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Meade MH, Radack T, Riebesell S, Schultz MJ, Buchan L, Hilibrand AS, Kurd MF, Hsu V, Kaye ID, Schroeder GD, Kepler C, Vaccaro AR, Woods BI. The Effect of Patient Resilience on Postoperative Scores After One- and Two-Level Anterior Cervical Discectomy and Fusion. World Neurosurg 2024:S1878-8750(24)01193-8. [PMID: 39004180 DOI: 10.1016/j.wneu.2024.07.053] [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: 03/01/2024] [Revised: 07/04/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To investigate the association between resilience and outcomes of pain and neck-related disability after single- and double-level anterior cervical discectomy and fusion (ACDF). METHODS Patients who underwent single- or double-level ACDF were sent a survey between 6 months and 2 years after surgery. The survey included the Brief Resilience Scale (BRS), visual analogue scale (VAS) for pain, Neck Disability Index (NDI), and Pain Self-Efficacy Questionnaire (PSEQ-2). Patients completed the VAS and NDI twice, once describing preoperative pain and disability and once describing current pain and disability. Respondents were classified as high resilience (HR), medium resilience (MR), or low resilience (LR). Demographics, PSEQ-2 scores, pre- and postoperative VAS and NDI scores, and change in VAS (ΔVAS) and NDI (ΔNDI) scores were compared between groups. RESULTS Thirty-three patients comprised the HR group, 273 patients comprised the MR group, and 47 patients comprised the LR group. All groups demonstrated postoperative improvement in VAS and NDI scores that exceeded previously established MCID values. The HR group demonstrated greater improvement in pain compared with the LR group (ΔVAS: -5.8 for HR vs. -4.4 for LR, P = 0.05). Compared with the MR group, the LR group demonstrated greater postoperative pain (VAS: 3.2 for LR vs. 2.5 for MR, P = 0.02) and disability (NDI: 11.9 for LR vs. 8.6 for MR, P = 0.02). CONCLUSIONS Patients demonstrated improvement in pain and neck-related disability after single- and double-level ACDF, regardless of resilience score. Patients with greater resilience may be expected to demonstrate more improvement in pain after ACDF.
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Affiliation(s)
- Matthew H Meade
- Division of Orthopedic Surgery, Jefferson Health-NJ, Stratford, New Jersey, USA.
| | - Tyler Radack
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Samantha Riebesell
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Matthew J Schultz
- Division of Orthopedic Surgery, Jefferson Health-NJ, Stratford, New Jersey, USA
| | - Levi Buchan
- Division of Orthopedic Surgery, Jefferson Health-NJ, Stratford, New Jersey, USA
| | - Alan S Hilibrand
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mark F Kurd
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Victor Hsu
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ian David Kaye
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Gregory D Schroeder
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Christopher Kepler
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alexander R Vaccaro
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Barrett I Woods
- Department of Orthopaedic Spine Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Tran SK, Yeager MT, Rutz RW, Mohammed Z, Johnson JP, Spitler CA. Resilience Improves Patient-Reported Outcomes After Orthopaedic Trauma. J Orthop Trauma 2024; 38:e163-e168. [PMID: 38506510 DOI: 10.1097/bot.0000000000002785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/12/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVES To analyze the relationship between patient resilience and patient-reported outcomes after orthopaedic trauma. METHODS DESIGN Retrospective analysis of prospectively collected data. SETTING Single Level 1 Trauma Center. PATIENT SELECTION CRITERIA Patients were selected based on completion of the Patient-Reported Outcomes Measurement Information System (PROMIS) and Brief Resilience Scale (BRS) surveys 6 months after undergoing operative fracture fixation following orthopaedic trauma. Patients were excluded if they did not complete all PROMIS and BRS surveys. OUTCOME MEASURES AND COMPARISONS Resilience, measured by the BRS, was analyzed for its effect on patient-reported