelerometry. Physiological fall risk was assessed using the portable BTrackS™ balance system and FOF was assessed using a short version of the Falls Efficacy Scale-International. Participants were categorized into four groups: rational (low FOF/normal balance), irrational (high FOF/normal balance), incongruent (low FOF/poor balance), and congruent (high FOF/poor balance). One third of older adults had a mismatch between their FOF and actual fall risk. Accelerometer-based moderate to vigorous physical activity (MVPA) was significantly different in the irrational group compared to the rational group (p = 0.023) and the congruent group compared to the rational group (p = 0.032). Encouraging older adults to improve MVPA may prevent them from shifting from rational to irrational or congruent groups, thereby reducing the risk of injurious falls. [Journal of Gerontological Nursing, 49(6), 41-49.].
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Correia IR, Cardoso V, Cargaleiro C, Magalhães JP, Hetherington-Rauth M, Rosa GB, Malveiro C, de Matos LV, Cardoso MJ, Sardinha LB. Effects of home-based exercise programs on physical fitness in cancer patients undergoing active treatment: A systematic review and meta-analysis of randomized controlled trials. J Sci Med Sport 2023:S1440-2440(23)00047-6. [DOI: 10.1016/j.jsams.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/16/2023] [Accepted: 03/15/2023] [Indexed: 03/31/2023]
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Choudhury R, Park JH, Banarjee C, Thiamwong L, Xie R, Stout JR. Associations of Mutually Exclusive Categories of Physical Activity and Sedentary Behavior with Body Composition and Fall Risk in Older Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3595. [PMID: 36834290 PMCID: PMC9961100 DOI: 10.3390/ijerph20043595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
The individual effects of physical activity (PA) and sedentary behavior (SB) on health are well-recognized. However, little is known about the extent to which different combinations of these behaviors are associated with body composition and fall risk in older adults. This cross-sectional study examined the associations of mutually exclusive categories of PA and SB with body composition and fall risk in older women. Accelerometer-measured PA, body composition and fall risk (static and dynamic balance) parameters were assessed among 94 community-dwelling older women. The participants were categorized into four groups: active-low sedentary, active-high sedentary, inactive-low sedentary and inactive-high sedentary (active: ≥150 min/week moderate-to-vigorous PA (MVPA); low sedentary: lowest tertile of SB and light PA ratio). Compared to the inactive-high sedentary group, more favorable body composition and dynamic balance results were found in the active-low sedentary (body fat mass index (BFMI): β = -4.37, p = 0.002; skeletal muscle mass index (SMI): β = 1.23, p = 0.017; appendicular lean mass index (ALMI): β = 1.89, p = 0.003; appendicular fat mass index (AFMI): β = -2.19, p = 0.003; sit-to-stand: β = 4.52, p = 0.014) and inactive-low sedentary (BFMI: β = -3.14, p = 0.007; SMI: β = 1.05, p = 0.014; AFMI: β = -1.74, p = 0.005, sit-to-stand: β = 3.28, p = 0.034) groups. Our results suggest that PA programs focusing on concurrently achieving sufficient MVPA and reduced SB might promote a healthy body composition and reduced fall risk among older adults.
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Affiliation(s)
- Renoa Choudhury
- Department of Mechanical Engineering, University of Central Florida, Orlando, FL 32816, USA
| | - Joon-Hyuk Park
- Department of Mechanical Engineering, University of Central Florida, Orlando, FL 32816, USA
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA
| | - Chitra Banarjee
- College of Medicine, University of Central Florida, Orlando, FL 32816, USA
| | - Ladda Thiamwong
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA
| | - Rui Xie
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL 32816, USA
| | - Jeffrey R. Stout
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL 32816, USA
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Pan H, Ng SSM, Liu TW, Tsoh J, Wong TWL. Psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index in people with chronic stroke. Front Neurol 2023; 14:989403. [PMID: 36908608 PMCID: PMC9998711 DOI: 10.3389/fneur.2023.989403] [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: 07/13/2022] [Accepted: 02/03/2023] [Indexed: 03/14/2023] Open
Abstract
Objective To culturally adapt and examine the psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index (C-UEFI) in people with chronic stroke. Design Cross-sectional study. Settings University-affiliated neurorehabilitation research laboratory. Participants The participants (N = 151) were people with chronic stroke (N = 101) and healthy controls (n = 50). Main outcome measures We assessed the C-UEFI, Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Six-Minute Walk Test (6MWT), Motor Activity Log (MAL), Activity-Specific Balance Confidence (ABC) scale, Lawton Instrumental Activities of Daily Living (IADL) scale, Survey of Activities and Fear of Falling in the Elderly (SAFFE), Stroke Impact Scale (SIS) and Community Integration Measure (CIM) as outcome measures. Results The C-UEFI items demonstrated good test-retest reliability (intraclass correlation coefficient [ICC]3, 1 = 0.872) and excellent internal consistency (Cronbach's α = 0.922). People with chronic stroke had poorer C-UEFI scores than the healthy controls. The overall C-UEFI mean score of 101 people with stroke was significantly correlated with the mean scores of the FMA-UE, WMFT, MAL, ABC scale, IADL scale, SAFFE, SIS and CIM and the distance covered in the 6MWT. The C-UEFI cut-off score to distinguish between people with chronic stroke and healthy older adults according to upper extremity function was 57.5 out of 59 (sensitivity: 88.1%; specificity: 84%). The C-UEFI had good content validity, with an acceptable fit to the two-factor structure model. Conclusions The C-UEFI is reliable and valid for assessing functional recovery of upper extremity activity in Chinese people with chronic stroke.
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Affiliation(s)
- Hong Pan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital and Shatin Hospital, Hong Kong, Hong Kong SAR, China
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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13
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Benefits of Virtual Reality Program and Motor Imagery Training on Balance and Fall Efficacy in Isolated Older Adults: A Randomized Controlled Trial. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111545. [PMID: 36363502 PMCID: PMC9692723 DOI: 10.3390/medicina58111545] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/05/2022]
Abstract
Background and Objectives: for isolated older adults, alternative training indoors to maintain balance is essential; however, related studies are lacking. To improve the balance of isolated older adults and reduce their fear of falling, we aimed to examine the balance−keeping effect of a virtual reality (VR) program and motor imagery training (MIT) and propose training that could improve physical activity among older adults. Methods: a total of 34 older adults admitted to a convalescent hospital were assessed. VR (n = 12) and MIT (n = 10) groups completed their assigned intervention in six weeks, whereas the control group (CG) (n = 12) did not. The follow−up was performed after two weeks. Results: in group × time interactions, body center movement area, open and closed eyes balance scores, and fall efficacy were significantly different (p < 0.05). In contrast with the VR group, the MIT group did not show a significant difference in the open or closed eyes balance scores depending on the period. However, there was a significant difference between the MIT group and CG in the open eyes balance score post-test (d = 1.13, 95% confidence interval, 0.40−12.33). Conclusions: we propose VR and MIT as training methods to prevent physical weakness in isolated older adults.
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14
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Park MJ, Kim JW, Roh E, Choi KM, Baik SH, Hwang HJ, Yoo HJ. Sestrin2 Regulates Beneficial β3-Adrenergic Receptor-Mediated Effects Observed in Inguinal White Adipose Tissue and Soleus Muscle. Endocrinol Metab (Seoul) 2022; 37:552-557. [PMID: 35798554 PMCID: PMC9262693 DOI: 10.3803/enm.2022.1421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/25/2022] [Indexed: 11/11/2022] Open
Abstract
Sestrin2, a well-known adenosine monophosphate-activated protein kinase (AMPK) regulator, plays a protective role against metabolic stress. The β3-adrenergic receptor (β3AR) induces fat browning and inhibits muscle atrophy in an AMPK-dependent manner. However, no prior research has examined the relationship of sestrin2 with β3AR in body composition changes. In this study, CL 316,243 (CL), a β3AR agonist, was administered to wild-type and sestrin2-knockout (KO) mice for 2 weeks, and fat and muscle tissues were harvested. CL induced AMPK phosphorylation, expression of brown-fat markers, and mitochondrial biogenesis, which resulted in the reduction of lipid droplet size in inguinal white adipose tissue (iWAT). These effects were not observed in sestrin2-KO mice. In CL-treated soleus muscle, sestrin2-KO was related to decreased myogenic gene expression and increased levels of muscle atrophy-related molecules. Our results suggest that sestrin2 is associated with beneficial β3AR-mediated changes in body composition, especially in iWAT and in the soleus.