outcomes, measured by PROMIS Global Physical Health, Physical Function, Pain Interference, Global Mental Health, Depression, and Anxiety. Variables collected were demographics (age, gender, race, body mass index), injury severity score, and postoperative complications (nonunion, infection). All variables were analyzed with univariate for effect on all PROMIS scores. Variables with significance were included in multivariate analysis. Patients were then separated into high resilience (BRS >4.3) and low resilience (BRS <3.0) groups for additional analysis. RESULTS A total of 99 patients were included in the analysis. Most patients were male (53%) with an average age of 47 years. Postoperative BRS scores significantly correlated with PROMIS Global Physical Health, Pain Interference, Physical Function, Global Mental Health, Depression, and Anxiety ( P ≤ 0.001 for all scores) at 6 months after injury on both univariate and multivariate analyses. The high resilience group had significantly higher PROMIS Global Physical Health, Physical Function, and Global Mental Health scores and significantly lower PROMIS Pain Interference, Depression, and Anxiety scores ( P ≤ 0.001 for all scores). CONCLUSIONS Resilience in orthopaedic trauma has a positive association with patient outcomes at 6 months postoperatively. Patients with higher resilience report higher scores in all PROMIS categories regardless of injury severity. Future studies directed at increasing resilience may improve outcomes in patients who experience orthopaedic trauma. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Sterling K Tran
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL
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DeFoor MT, Cognetti DJ, Bedi A, Carmack DB, Arner JW, DeFroda S, Ernat JJ, Frangiamore SJ, Nuelle CW, Sheean AJ. Patient Resilience Does Not Conclusively Affect Clinical Outcomes Associated With Arthroscopic Surgery but Substantial Limitations of the Literature Exist. Arthrosc Sports Med Rehabil 2024; 6:100812. [PMID: 38379604 PMCID: PMC10877194 DOI: 10.1016/j.asmr.2023.100812] [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: 03/12/2023] [Accepted: 09/13/2023] [Indexed: 02/22/2024] Open
Abstract
Purpose To determine whether low resilience is predictive of worse patient-reported outcomes (PROs) or diminished improvements in clinical outcomes after joint preserving and arthroscopic surgery. Methods A comprehensive search of PubMed, Medline, Embase, and Science Direct was performed on September 28, 2022, for studies investigating the relationship between resilience and PROs after arthroscopic surgery in accordance with the Preferred Reported Items for Systematic Reviews and Meta-analyses guidelines. Results Nine articles (level II-IV studies) were included in the final analysis. A total of 887 patients (54% male, average age 45 years) underwent arthroscopic surgery, including general knee (n = 3 studies), ACLR-only knee (n = 1 study), rotator cuff repair (n = 4 studies), and hip (n = 1 study). The Brief Resilience Scale was the most common instrument measuring resilience in 7 of 9 studies (78%). Five of 9 studies (56%) stratified patients based on high, normal, or low resilience cohorts, and these stratification threshold values differed between studies. Only 4 of 9 studies (44%) measured PROs both before and after surgery. Three of 9 studies (33%) reported rates of return to activity, with 2 studies (22%) noting high resilience to be associated with a higher likelihood of return to sport/duty, specifically after knee arthroscopy. However, significant associations between resilience and functional outcomes were not consistently observed, nor was resilience consistently observed to be predictive of subjects' capacity to return to a preinjury level of function. Conclusions Patient resilience is inconsistently demonstrated to affect clinical outcomes associated with joint preserving and arthroscopic surgery. However, substantial limitations in the existing literature including underpowered sample sizes, lack of standardization in stratifying patients based on pretreatment resilience, and inconsistent collection of PROs throughout the continuum of care, diminish the strength of most conclusions that have been drawn. Level of Evidence Level IV, systematic review of level II-IV studies.