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Affiliation(s)
- Min Jeong Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joo Won Kim
- BK21 Graduate Program, Department of Biomedical Sciences and Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hwan-Jin Hwang
- BK21 Graduate Program, Department of Biomedical Sciences and Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Hwan-Jin Hwang BK21 Graduate Program, Department of Biomedical Sciences and Department of Internal Medicine, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea Tel: +82-2-2626-1971, Fax: +82-2-2626-1096, E-mail:
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Corresponding authors: Hye Jin Yoo Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea Tel: +82-2-2626-3045, Fax: +82-2-2626-1096, E-mail:
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15
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Relationships between the Perception of Footwear Comfort and the Fear of Falls in People at the Early Period of Old Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106267. [PMID: 35627804 PMCID: PMC9141443 DOI: 10.3390/ijerph19106267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/13/2022] [Accepted: 05/20/2022] [Indexed: 12/04/2022]
Abstract
Objective: The present study aimed to analyze the relationships between the perceptions of footwear comfort with fear of falls in younger-old women and men. Participants: the population sample involved 100 free-living community dwellers aged 65−74. Design: the Falls Efficacy Scale-International and a visual analogue scale to assess perception of footwear comfort were used as research tools. Results: there were statistically significant differences in the FES-I results in people who suffered a fall in the last year compared to those who did not experience a fall (p < 0.001), as well as in the subjective assessment of mediolateral control in people who have suffered and have not suffered a fall in the last year (p = 0.033). In women, statistically significant relationships were found in the subjective assessment of shoe comfort in terms of arch height (p = 0.025) and material properties of the footwear (p = 0.036) with the results of FES-I. Conclusions: People who have fallen show a higher level of fear of falling. The assessment of footwear comfort in terms of mediolateral control was lower in the younger-old who had experienced a fall in the last year. In women, a worse assessment of arch height and material properties of the footwear is accompanied by greater fear of falling.
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16
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Jiang YN, Wang JX, Chen LY, Yao JJ, Ni L, Sheng JM, Shen X. Reliability and Validity of the Composite Activity-Related Fall Risk Scale. Front Neurol 2022; 13:832691. [PMID: 35392635 PMCID: PMC8980318 DOI: 10.3389/fneur.2022.832691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/28/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction The newly developed Composite Activity-related Risk of Falls Scale (CARFS) is designed to measure composite activity-related risk of falls (CARF) in relation to the activity-specific fear of falling and physical behavior. This study tested the reliability and validity of the CARFS in older people with various health statuses and persons with stroke or spinal cord injury. Methods Participants included 70 older adults, 38 persons with stroke, and 18 with spinal cord injury. They were first surveyed using a combined questionnaire including the CARFS and activity-specific balance confidence (ABC) scale in addition to items asking for personal and disease-related information, fall history, walking independence levels for examining internal consistency, ceiling and floor effects, and convergent validity in each participant group. One week after the initial survey, 33 older participants were reexamined using the CARFS to analyze test-retest reliability, where a minimal detectable change was found. Significance was set at α = 0.05 for all analyses. Results The CARFS showed excellent test-retest reliability in the dimensions of fear of falling, physical behavior, and CARF [ICC (3,1) = 0.972, 0.994, and 0.994, respectively for their overall score], with a minimal detectable change of 3.944 in the older population. The internal consistency of CARFS items was excellent in the older participants, good in participants with stroke or spinal cord injury (Cronbach's alpha = 0.945, 0.843, 0.831 in each participant group, respectively). No ceiling and floor effects were demonstrated in the wide range of people. For the convergent validity, overall CARF score was significantly correlated with the average ABC score in each participant group (rho = −0.824, −0.761, and −0.601, respectively; p < 0.01), and was significantly correlated with walking independence levels in each participant group (rho = −0.636, −0.423, and −0.522, respectively; p < 0.01). It showed weak correlation with the number of previous falls only in participants with stroke (rho = 0.291, p = 0.076). Conclusion The CARFS is a reliable and valid tool for measuring fall risk in older people and persons with stroke or spinal cord injury.
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Affiliation(s)
- Yan N. Jiang
- Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, China
| | - Jing X. Wang
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Lin Y. Chen
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Jia J. Yao
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Ling Ni
- Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, China
| | - Jie M. Sheng
- Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, China
| | - Xia Shen
- Rehabilitation Medicine Research Center, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Department of Rehabilitation Sciences, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Xia Shen
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17
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Löppönen A, Karavirta L, Koivunen K, Portegijs E, Rantanen T, Finni T, Delecluse C, Van Roie E, Rantalainen T. Association between free-living sit-to-stand transition characteristics, and lower-extremity performance, fear of falling, and stair negotiation difficulties among community-dwelling 75 to 85-year-old adults. J Gerontol A Biol Sci Med Sci 2022; 77:1644-1653. [PMID: 35313347 PMCID: PMC9373963 DOI: 10.1093/gerona/glac071] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Indexed: 11/28/2022] Open
Abstract
Background Good sit-to-stand (STS) performance is an important factor in maintaining functional independence. This study investigated whether free-living STS transition volume and intensity, assessed by a thigh-worn accelerometer, is associated with characteristics related to functional independence. Methods Free-living thigh-worn accelerometry was recorded continuously for 3–7 days in a population-based sample of 75-, 80-, and 85-year-old community-dwelling people (479 participants; women n = 287, men n = 192). The records were used to evaluate the number and intensity (angular velocity of the STS phase) of STS transitions. Associations with short physical performance battery (SPPB), 5-times-sit-to-stand test (5×STS), isometric knee extension force, self-reported fear of falls, and self-reported difficulty in negotiating stairs were also assessed. Results The number of STS transitions, mean and maximal angular velocity were lower in older age groups (p < .05). All variables were higher in men than in women (p < .001) and were positively associated with SPPB total points, knee extension force (r ranged from 0.18 to 0.39, all p < .001) and negatively associated with 5×STS (r = −0.13 – −0.24, all p < .05), lower extremity functional limitations (p < .01), fear of falls (p < .01), and stair negotiation difficulties (p < .01). Conclusions Free-living STS characteristics were related to lower-extremity performance, lower extremity functional limitations, self-reported fear of falls, and stair negotiation difficulties, which can be a sensitive indicator of impending functional decline. Moreover, STS transitions may provide an indicator of adequacy of lower-limb muscle strength among older individuals.
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Affiliation(s)
- Antti Löppönen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland.,Department of Movement Sciences, Physical Activity, Sports and Health Research Group, KU Leuven, Leuven, Belgium
| | - Laura Karavirta
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisa Koivunen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Erja Portegijs
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences and Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Christophe Delecluse
- Department of Movement Sciences, Physical Activity, Sports and Health Research Group, KU Leuven, Leuven, Belgium
| | - Evelien Van Roie
- Department of Movement Sciences, Physical Activity, Sports and Health Research Group, KU Leuven, Leuven, Belgium
| | - Timo Rantalainen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
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18
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Aoyagi GA, Pinto RZ, Lemes ÍR, Pastre CM, Eto BY, Faria MS, Morelhão PK, Franco MR. Fear of falling does not predict self-reported physical activity: an observational study with community-dwelling older adults. Physiotherapy 2022; 116:50-57. [DOI: 10.1016/j.physio.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 11/30/2022]
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19
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Brodowski H, Strutz N, Mueller-Werdan U, Kiselev J. Categorizing fear of falling using the survey of activities and fear of falling in the elderly questionnaire in a cohort of hospitalized older adults: A cross-sectional design. Int J Nurs Stud 2021; 126:104152. [PMID: 34923318 DOI: 10.1016/j.ijnurstu.2021.104152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Fear of falling is commonly assessed using the Activities-specific Balance Confidence Scale which is an instrument to measure balance confidence, based on the assumption that fear of falling is due to the absence of balance confidence. The "Survey of Activities and Fear of Falling in the Elderly" measures the concept of fear of falling more directly on a scale of 0.0 and 3.0 points. However, there are no valid cut-off points that might help practitioners to interpret "Survey of Activities and Fear of Falling in the Elderly" scores. The aim of this study was to identify such cut-off points and distinguish between low, moderate and high fear of falling, in relation to balance confidence. METHOD In this cross-sectional study different cut-off point schemes for classifying fear of falling scores as low, moderate or high were compared with F-values in ANOVA using the cut-off point scheme as an independent variable and the balance confidence scores as a dependent variable. The analysis was performed using data from a cohort of 98 hospitalized older adults. RESULTS Using the Activities-specific Balance Confidence Scale as a reference tool, values of 0.6 and 1.4 were identified as optimal cut-off points for low, moderate and high fear of falling. CONCLUSIONS This study was the first to systematically classify fear of falling using the "Survey of Activities and Fear of Falling in the Elderly". This classification can assist health practitioners to interpret fear of falling score and guide clinical decision making. Registration: The study is registered with the German Clinical Trials Register (DRKS00010773, date of registration 2016/05/07, date of recruitment 2016/11/07).
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Affiliation(s)
- Hanna Brodowski
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany; Geriatrics Research Group, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
| | - Nicole Strutz
- Geriatrics Research Group, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Ursula Mueller-Werdan
- Geriatrics Research Group, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Joern Kiselev
- Geriatrics Research Group, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany; Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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20
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Amaral Gomes ES, Ramsey KA, Rojer AGM, Reijnierse EM, Maier AB. The Association of Objectively Measured Physical Activity and Sedentary Behavior with (Instrumental) Activities of Daily Living in Community-Dwelling Older Adults: A Systematic Review. Clin Interv Aging 2021; 16:1877-1915. [PMID: 34737555 PMCID: PMC8560073 DOI: 10.2147/cia.s326686] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/27/2021] [Indexed: 12/16/2022] Open
Abstract
Up to 60% of older adults have a lifestyle characterized by low physical activity (PA) and high sedentary behavior (SB). This can amplify age-related declines in physical and cognitive functions and may therefore affect the ability to complete basic and instrumental activities of daily living (ADL and IADL, respectively), which are essential for independence. This systematic review aims to describe the association of objectively measured PA and SB with ADL and IADL in community-dwelling older adults. Six databases (PubMed, Embase, the Cochrane library, CINAHL, PsychINFO, SPORTDiscuss) were searched from inception to 21/06/2020 for articles meeting our eligibility criteria: 1) observational or experimental study, 2) participants’ mean/median age ≥60 years, 3) community-dwelling older adults, 4) PA and SB were measured with a(n) accelerometer/pedometer, 5) PA and SB were studied in relation to ADL and/or IADL. Risk of bias was assessed in duplicate using modified versions of the Newcastle–Ottawa scale. Effect direction heat maps provided an overview of associations and standardized regression coefficients (βs) were depicted in albatross plots. Thirty articles (6 longitudinal; 24 cross-sectional) were included representing 24,959 (range: 23 to 2749) community-dwelling older adults with mean/median age ranging from 60.0 to 92.3 years (54.6% female). Higher PA and lower SB were associated with better ability to complete ADL and IADL in all longitudinal studies and overall results of cross-sectional studies supported these associations, which underscores the importance of an active lifestyle. The median [interquartile range] of βs for associations of PA/SB with ADL and IADL were, respectively, 0.145 [0.072, 0.280] and 0.135 [0.093, 0.211]. Our strategy to address confounding may have suppressed the true relationship of PA and SB with ADL or IADL because of over-adjustment in some included studies. Future research should aim for standardization in PA and SB assessment to unravel dose–response relationships and inform guidelines.
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Affiliation(s)
- Elvira S Amaral Gomes
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Keenan A Ramsey
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Anna G M Rojer
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, 3050, Australia
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.,Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, 3050, Australia.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore
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21
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Wang T, Kamon M, Okada S, Sawada S, Ogawa R, Shiozawa N, Machida S. Design and Evaluation of an Online Squat Fitness System: Lessons Learned During the Early COVID-19 Pandemic in Japan. Front Digit Health 2021; 3:679630. [PMID: 34713150 PMCID: PMC8521995 DOI: 10.3389/fdgth.2021.679630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/03/2021] [Indexed: 11/25/2022] Open
Abstract
COVID-19 has changed our lives and limited our ability to have adequate physical activity (PA). It is necessary to replace outdoor PA with home-based fitness. However, people lack access, skills, and even motivation for home-based fitness. To address these issues, we designed a free access self-monitoring and coaching and music-based interactive online squat fitness system. Body weight squat was utilized for fitness exercise and evaluated based on three indices: knee width, hip depth, and rhythm. An online survey on changes in exercise due to the COVID-19 pandemic and exercise habits was conducted to investigate the effect of the COVID-19 pandemic on PA. We collected data from 557 respondents 5 months after the system first released and analyzed 200 visitors' performance on squat exercise and the other relevant parameters. Visitors were divided into three groups according to their age: younger, middle, and older groups. Results showed that the younger group had better squat performance than the middle and older groups in terms of hip depth and rhythm. We highlighted the lessons learned about the system design, fitness performance evaluation, and social aspects, for future study of the design and development of similar home-based fitness systems. We provided first-hand results on the relation between the COVID-19 pandemic and physical exercise among different age groups in Japan, which was valuable for policy making in the post-COVID-19 era.
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Affiliation(s)
- Tianyi Wang
- Department of Robotics, Faculty of Science and Engineering, Ritsumeikan University, Kusatsu, Japan.,Ritsumeikan Global Innovation Research Organization, Ritsumeikan University, Kusatsu, Japan
| | - Masamitsu Kamon
- Department of Robotics, Faculty of Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Shima Okada
- Department of Robotics, Faculty of Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Shuji Sawada
- Center of Innovation (COI) Project Center, Juntendo University, Tokyo, Japan
| | - Rui Ogawa
- Center of Innovation (COI) Site, Tokyo University of the Arts, Tokyo, Japan
| | - Naruhiro Shiozawa
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Shuichi Machida
- Center of Innovation (COI) Project Center, Juntendo University, Tokyo, Japan.,Graduate School of Health and Sports Science, Juntendo University, Inzai, Japan
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22
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Zahedian-Nasab N, Jaberi A, Shirazi F, Kavousipor S. Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial. BMC Geriatr 2021; 21:509. [PMID: 34563120 PMCID: PMC8465759 DOI: 10.1186/s12877-021-02462-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Deficient balance and fear of falling in elderly people can lead to disturbed daily activities, falling, and finally reduced quality of life. Therefore, evaluation of low-risk methods that might partially improve balance in this group of people is of utmost importance. The present study aimed to investigate the impact of Virtual Reality (VR) exercises based on Xbox Kinect on balance and fear of falling among elderly people. METHODS This clinical trial was performed on 60 elderly individuals living in nursing homes divided into two groups of control and Xbox. The participants in the intervention group received VR exercises based on Xbox Kinect in form of two 30-45-min sessions held on a weekly basis for 6 weeks. The individuals in the control group, on the other hand, received routine exercises of the nursing homes. The research tools used in this study included a demographic questionnaire, the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and the Falling Efficacy Scale (FES). RESULTS The findings of the current study demonstrated that the scores of BBS and TUG test as the indices of balance among elderly people improved significantly in the Xbox group after the intervention (p < 0.001 for both BBS and TUG test). Moreover, the score of fear of falling diminished significantly in the intervention group compared to the control group (p < 0.001). CONCLUSION According to the results of the present investigation, 6 weeks of VR balance exercises could enhance balance and fear of falling among elderly people living in nursing homes. TRIAL REGISTRATION Code: IRCT20190727044347N1 , Date: 17-8-2019.