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Affiliation(s)
| | | | - Asheesh Bedi
- NorthShore University Health System, Skokie, Illinois
| | | | - Justin W. Arner
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Sheean AJ, DeFoor MT, Spindler KP, Arner JW, Athiviraham A, Bedi A, DeFroda S, Ernat JJ, Frangiamore SJ, Nuelle CW, Sheean AJ, Spindler KP, Bedi A. The Psychology of ACL Injury, Treatment, and Recovery: Current Concepts and Future Directions. Sports Health 2024:19417381241226896. [PMID: 38374636 DOI: 10.1177/19417381241226896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
CONTEXT Interest in the relationship between psychology and the outcomes of anterior cruciate ligament (ACL) reconstruction (ACLR) continues to grow as variable rates of return to preinjury level of activity continue to be observed. EVIDENCE ACQUISITION Articles were collected from peer-reviewed sources available on PubMed using a combination of search terms, including psychology, resilience, mental health, recovery, and anterior cruciate ligament reconstruction. Further evaluation of the included bibliographies were used to expand the evidence. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS General mental health and wellbeing, in addition to a host of unique psychological traits (self-efficacy, resilience, psychological readiness and distress, pain catastrophizing, locus of control, and kinesiophobia) have been demonstrated convincingly to affect treatment outcomes. Moreover, compelling evidence suggests that a number of these traits may be modifiable. Although the effect of resilience on outcomes of orthopaedic surgical procedures has been studied extensively, there is very limited information linking this unique psychological trait to the outcomes of ACLR. Similarly, the available information related to other parameters, such as pain catastrophizing, is limited with respect to the existence of adequately sized cohorts capable of accommodating more rigorous and compelling analyses. A better understanding of the specific mechanisms through which psychological traits influence outcomes can inform future interventions intended to improve rates of return to preinjury level of activity after ACLR. CONCLUSION The impact of psychology on patients' responses to ACL injury and treatment represents a promising avenue for improving low rates of return to preinjury activity levels among certain cohorts. Future research into these areas should focus on specific effects of targeted interventions on known, modifiable risk factors that commonly contribute to suboptimal clinical outcomes. STRENGTH-OF-RECOMMENDATION TAXONOMY (SORT) B.
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Affiliation(s)
| | | | | | - Justin W Arner
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Asheesh Bedi
- NorthShore University Health System, Skokie, Illinois
| | | | | | | | | | | | | | - Asheesh Bedi
- NorthShore University Health System, Skokie, Illinois
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Preoperative psychological resilience and recovery after hip fracture: Secondary analysis of the REGAIN randomized trial. J Am Geriatr Soc 2023; 71:3792-3801. [PMID: 37698304 DOI: 10.1111/jgs.18552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND How psychological resilience influences postoperative outcomes remains poorly characterized. We tested the hypothesis that psychological resilience is associated with lower odds of death or new inability to walk independently and other outcomes at 60 days after hip fracture surgery. METHODS This was a pre-planned secondary analysis of a multicenter randomized trial comparing spinal versus general anesthesia for hip fracture surgery. We analyzed data on 1360 adults aged 50 years or older who were hospitalized for hip fracture surgery at one of 46 US or Canadian hospitals and provided psychological resilience data preoperatively as measured via the Brief Resilience Scale. Major exclusions were the inability to walk without human assistance before fracture and contraindications to spinal anesthesia. Death or new inability to walk independently at 60 days after surgery was the primary outcome; death or new nursing home residence at 60 days and 60-day mortality were secondary outcomes. RESULTS Greater psychological resilience was associated with lower odds of death or new inability to walk at day 60 (adjusted odds ratio [aOR] 0.77; 95% Confidence Interval [CI], 0.61 to 0.98; p = 0.03). We observed a similar association between psychological resilience and outcomes among patients who did not experience complications after surgery (aOR 0.72; CI 0.55 to 0.94, p = 0.02), but not those who had complications (aOR 1.00; CI 0.59 to 1.69, p = 0.99). Psychological resilience was associated with lower odds of 60-day death or new nursing home residence (aOR 0.73; 95% CI 0.58 to 0.93; p < 0.001) but not with 60-day mortality (aOR 0.92; 95% CI 0.56 to 1.49; p = 0.73). CONCLUSIONS Psychological resilience is associated with better outcomes for older adults after hip fracture surgery, but largely among those who do not have postoperative complications. Future interventions may focus on improving psychological resilience preoperatively or providing support to patients with lower psychological resilience.