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Affiliation(s)
- Noorolla Zahedian-Nasab
- Student Resarch Committe, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Jaberi
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Shirazi
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Somayyeh Kavousipor
- Occupational Therapy Department, School of Rehabilitation Sciences, Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Ramsey KA, Zhou W, Rojer AGM, Reijnierse EM, Maier AB. Associations of objectively measured physical activity and sedentary behaviour with fall-related outcomes in older adults: a systematic review. Ann Phys Rehabil Med 2021; 65:101571. [PMID: 34530151 DOI: 10.1016/j.rehab.2021.101571] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/23/2021] [Accepted: 07/11/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Higher physical activity (PA) and lower sedentary behaviour (SB) are associated with better muscle strength, balance, and functional ability, which are imperative for avoiding falls. This systematic review aimed to describe the association between objectively measured PA and SB with falls, fear of falling, and fractures. METHODS Six databases were searched from inception to July 21, 2020 for articles reporting the association of objectively measured PA/SB with falls, fear of falling, and/or fractures in community-dwelling older adults ≥60 years old. Results were synthesized in effect-direction heat maps and albatross plots expressed as Pearson's correlation coefficients (R). RESULTS A total of 43 articles were included, representing 27,629 (range 26 to 5,545) community-dwelling older adults (mean [SD] age 76.6 [8.4] years, 47% female). Longitudinal associations were reported in 13 articles and cross-sectional associations in 30. Falls were reported in 11 articles, fear of falling in 18 and fractures in 2. Higher PA and lower SB were associated with less fear of falling (median [interquartile range] Rs = steps: -0.214 [0.249; -0.148], total PA: -0.240 [0.267; -0.144], and moderate-to-vigorous PA: -0.180 [0.382; -0.121]), but these associations did not extend to falls or fractures, which showed inconsistent effect directions. CONCLUSION Fear of falling is associated with less engagement in PA and more SB, thus indicating that it is a psychological barrier to an active lifestyle. Varying effect directions for associations between PA and SB with falls and fractures may provide evidence for non-linear associations and require further research considering details of the fall or fracture incident. PROSPERO REGISTRATION NUMBER CRD42018103910.
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Affiliation(s)
- Keenan A Ramsey
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Waner Zhou
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
| | - Anna G M Rojer
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
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van Gameren M, Bossen D, Bosmans JE, Visser B, Frazer SWT, Pijnappels M. The (cost-)effectiveness of an implemented fall prevention intervention on falls and fall-related injuries among community-dwelling older adults with an increased risk of falls: protocol for the in balance randomized controlled trial. BMC Geriatr 2021; 21:381. [PMID: 34162353 PMCID: PMC8220122 DOI: 10.1186/s12877-021-02334-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/07/2021] [Indexed: 12/04/2022] Open
Abstract
Background Falls and fall-related injuries among older adults are a serious threat to the quality of life and result in high healthcare and societal costs. Despite evidence that falls can be prevented by fall prevention programmes, practical barriers may challenge the implementation of these programmes. In this study, we will investigate the effectiveness and cost-effectiveness of In Balance, a fourteen-week, low-cost group fall prevention intervention, that is widely implemented in community-dwelling older adults with an increased fall risk in the Netherlands. Moreover, we will be the first to include cost-effectiveness for this intervention. Based on previous evidence of the In Balance intervention in pre-frail older adults, we expect this intervention to be (cost-)effective after implementation-related adjustments on the target population and duration of the intervention. Methods This study is a single-blinded, multicenter randomized controlled trial. The target sample will consist of 256 community-dwelling non-frail and pre-frail adults of 65 years or older with an increased risk of falls. The intervention group receives the In Balance intervention as it is currently widely implemented in Dutch healthcare, which includes an educational component and physical exercises. The physical exercises are based on Tai Chi principles and focus on balance and strength. The control group receives general written physical activity recommendations. Primary outcomes are the number of falls and fall-related injuries over 12 months follow-up. Secondary outcomes consist of physical performance measures, physical activity, confidence, health status, quality of life, process evaluation and societal costs. Mixed model analyses will be conducted for both primary and secondary outcomes and will be stratified for non-frail and pre-frail adults. Discussion This trial will provide insight into the clinical and societal impact of an implemented Dutch fall prevention intervention and will have major benefits for older adults, society and health insurance companies. In addition, results of this study will inform healthcare professionals and policy makers about timely and (cost-)effective prevention of falls in older adults. Trial registration Netherlands Trial Register: NL9248 (registered February 13, 2021).
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Affiliation(s)
- Maaike van Gameren
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Daniël Bossen
- Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bart Visser
- Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Sanne W T Frazer
- Consumer Safety Institute (VeiligheidNL), Amsterdam, Netherlands
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
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Makino K, Lee S, Bae S, Chiba I, Harada K, Katayama O, Shinkai Y, Makizako H, Shimada H. Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study. Phys Ther 2021; 101:6131766. [PMID: 33561290 DOI: 10.1093/ptj/pzab059] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/06/2020] [Accepted: 01/03/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. METHODS A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48 ± 2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to "Are you afraid of falling?") at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. RESULTS Multivariable logistic regression showed that prefrailty or frailty increase the risk of not only future falls (odds ratio [OR]: 1.57; 95% CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95% CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95% CI = 1.04-1.68). CONCLUSIONS Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. IMPACT Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high risk not only for falls but also for FOF.
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Affiliation(s)
- Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Yohei Shinkai
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hyuma Makizako
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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Wang JX, Chen LY, Jiang YN, Ni L, Sheng JM, Shen X. Establishing content validity for a composite activities-specific risk of falls scale:linkage between fear of falling and physical activity. BMC Geriatr 2021; 21:275. [PMID: 33902488 PMCID: PMC8077745 DOI: 10.1186/s12877-021-02211-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 04/11/2021] [Indexed: 11/05/2022] Open
Abstract
Background Fear of falling (FoF) and physical activity (PA) are important psychological and behavioral factors associated with falls. No instrument quantifies the link between these two factors to evaluate the risk of falls. We aimed to design a scale linking FoF with PA (Composite Activities-specific Risk of Falls Scale, CARFS) for people with various disability levels. Methods First, we designed a questionnaire comprising 40 balance-related activities from the International Classification of Functioning, Disability, and Health (ICF) for a pilot survey. Second, participants were interviewed about their activities-specific FoF degree and PA frequency. The participants comprised 30 community-dwelling older adults, hospitalized patients with strokes, and those with spinal cord injuries, each with different disability levels. Third, the content validity of the items was evaluated twice by 12 experienced rehabilitation professionals: one based on experience and the other on the survey responses. Items with a higher than moderate relevance in both evaluations were included in the CARFS. The panel of professionals discussed and voted on the contribution of FoF and PA on the CARF score. Finally, the scale sensitivity in distinguishing disability levels was analyzed to evaluate the population suitability to the CARFS. Results The CARFS included 14 activities. A five-point Likert scale was used to quantify degree of FoF (A) and frequency of PA (B). The CARF score (C), which was determined using the eq. C = A+(4-B) + A × B/2, reflected sensitivity to disability levels in most items. Conclusions The CARFS has strong content validity for measuring risk of falls in relation to the FoF and PA of people with various disability levels. It has a potential to provide a guide for designing individualized exercise- and behavior-focused fall prevention programs and enable the precise trtrun 0acking of program effectiveness as a multidimensional outcome measure. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02211-z.
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Affiliation(s)
- Jing X Wang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China
| | - Lin Y Chen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China
| | - Yan N Jiang
- Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, 200092, China
| | - Ling Ni
- Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, 200092, China
| | - Jie M Sheng
- Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, 200092, China
| | - Xia Shen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China. .,Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, 200092, China. .,Department of Physical Therapy, Yangzhi Affiliated Rehabilitation Hospital of Tongji University, Shanghai, 201619, China.
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27
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Thiamwong L, Stout JR, Park JH, Yan X. Technology-Based Fall Risk Assessments for Older Adults in Low-Income Settings: Protocol for a Cross-sectional Study. JMIR Res Protoc 2021; 10:e27381. [PMID: 33825688 PMCID: PMC8060859 DOI: 10.2196/27381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/19/2021] [Indexed: 01/20/2023] Open
Abstract
Background One-third of older adults have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between the level of fear of falling (FOF) and physiological fall risk (balance performance). Older adults who overestimate their physiological fall risk and report a high FOF are less likely to participate in physical activity. Limited data suggest that the association among FOF, body composition, and physical activity intensity differs by fear severity.
Objective This study aims to examine the associations among FRA, body composition, and physical activity using assistive health technology, including the BTrackS balance system, bioelectrical impedance analysis, and activity monitoring devices. This study also aims to examine the feasibility of recruitment and acceptability of technologies and procedures for use among older adults in low-income settings.
Methods This cross-sectional study will be conducted in older adults’ homes or apartments in low-income settings in Central Florida, United States. Following consent, participants will be contacted, and our team will visit them twice. The first visit includes questionnaire completion (eg, sociodemographic or FOF) and balance performance test using the BTrackS balance system. The participants will be stratified by the FRA matrix. In addition, they will perform hand grip strength and dynamic balance performance tests. Participants will then be asked to wear the ActiGraph GT9X Link wireless activity monitor on the nondominant wrist for 7 consecutive days. The second visit includes body composition testing and a structured interview about the acceptability of the technologies and procedures.
Results Ethical approval was obtained from the institutional review board of the University of Central Florida (protocol number 2189; September 10, 2020). As of December 2020, participation enrollment is ongoing and the results are expected to be published in Summer 2022.
Conclusions Accurate FRA is essential for implementing physical activity programs, especially in older adults with low income. This study will provide data for developing technology-based fall risk assessments to improve participation in physical activity, thus enhancing healthy longevity among older adults in low-income settings.
International Registered Report Identifier (IRRID) PRR1-10.2196/27381
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Affiliation(s)
- Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, United States.,Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R Stout
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States.,School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States.,Mechanical and Aerospace Engineering Department, University of Central Florida, Orlando, FL, United States
| | - Xin Yan
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States
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Association Between the Modified Functional Movement Screen Scores, Fear of Falling, and Self-Perceived Balance in Active Older Adults. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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“Someone’s Got My Back”: Older People’s Experience of the Coaching for Healthy Ageing Program for Promoting Physical Activity and Preventing Falls. J Aging Phys Act 2021; 29:296-307. [DOI: 10.1123/japa.2020-0116] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/22/2020] [Accepted: 07/08/2020] [Indexed: 11/18/2022]
Abstract
The Coaching for Healthy Ageing trial evaluated the impact on physical activity (PA) and falls based on a year-long intervention in which participants aged 60+ receive a home visit, regular health coaching by physiotherapists, and a free activity monitor. This interview study describes the participants’ experiences of the intervention and ideas for improvement. The authors sampled purposively for maximum variation in experiences. The data were analyzed thematically by two researchers. Most of the 32 participants reported that the intervention increased PA levels, embedded activities, and generated positivity about PA. They were motivated by quantified PA feedback, self-directed goals, and person-centered coaching. Social connectivity motivated some, but the intervention did not support this well. The intervention structure allowed participants to trial and embed activities. Autonomy and relatedness were emphasized and should be included in future program theory. The authors identified synergistic effects, likely “essential ingredients,” and potential areas for improving this and similar interventions.
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30
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Effect of Progressive Step Marching Exercise on Balance Ability in the Elderly: A Cluster Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063146. [PMID: 33803720 PMCID: PMC8003065 DOI: 10.3390/ijerph18063146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 12/28/2022]
Abstract
Exercise may reduce the risk of falls in the elderly. The objective of the study was to determine the effect of a progressive step marching exercise (PSME) program on balance ability, lower limb muscle strength, aerobic capacity, quality of life, and fear of falling in the elderly. A cluster randomized controlled trial was selected where 30 elderly participants (aged 69 ± 3 years) from a community were supervised while performing a PSME program and 30 (aged 70 ± 3 years) from another community were assigned to a control group. All participants in both groups underwent timed up and go test, one leg standing test, five time sit to stand test, two minutes step test, World Health Organization Quality of Life-Thai version, and fall efficacy scale Thai version at baseline, after exercise at 4 and 8 weeks. The PSME group underwent the program for 8 weeks while those in the control group were instructed to continue their normal activity. After training, the PSME showed significant improvement (p < 0.05) in all parameters except one leg standing and two minutes step test when compared to the control group (p < 0.05). In conclusion, the PSME program could improve balance ability, lower limb muscle strength, quality of life, and fear of falling in the elderly.
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31
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Yoshikawa A, Ramirez G, Smith ML, Lee S, Ory MG. Systematic review and meta-analysis of fear of falling and fall-related efficacy in a widely disseminated community-based fall prevention program. Arch Gerontol Geriatr 2020; 91:104235. [PMID: 32911232 DOI: 10.1016/j.archger.2020.104235] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 07/29/2020] [Accepted: 08/12/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fear of falling restricts mobility and increases fall risk among older adults. Fall-related efficacy (i.e. the confidence to perform activities without falling), a construct related to fear of falling, has also been associated with active living and fall prevention. This study statistically synthesized the program effects of A Matter of Balance Volunteer Lay Leader (AMOB/VLL) model, designed to improve fall-related efficacy and promote daily activities among community-dwelling older adults. METHODS Research articles and doctoral dissertations that examined the effect of the AMOB/VLL on fear of falling and fall-related efficacy were searched from multiple databases. A random effects model was used to compute mean weighted effect sizes, 95 % CIs, and heterogeneity (I2). Bias was examined through a funnel plot and Egger's test. Factors associated with heterogeneity were also explored. RESULTS Seventeen AMOB/VLL studies involving 3,860 participants were identified. The pooled effects of the 13 studies with sufficient information for effect size calculation, were -0.29 (95 % CI: -0.40, -0.19) for fear of falling and 0.51 (95 % CI: 0.42, 0.60) for fall-related efficacy. Effect sizes differed partially due to outcome measures of fall-related efficacy. Covariate adjustment and study quality were not associated with differences in effect sizes. No substantial evidence of asymmetry and publication bias was found. CONCLUSION This study provides evidence supporting AMOB/VLL as an effective intervention for reducing fear of falling and improving fall-related efficacy. A greater consistency in outcome measures is needed to optimally capture changes in fear of falling and fall-related efficacy among community-dwelling older adults.
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Affiliation(s)
- Aya Yoshikawa
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA.
| | - Gilbert Ramirez
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX 77843, USA.
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA; Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA 30602, USA.
| | - Shinduk Lee
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA.
| | - Marcia G Ory
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA.
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E JY, Mihailovic A, Kuo PL, West SK, Friedman DS, Gitlin LN, Li T, Schrack JA, Ramulu PY. Characterizing the Impact of Fear of Falling on Activity and Falls in Older Adults with Glaucoma. J Am Geriatr Soc 2020; 68:1847-1851. [PMID: 32413186 DOI: 10.1111/jgs.16516] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/25/2020] [Accepted: 04/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Fear of falling (FoF) may alter mobility in older adults, especially among those with visual impairment. Using a longitudinal prospective cohort of older glaucoma patients, we investigated whether and how FoF is associated with future falls and physical activity. DESIGN Prospective observational cohort study. SETTING Hospital-based single-center recruitment. PARTICIPANTS Individuals with glaucoma or suspected glaucoma. MEASUREMENTS FoF was measured annually over a 3-year period using the University of Illinois at Chicago FoF Questionnaire, with lower Rasch-analyzed FoF scores (in logit units) indicating less fear. Participants recorded falls prospectively over the 3-year period using monthly mail-in calendars. Daily steps were collected annually over 7 days using an accelerometer. Visual field (VF) sensitivity was derived by combining sensitivities from monocular VF results. Participants completed questionnaires to determine other demographic/health characteristics. Multivariate random effects models evaluated within-participant changes in fall rates and physical activity across study years. RESULTS At lower FoF levels (FoF≤0), each one-unit worsening in FoF score across study years was associated with 2.73 times higher odds of reporting at least one fall in the next year (95% confidence interval [CI] = 1.55-4.81) but was not associated with average daily steps (P = .44). Similar results were seen when fall rates were normalized by number of steps taken (P = .97). At higher FoF levels (FoF > 0), inter-year changes in FoF scores were not significantly associated with reporting a fall in the following year (P = .78) but were associated with 407 fewer average daily steps per one-unit change in FoF (95% CI = -743 to -71). CONCLUSION FoF is an important psychological factor associated with mobility in glaucoma patients, although specific aspects of mobility (fall rates vs activity levels) affected vary by the degree of FoF. Our findings suggest that customizing behavioral interventions for older adults based on their levels of FoF may be an important strategy for fall prevention and activity promotion. J Am Geriatr Soc 68:1847-1851, 2020.