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Ansah JP, Chia AWY, Koh VJW, Lai WX, Koh JSB, Goh KS, Yeo W, Howe TS, Seow DCC, Mamun K, Balasubramanian D, Varman SD, Yeo AKS, Elamin A, Chan AWM, Matchar DB. Systems modelling as an approach for eliciting the mechanisms for hip fracture recovery among older adults in a participatory stakeholder engagement setting. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1184484. [PMID: 37424878 PMCID: PMC10327561 DOI: 10.3389/fresc.2023.1184484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/08/2023] [Indexed: 07/11/2023]
Abstract
Introduction Due to an aging population, the rising prevalence and incidence of hip fractures and the associated health and economic burden present a challenge to healthcare systems worldwide. Studies have shown that a complex interplay of physiological, psychological, and social factors often affects the recovery trajectories of older adults with hip fractures, often complicating the recovery process. Methods This research aims to actively engage stakeholders (including doctors, physiotherapists, hip fracture patients, and caregivers) using the systems modeling methodology of Group Model Building (GMB) to elicit the factors that promote or inhibit hip fracture recovery, incorporating a feedback perspective to inform system-wide interventions. Hip fracture stakeholder engagement was facilitated through the Group Model Building approach in a two-half-day workshop of 25 stakeholders. This approach combined different techniques to develop a comprehensive qualitative whole-system view model of the factors that promote or inhibit hip fracture recovery. Results A conceptual, qualitative model of the dynamics of hip fracture recovery was developed that draws on stakeholders' personal experiences through a moderated interaction. Stakeholders identified four domains (i.e., expectation formation, rehabilitation, affordability/availability, and resilience building) that play a significant role in the hip fracture recovery journey.. Discussion The insight that recovery of loss of function due to hip fracture is attributed to (a) the recognition of a gap between pre-fracture physical function and current physical function; and (b) the marshaling of psychological resilience to respond promptly to a physical functional loss via uptake of rehabilitation services is supported by findings and has several policy implications.
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Affiliation(s)
- John Pastor Ansah
- Center for Community Health Integration, School of Medicine, Case Western Reserve University, Cleveland, United States
- Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Aloysius Wei-Yan Chia
- Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Vanessa Jean Wen Koh
- Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Wei Xuan Lai
- Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Joyce Suang Bee Koh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Kiat Sern Goh
- Department of Geriatric Medicine, Changi General Hospital, Singapore, Singapore
| | - William Yeo
- Orthopaedic Diagnostics Centre, Singapore General Hospital, Singapore, Singapore
| | - Tet Sen Howe
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | | | - Kaysar Mamun
- Department of Geriatric Medicine, Singapore General Hospital, Singapore, Singapore
| | | | | | - Andy Kuei Siong Yeo
- Department of Orthopaedic Surgery, Changi General Hospital, Singapore, Singapore
| | - Amal Elamin
- School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom
| | - Angelique Wei-Ming Chan
- Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - David Bruce Matchar
- Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
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Lee S. Cross-Lagged Associations Between Physical Activity, Self-Rated Health, and Psychological Resilience Among Older American Adults: A 3-Wave Study. J Phys Act Health 2023:1-8. [PMID: 37185450 DOI: 10.1123/jpah.2022-0455] [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: 08/22/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 05/17/2023]
Abstract
The current study examined the reciprocal association between psychological resilience, physical activity, and self-rated health in older America adults. A 3-wave cross-lagged panel design was employed using data sampled from the Health and Retirement Study 2010, 2014, and 2018. In total, 8380 older adults, age ranged between 56 and 95 years at the baseline (mean age = 68.06, SD = 7.77), were analyzed. Using structural equation modeling, standardized path coefficients were estimated to determine the relationship between physical activity, self-rated health, and psychological resilience across 2 follow-up points. Cross-lagged analysis revealed that higher levels of physical activity at T1 and T2 were significantly associated with higher levels of self-rated health at T2 and T3, respectively. Self-rated health at T1 and T2 were significantly associated with physical activity at T2 and T3, respectively. Self-rated health and psychological resilience were positively related to one another at each time point. However, relationship between physical activity and psychological resilience was complex across time. Study findings support reciprocal prospective relationship between physical activity and self-rated health and the relationship between self-rated health and psychological resilience.
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Affiliation(s)
- Sunwoo Lee
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc,Czech Republic
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Huang MZ, Rogers MW, Pizac D, Gruber-Baldini AL, Orwig D, Hochberg MC, Beamer BA, Creath RA, Savin DN, Conroy VM, Mangione KK, Craik R, Zhang LQ, Magaziner J. Effect of Multicomponent Home-Based Training on Gait and Muscle Strength in Older Adults After Hip Fracture Surgery: A Single Site Randomized Trial. Arch Phys Med Rehabil 2023; 104:169-178. [PMID: 36087806 PMCID: PMC10039715 DOI: 10.1016/j.apmr.2022.08.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the effect of 16-week home-based physical therapy interventions on gait and muscle strength. DESIGN A single-blinded randomized controlled trial. SETTING General community. PARTICIPANTS Thirty-four older adults (N=34) post hip fracture were randomly assigned to either experimental group (a specific multi-component intervention group [PUSH], n=17, 10 women, age=78.6±7.3 years, 112.1±39.8 days post-fracture) or active control (a non-specific multi-component intervention group [PULSE], n=17, 11 women, age=77.8±7.8 years, 118.2±37.5 days post-fracture). INTERVENTION PUSH and PULSE groups received 32-40 sessions of specific or non-specific multi-component home-based physical therapy, respectively. Training in the PUSH group focused on lower extremity strength, endurance, balance, and function for community ambulation, while the PULSE group received active movement and transcutaneous electrical nerve stimulation on extremities. MAIN OUTCOME MEASURES Gait characteristics, and ankle and knee muscle strength were measured at baseline and 16 weeks. Cognitive testing of Trail Making Test (Part A: TMT-A; Part-B: TMT-B) was measured at baseline. RESULTS At 16 weeks, both groups demonstrated significant increases in usual (P<.05) and fast (P<.05) walking speed, while there was no significant difference in increases between the groups. There was only 1 significant change in lower limb muscle strength over time (non-fractured side) between the groups, such that PUSH did better (mean: 4.33%, 95% confidence interval:1.43%-7.23%). The increase in usual and fast walking speed correlated with the baseline Trail-making Test-B score (r=-0.371, P=.037) and improved muscle strength in the fractured limb (r=0.446, P=.001), respectively. CONCLUSION Gait speed improved in both home-based multicomponent physical therapy programs in older adults after hip fracture surgery. Muscle strength of the non-fractured limb improved in the group receiving specific physical therapy training. Specific interventions targeting modifiable factors such as muscle strength and cognitive performance may assist gait recovery after hip fracture surgery.
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Affiliation(s)
- Mei Zhen Huang
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine, Baltimore, MD
| | - Mark W Rogers
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine, Baltimore, MD
| | - Douglas Pizac
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine, Baltimore, MD
| | - Ann L Gruber-Baldini
- Department of Epidemiology and Public Health, University of Maryland, School of Medicine, Baltimore, MD
| | - Denise Orwig
- Department of Epidemiology and Public Health, University of Maryland, School of Medicine, Baltimore, MD
| | - Marc C Hochberg
- Department of Medicine, University of Maryland, School of Medicine, Baltimore, MD
| | - Brock A Beamer
- Department of Medicine, University of Maryland, School of Medicine, Baltimore, MD; Geriatric Research, Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD
| | - Robert A Creath
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine, Baltimore, MD; Department of Exercise Science, Lebanon Valley College, Annville, PA
| | - Douglas N Savin
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine, Baltimore, MD
| | - Vincent M Conroy
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine, Baltimore, MD; Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD
| | - Kathleen K Mangione
- Department of Physical Therapy, College of Health Sciences, Arcadia University, Glenside, PA
| | - Rebecca Craik
- Department of Physical Therapy, College of Health Sciences, Arcadia University, Glenside, PA
| | - Li-Qun Zhang
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine, Baltimore, MD; Department of Orthopaedics, University of Maryland, School of Medicine, Baltimore, MD; Department of Bioengineering, University of Maryland, College Park, MD
| | - Jay Magaziner
- Department of Epidemiology and Public Health, University of Maryland, School of Medicine, Baltimore, MD.