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Affiliation(s)
- Jian-Yu E
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Pei-Lun Kuo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sheila K West
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David S Friedman
- Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Pradeep Y Ramulu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
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Anders P, Bengtson EI, Grønvik KB, Skjæret-Maroni N, Vereijken B. Balance Training in Older Adults Using Exergames: Game Speed and Cognitive Elements Affect How Seniors Play. Front Sports Act Living 2020; 2:54. [PMID: 33345045 PMCID: PMC7739609 DOI: 10.3389/fspor.2020.00054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/16/2020] [Indexed: 11/21/2022] Open
Abstract
Falls in older adults are a serious threat to their health and independence, and a prominent reason for institutionalization. Incorrect weight shifts and poor executive functioning have been identified as important causes for falling. Exergames are increasingly used to train both balance and executive functions in older adults, but it is unknown how game characteristics affect the movements of older adults during exergaming. The aim of this study was to investigate how two key game elements, game speed, and the presence of obstacles, influence movement characteristics in older adults playing a balance training exergame. Fifteen older adults (74 ± 4.4 years) played a step-based balance training exergame, designed specifically for seniors to elicit weight shifts and arm stretches. The task consisted of moving sideways to catch falling grapes and avoid obstacles (falling branches), and of raising the arms to catch stationary chickens that appeared above the avatar. No steps in anterior-posterior direction were required in the game. Participants played the game for eight 2 min trials in total, at two speed settings and with or without obstacles, in a counterbalanced order across participants. A 3D motion capture system was used to capture position data of 22 markers fixed to upper and lower body. Calculated variables included step size, step frequency, single leg support, arm lift frequency, and horizontal trunk displacement. Increased game speed resulted in a decrease in mean single support time, step size, and arm lift frequency, and an increase in cadence, game score, and number of error messages. The presence of obstacles resulted in a decrease in single support ratio, step size, cadence, frequency of arm lifts, and game score. In addition, step size increased from the first to the second trial repetition. These results show that both game speed and the presence of obstacles influence players' movement characteristics, but only some of these effects are considered beneficial for balance training whereas others are detrimental. These findings underscore that an informed approach is necessary when designing exergames so that game settings contribute to rather than hinder eliciting the required movements for effective balance training.
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Affiliation(s)
- Phillipp Anders
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Espen Ingvald Bengtson
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway
| | - Karoline Blix Grønvik
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Nina Skjæret-Maroni
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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The Effect of Chemotherapy on Balance, Gait, and Falls Among Cancer Survivors: A Scoping Review. REHABILITATION ONCOLOGY 2020. [DOI: 10.1097/01.reo.0000000000000238] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ganesh GS, Dakshinamoorthy A, Ponmathi P, Swain S. Association Between Falls Experience and Physical Performance Measures in Community-Living Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2019.1709601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- G. Shankar Ganesh
- Faculty of Physiotherapy, Composite Regional Center for Skill Development, Rehabilitation, and Empowerment of Persons with Disabilities, Lucknow, India
| | | | - P. Ponmathi
- Faculty of Physiotherapy, Sri Ramachandra University, Chennai, India
| | - Subhashisa Swain
- School of Medicine, Clinical Sciences Building, University of Nottingham, Nottingham, UK
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Kang GE, Najafi B. Sensor-Based Daily Physical Activity: Towards Prediction of the Level of Concern about Falling in Peripheral Neuropathy. SENSORS 2020; 20:s20020505. [PMID: 31963201 PMCID: PMC7014201 DOI: 10.3390/s20020505] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/10/2020] [Accepted: 01/15/2020] [Indexed: 12/16/2022]
Abstract
Concern about falling is prevalent and increases the risk of falling in people with peripheral neuropathy (PN). However, the assessment of concern about falling relies on self-report surveys, and thus continuous monitoring has not been possible. We investigated the influence of concern about falling on sensor-based daily physical activity among people with PN. Forty-nine people with PN and various levels of concern about falling participated in this study. Physical activity outcomes were measured over a period of 48 hours using a validated chest-worn sensor. The level of concern about falling was assessed using the falls efficacy scale-international (FES-I). The low concern group spent approximately 80 min more in walking and approximately 100 min less in sitting/lying compared to the high concern group. In addition, the low concern group had approximately 50% more walking bouts and step counts compared to the high concern group. Across all participants, the duration of walking bouts and total step counts was significantly correlated with FES-I scores. The duration of walking bouts and total step counts may serve as eHealth targets and strategies for fall risk assessment among people with PN.
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Lipardo DS, Leung AYM, Gabuyo CMA, Escuadra CJT, Leung PA, Aseron AMC, Hernandez KAV, Diaz JB, Tsang WWN. Cross-cultural adaptation and psychometric properties of the Falls Efficacy Scale - International in Filipino community-dwelling older adults. Disabil Rehabil 2019; 42:1292-1298. [PMID: 30668161 DOI: 10.1080/09638288.2018.1519045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: The Falls Efficacy Scale - International is universally used in assessing the level of concern about falling in older adults. The objectives of this study were to conduct a cross-cultural adaptation and to establish psychometric properties of Falls Efficacy Scale - International in Filipino (FES-I F).Methods: The standardized 10-step translation protocol of the Prevention of Falls Network Europe was followed. Community-dwelling older adults aged 60 or above (N = 211) from Manila, Philippines were recruited. The internal consistency and test-retest reliability of the translated tool was assessed. Convergent validity was compared with fall-related factors. The receiver operating characteristics were used to determine the cutoff score.Results: The FES-I F has high internal consistency (α = 0.91) and good test-retest reliability (intraclass correlation coefficient = 0.86). Overall scores were significantly higher among those with subjective report of fear of falling (p < 0.001), lower timed up and go test scores (p = 0.014), slower gait speed (p = 0.003), and lower perceived well-being scores (p = 0.003) indicating acceptable convergent validity. The cutoff score of FES-I F was 22 points.Conclusions: The FES-I F has high internal reliability and acceptable validity, and can be a practical tool to measure the concern about falling in Filipino older adults. Future research is necessary to establish its utilization as an outcome measure in intervention studies.Implications for rehabilitationThe psychometric properties of the Filipino version of the Falls Efficacy Scale - International were good when assessed in older adults living in the community.The cutoff score to demarcate those with fear of falling from those without is 22 points.Falls Efficacy Scale - International in Filipino is recommended for the assessment of fear of falling for research and clinical purposes.
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Affiliation(s)
- Donald S Lipardo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.,Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Angela Y M Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Cherry May A Gabuyo
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Catherine Joy T Escuadra
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Patrick Ansel Leung
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Anne Marie C Aseron
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Kathlene Anne V Hernandez
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Joselito B Diaz
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - William W N Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Abstract
PURPOSE The aim of the study was to identify risk factors for falls among cancer survivors. DESIGN Integrative literature review. METHODS We searched PubMed, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and PEDro for studies investigating fall risk in cancer. Reports of randomized controlled trials, descriptive studies (quantitative and qualitative), and theoretical papers meeting predetermined criteria were included. Quality ratings of included studies were done, and data were extracted and compiled by two independent reviewers. FINDINGS Twenty-nine articles met inclusion criteria. Literature quality was moderate (median quality score: 1.67 out of 3 possible points). Heterogeneity of statistics and reporting methods precluded calculation of summary effect sizes, but physical function, cognitive function, balance/gait, and certain medication types appear to increase fall risk. CONCLUSIONS AND CLINICAL RELEVANCE Modifiable risk factors, such as those identified in this review, represent tangible intervention targets for rehabilitation professionals for decreasing the risk of falls among cancer survivors.
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Rodrigues EV, Gallo LH, Guimarães ATB, Melo Filho J, Luna BC, Gomes ARS. Effects of Dance Exergaming on Depressive Symptoms, Fear of Falling, and Musculoskeletal Function in Fallers and Nonfallers Community-Dwelling Older Women. Rejuvenation Res 2018; 21:518-526. [PMID: 29669458 DOI: 10.1089/rej.2017.2041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to evaluate the effects of a pop dance exergaming protocol on fall risk factors-depressive symptoms, fear of falling, and musculoskeletal function-in community-dwelling older female fallers and nonfallers. There were 47 community-dwelling older women assigned to the intervention group (IG) [fallers (n = 10, 69.8 ± 4.3 years); nonfallers (n = 12, 68.9 ± 3.3 years)] and the control group (CG) [fallers (n = 12, 73.6 ± 5.4 years); nonfallers (n = 13, 68.7 ± 4.8 years)]. The CG maintained their lifestyle and the IG performed a videogame dance training three times per week for 12 weeks. The Dance Central game for Xbox 360® and Kinect motion sensor were used. The primary outcomes were geriatric depressive symptoms, fear of falling, and concentric and eccentric isokinetic peak torque (PT) of quadriceps and hamstrings. Secondary outcomes included cross-sectional area of quadriceps and hamstring muscles, functionality (Timed Up and Go test, gait speed, the Five Times Sit-to-Stand test), and a fall circumstances and outcomes recording. The depressive symptoms decreased in the Intervention Fallers Group. The eccentric hamstrings PT at 180°/s increased in the Intervention Nonfallers Group. There were no significant differences between groups for the other variables analyzed. The training attendance was 83% for the Intervention Fallers Group and 88% for the Intervention Nonfallers Group. Dance exergaming can be indicated to decrease depressive symptoms in fallers and increase the PT in nonfallers among community-dwelling older women.
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Affiliation(s)
- Elisângela Valevein Rodrigues
- 1 Massage Therapy Department, Federal Institute of Parana, Curitiba, Parana, Brazil
- 2 Department of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
| | - Luiza Herminia Gallo
- 2 Department of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
| | | | - Jarbas Melo Filho
- 2 Department of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
| | - Bruna Cavon Luna
- 4 Prevention and Rehabilitation in Physiotherapy Department, Federal University of Parana, Curitiba, Parana, Brazil
| | - Anna Raquel Silveira Gomes
- 2 Department of Physical Education, Federal University of Parana, Curitiba, Parana, Brazil
- 4 Prevention and Rehabilitation in Physiotherapy Department, Federal University of Parana, Curitiba, Parana, Brazil
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Mahmoodabad SSM, Zareipour M, Askarishahi M, Beigomi A. Effect of the Living Environment on falls among the Elderly in Urmia. Open Access Maced J Med Sci 2018; 6:2233-2238. [PMID: 30559894 PMCID: PMC6290408 DOI: 10.3889/oamjms.2018.434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 10/19/2018] [Accepted: 10/21/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The living environment has an impact on the health of the elderly, and the safety of the house is one of the concerns of the elderly. Disregarding the safety concerns increases the falling. AIM: This research was conducted with the aim of influencing the living environment on falls among elderly people in Urmia city. METHODS: This is a cross-sectional (descriptive-analytic) study which 200 elderly people were selected by random cluster sampling. Data were collected by using a two-part questionnaire including demographic information, and home safety assessment checklist. Data were analysed by using chi-square test and logistic regression in SPSS v. 21 software. RESULTS: The incidence of falling in the elderly was 30%. There was a significant statistical association with age, sex, marital status and history of chronic disease. Results of logistic regression showed non-safe stairs (OR = 1.1, p = 0.002), unsafe toilet/bath (OR = 1.3, p = 0.001), unsafe bedrooms (OR = 1.7, p = 0.05) unsafe living room (OR = 1.4, p = 0.02) increase the falls in the elderly, as well as male gender (OR = 1.14, p < 0.001) and living with other people (OR = 0.19, p = 0.002) reduce the falls in the elderly. CONCLUSION: By identifying the risk factors of the physical space of the home, we can plan for implementing necessary interventions according to the risk factor or risk factors to prevent and reduce the falls in the elderly community.
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Affiliation(s)
- Seyed Saeed Mazloomy Mahmoodabad
- Social Determinants of Health Research Center, Department of Health Education & Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Moradali Zareipour
- Social Determinants of Health Research Center, Department of Health Education & Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Askarishahi
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Bio-Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Beigomi
- Department of Health Education & Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Sawa R, Asai T, Doi T, Misu S, Murata S, Ono R. The Association Between Physical Activity, Including Physical Activity Intensity, and Fear of Falling Differs by Fear Severity in Older Adults Living in the Community. J Gerontol B Psychol Sci Soc Sci 2018; 75:953-960. [DOI: 10.1093/geronb/gby103] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
Fear of falling (FoF) is common in older adults. Physical activity decreases as FoF increases. However, this association between physical activity and FoF may vary depending on activity intensity. The current study was performed to explore the associations between FoF and step count, light-intensity physical activity (LPA), and moderate/vigorous-intensity physical activity (MVPA) in community-dwelling older adults.
Methods
This cross-sectional observational study was held at a local community association center, with 242 older adults living independently in the community (mean age: 75.1 ± 5.4 years). FoF was defined using the Falls Efficacy Scale-International and categorized into three levels (low, moderate, and high). Physical activity was measured using a uniaxial accelerometer worn for 7 consecutive days, and by calculating daily step count, LPA, and MVPA, over this period.
Results
Step count and physical activity intensity showed significant linear trends across FoF severity (p < .01, respectively). High FoF decreased step count by approximately 2,000 steps/day. Further, high FoF was significantly associated with short durations of both LPA and MVPA. In addition, moderate FoF was associated with decreased LPA duration, even after adjustment for confounding variables.
Discussion
Physical activity decreased concomitantly with a rise in FoF severity. Moreover, the association between physical activity and FoF differed by physical activity intensity level in community-dwelling older adults. Further studies are needed to investigate the causal relationship between FoF and objective physical activity in this population.
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Affiliation(s)
- Ryuichi Sawa
- Japan Center for International Exchange, Japan
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Japan
| | - Tsuyoshi Asai
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Shogo Misu
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Japan
| | - Shunsuke Murata
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Japan
- Japan Society for the Promotion of Science, Japan
| | - Rei Ono
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Japan
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Edwards N, Dulai J. Examining the relationships between walkability and physical activity among older persons: what about stairs? BMC Public Health 2018; 18:1025. [PMID: 30119657 PMCID: PMC6098658 DOI: 10.1186/s12889-018-5945-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 08/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Walkability is considered an important dimension of healthy communities. However, variable associations between measures of walkability and physical activity have been observed, particularly among older persons. Given the challenges older persons may have navigating stairs on walking routes, the presence of stairs may be an explanatory factor for these mixed associations. The purposes of this scoping review were to determine whether studies examining the relationship between walkability and physical activity included items that assessed stairs and what relationships were found. METHODS Systematic reviews were identified by entering search terms into five database search engines. Eligibility criteria were: a) published between 2008 and 2017, b) examined the relationship between walkability and physical activity, c) included a focus on persons aged 65 years and older, and d) written in English. The full articles for all primary studies included in eligible systematic reviews were then retrieved. Duplicates were removed. Information about where the study took place, walkability measures used, types of walkability data obtained (objective and/or subjective) and questions asked about stairs were extracted from the full text articles. RESULTS Eleven systematic reviews were identified; seven were eligible. After removing duplicates, 289 primary studies remained for review. Measures of neighborhood walkability were present in 205 studies; a minority (n = 5, 2.4%) included items about stairs. No information was obtained on the structural features of the stairs. CONCLUSIONS The presence of stairs may deter older persons (and others) from walking outdoors. Standard measures to document the presence and characteristics of stairs, and sampling approaches to select stairs for assessment are needed. The inclusion of these measures would augment the utility and comparability of studies examining relationships between walkability and physical activity and better inform planning and policy decisions.
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Affiliation(s)
- Nancy Edwards
- School of Nursing, University of Ottawa, 1 Stewart Street Room 205, Ottawa, ON K1H8M5 Canada
| | - Joshun Dulai
- School of Nursing, University of Ottawa, 1 Stewart Street, Room 127, Ottawa, ON K1N 7M9 Canada
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Cross-cultural validation of the Modified Falls Efficacy Scale in Serbian community-dwelling women at risk for osteoporotic fracture. Menopause 2018; 25:444-450. [DOI: 10.1097/gme.0000000000001009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Mortazavi H, Tabatabaeichehr M, Taherpour M, Masoumi M. Relationship Between Home Safety and Prevalence of Falls and Fear of Falling Among Elderly People: a Cross-sectional Study. Mater Sociomed 2018; 30:103-107. [PMID: 30061798 PMCID: PMC6029911 DOI: 10.5455/msm.2018.30.103-107] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Falls and fear of falling are considered as the major factors affecting the elderly’s disabilities, so that most of these individuals often find their homes as a safe environment. Aim: The aim of this study was to evaluate the relationship between home safety and prevalence of falls and fear of falling among older adults. Materials and Methods: This cross-sectional study was conducted on 450 elderly people who lived in Bojnrud, Northeast of Iran, from December 2016 to July 2017 using cluster sampling method. A demographic characteristics questionnaire, Fall Efficiency Scale-International (FES-I)questionnaire, and Home Safety Checklist were employed as research instruments. Results: Out of the study population, 157 individuals (35.7%) had a history of falls in the past one year. The mean score for fear of falling in the elderly people examined was 29.14±11.07 and the same value for home safety status was equal to 11.31±4.17. The mean score for fear of falling was significantly correlated with history of falls in older adults (p<0.0001). There was also a statistically significant relationship between home safety status and prevalence of falls and fear of falling in the elderly (p<0.0001). Besides, the results of logistic regression analysis showed that fear of falling could be estimated by 29-51%, taking the history of falls in the last 12 months and home safety mean score into account (p<0.0001). Conclusion: Home safety status and demographic variables could have effects on falls and fear of falling in elderly individuals. Therefore, putting these factors together, older adults at the risk of further falls can be identified and provided with trainings through planning and appropriate interventions to prevent the incidence of falls and their negative consequences among them.
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Affiliation(s)
- Hamed Mortazavi
- Gerontological Care Research Center, Department of Geriatric Nursing, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mahbubeh Tabatabaeichehr
- Gerontological Care Research Center, Department of Midwifery, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Masoumeh Taherpour
- Department of Biostatistics, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohadece Masoumi
- Student Research Committee, Gerontological Care Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Rye Hanton C, Kwon YJ, Aung T, Whittington J, High RR, Goulding EH, Schenk AK, Bonasera SJ. Mobile Phone-Based Measures of Activity, Step Count, and Gait Speed: Results From a Study of Older Ambulatory Adults in a Naturalistic Setting. JMIR Mhealth Uhealth 2017; 5:e104. [PMID: 28974482 PMCID: PMC5645644 DOI: 10.2196/mhealth.5090] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 01/05/2016] [Indexed: 11/13/2022] Open
Abstract
Background Cellular mobile telephone technology shows much promise for delivering and evaluating healthcare interventions in cost-effective manners with minimal barriers to access. There is little data demonstrating that these devices can accurately measure clinically important aspects of individual functional status in naturalistic environments outside of the laboratory. Objective The objective of this study was to demonstrate that data derived from ubiquitous mobile phone technology, using algorithms developed and previously validated by our lab in a controlled setting, can be employed to continuously and noninvasively measure aspects of participant (subject) health status including step counts, gait speed, and activity level, in a naturalistic community setting. A second objective was to compare our mobile phone-based data against current standard survey-based gait instruments and clinical physical performance measures in order to determine whether they measured similar or independent constructs. Methods A total of 43 ambulatory, independently dwelling older adults were recruited from Nebraska Medicine, including 25 (58%, 25/43) healthy control individuals from our Engage Wellness Center and 18 (42%, 18/43) functionally impaired, cognitively intact individuals (who met at least 3 of 5 criteria for frailty) from our ambulatory Geriatrics Clinic. The following previously-validated surveys were obtained on study day 1: (1) Late Life Function and Disability Instrument (LLFDI); (2) Survey of Activities and Fear of Falling in the Elderly (SAFFE); (3) Patient Reported Outcomes Measurement Information System (PROMIS), short form version 1.0 Physical Function 10a (PROMIS-PF); and (4) PROMIS Global Health, short form version 1.1 (PROMIS-GH). In addition, clinical physical performance measurements of frailty (10 foot Get up and Go, 4 Meter walk, and Figure-of-8 Walk [F8W]) were also obtained. These metrics were compared to our mobile phone-based metrics collected from the participants in the community over a 24-hour period occurring within 1 week of the initial assessment. Results We identified statistically significant differences between functionally intact and frail participants in mobile phone-derived measures of percent activity (P=.002, t test), active versus inactive status (P=.02, t test), average step counts (P<.001, repeated measures analysis of variance [ANOVA]) and gait speed (P<.001, t test). In functionally intact individuals, the above mobile phone metrics assessed aspects of functional status independent (Bland-Altman and correlation analysis) of both survey- and/or performance battery-based functional measures. In contrast, in frail individuals, the above mobile phone metrics correlated with submeasures of both SAFFE and PROMIS-GH. Conclusions Continuous mobile phone-based measures of participant community activity and mobility strongly differentiate between persons with intact functional status and persons with a frailty phenotype. These measures assess dimensions of functional status independent of those measured using current validated questionnaires and physical performance assessments to identify functional compromise. Mobile phone-based gait measures may provide a more readily accessible and less-time consuming measure of gait, while further providing clinicians with longitudinal gait measures that are currently difficult to obtain.
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Affiliation(s)
- Cassia Rye Hanton
- Department of Internal Medicine, Division of Geriatrics, University of Nebraska Medical Center, Omaha, NE, United States
| | - Yong-Jun Kwon
- Department of Physics, Randolph College, Lynchburg, VA, United States
| | - Thawda Aung
- Department of Physics, Randolph College, Lynchburg, VA, United States
| | - Jackie Whittington
- Department of Internal Medicine, Division of Geriatrics, University of Nebraska Medical Center, Omaha, NE, United States
| | - Robin R High
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Evan H Goulding
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, United States
| | - A Katrin Schenk
- Department of Physics, Randolph College, Lynchburg, VA, United States
| | - Stephen J Bonasera
- Department of Internal Medicine, Division of Geriatrics, University of Nebraska Medical Center, Omaha, NE, United States
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Quicke JG, Foster NE, Ogollah RO, Croft PR, Holden MA. Relationship Between Attitudes and Beliefs and Physical Activity in Older Adults With Knee Pain: Secondary Analysis of a Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2017; 69:1192-1200. [PMID: 27696795 PMCID: PMC5601293 DOI: 10.1002/acr.23104] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/19/2016] [Accepted: 09/27/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA). METHODS We conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross-sectional and longitudinal associations between baseline Self-Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self-report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6-month followup) were investigated using multiple linear and logistic regression. RESULTS Cross-sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found. CONCLUSION Greater exercise self-efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity.
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Affiliation(s)
- Jonathan G Quicke
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Nadine E Foster
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Reuben O Ogollah
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Peter R Croft
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Melanie A Holden
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
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Kim M, Lim SK, Shin S, Lee JH. The effects of objectively measured physical activity and fitness on fear of falling among Korean older women. J Exerc Rehabil 2016; 12:489-493. [PMID: 27807530 PMCID: PMC5091067 DOI: 10.12965/jer.1632716.358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 09/20/2016] [Indexed: 11/22/2022] Open
Abstract
We examined the effects of objectively measured physical activity (PA) and physical fitness (PF) on fear of falling (FOF) among older adults. The subjects were 94 Korean females aged 65–79. PA was measured with accelerometers, PF with the senior fitness test and FOF with the Korean Survey of Activities and Fear of Falling in the Elderly. With the subjects’ age, number of chronic conditions, and history of falls included as correction factors, a multiple regression analysis showed that PA (P=0.016) and agility/dynamic balance measured by the 8-foot up-and-go test (UNG) (P=0.001) significantly influenced FOF. The FOF of the slowest UNG quartile was significantly higher than those of other groups (P=0.002). This study concludes that among female older adults agility/dynamic balance as measured by UNG is the main factor impacting FOF and individuals with markedly low UNG tend to have high FOF.
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Affiliation(s)
- Myung Kim
- Department of Health Convergence, Ewha Womans University, Seoul, Korea
| | - Seung-Kil Lim
- Department of Exercise Prescription, Dongshin University, Naju, Korea
| | - Sohee Shin
- School of Exercise and Sport Science, University of Ulsan, Ulsan, Korea
| | - Jae-Hyun Lee
- Department of Health Convergence, Ewha Womans University, Seoul, Korea
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Hammarlund CS, Hagell P, Westergren A. Fall Risk and Its Associated Factors among Older Adults without Home-Help Services in a Swedish Municipality. J Community Health Nurs 2016; 33:181-189. [DOI: 10.1080/07370016.2016.1227211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Auais M, Alvarado BE, Curcio CL, Garcia A, Ylli A, Deshpande N. Fear of falling as a risk factor of mobility disability in older people at five diverse sites of the IMIAS study. Arch Gerontol Geriatr 2016; 66:147-53. [DOI: 10.1016/j.archger.2016.05.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/29/2016] [Accepted: 05/29/2016] [Indexed: 11/30/2022]
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