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Gong Y, Wang Y, Wu W, Li L, Li Y, Song J, Jiang L, Hu S, Yang J, Wang A. The Relationship Between Pain Intensity and Pain-Related Activity Patterns in Older Adults with Chronic Musculoskeletal Pain: Mediating Roles of Pain Resilience and Pain Catastrophizing. J Pain Res 2023; 16:797-807. [PMID: 36925624 PMCID: PMC10013585 DOI: 10.2147/jpr.s393359] [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: 10/13/2022] [Accepted: 02/25/2023] [Indexed: 03/12/2023] Open
Abstract
Purpose To explore the relationship between pain intensity, pain resilience, pain catastrophizing, and pain-related activity patterns in older adults with chronic musculoskeletal pain (CMP). Patients and Methods A total of 220 elderly Chinese with chronic musculoskeletal pain were recruited from a tertiary general hospital. Participants completed several measures including a demographic questionnaire, Brief Pain Inventory (BPI), Pain Resilience Scale (PRS), Pain Catastrophizing Scale (PCS), and Patterns of Activity Measure-Pain (POAM-P). Moreover, Process version 3.5 plug-in SPSS26 was used to test the mediation effect between variables. Results The scores of POAM-P in older adults with CMP from high to low were: avoidance (27.39 ± 8.10), pacing (24.25 ± 9.48), and overdoing (16.65 ± 10.95). Mediation analysis revealed that pain resilience and pain catastrophizing mediated the relationship between pain intensity and pain-related activity patterns (avoidance and pacing) in older adults with CMP. Conclusion These results provide evidence for the role of pain resilience and pain catastrophizing in the relationship between pain intensity and pain-related activity patterns. Interventions targeting these factors should be included in activity management programs for elderly CMP patients. It may be possible to reduce the negative impact of pain intensity on activity patterns by improving pain resilience and reducing pain catastrophizing.
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Affiliation(s)
- Yan Gong
- School of Nursing, Chengdu Medical College, Chengdu, People's Republic of China
| | - Yonghua Wang
- Department of Nursing, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Wei Wu
- Department of Anesthesiology and Pain Medicine, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Ling Li
- Department of Nursing, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Yunming Li
- Department of Information, Medical Support Center, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Jie Song
- Department of Nursing, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Lingli Jiang
- Department of Neurosurgery, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Shibei Hu
- School of Nursing, Chengdu Medical College, Chengdu, People's Republic of China
| | - Juan Yang
- School of Nursing, Chengdu Medical College, Chengdu, People's Republic of China
| | - Aihua Wang
- School of Nursing, Chengdu Medical College, Chengdu, People's Republic of China
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Robinson EM, Clothier PJ, Slater H, Gupta A. A scoping review on the methods of assessment and role of resilience on function and movement-evoked pain when experiencing a musculoskeletal injury. BMC Musculoskelet Disord 2022; 23:1097. [PMID: 36522734 PMCID: PMC9753293 DOI: 10.1186/s12891-022-06058-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Resilience refers to an individual's ability to maintain effective functioning, by resisting, withstanding or recovering from stressors or adversity, including pain associated with physical injury (J Clin Psychol Med Settings 28:518-28, 2021). The aim of this scoping review is to determine the role of resilience in the experience of movement-evoked pain (MEP) and return to functional activity following a musculoskeletal injury. METHODS This review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the scoping review protocol of the Joanna Briggs Institute (JBI). Five databases and one grey literature database were searched using predetermined key words and index terms to capture published and unpublished records on the topic. Two authors independently screened the title and abstract of each record, with the full-text of eligible records being reviewed. Papers were eligible for inclusion if they examined the population, concept and context of interest, were written in English and the full text was available. Data were extracted from each eligible record to guide discussion of the available literature on this topic. RESULTS Of 4771 records, 2695 articles underwent screening based on their title and abstract. After title and abstract screening 132 articles were eligible for full text review, with 24 articles included in the final analysis. This review identified that psychological resilience has primarily been investigated in the context of a range of age-related pathologies. The choice of functional and movement-evoked pain assessments in the included studies were often guided by the pathology of interest, with some being general or injury specific. CONCLUSION This scoping review identified inconsistent conclusions regarding the role of resilience in the experience of MEP and the ability to return to function for older adults with a musculoskeletal injury. This scoping review highlights the need for longitudinal research to be conducted that allows a broader age range, including younger adults, to determine if multidimensional resilience may promote recovery form musculoskeletal injury.
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Affiliation(s)
- Elise M. Robinson
- grid.1029.a0000 0000 9939 5719Western Sydney University, School of Health Sciences, PO Box 1797, Penrith, NSW 2751 Australia
| | - Peter J. Clothier
- grid.1029.a0000 0000 9939 5719Western Sydney University, School of Health Sciences, PO Box 1797, Penrith, NSW 2751 Australia
| | - Helen Slater
- grid.1032.00000 0004 0375 4078Curtin University, Curtin School of Allied Health, enAble Institute, Bentley, Australia
| | - Amitabh Gupta
- grid.1029.a0000 0000 9939 5719Western Sydney University, School of Health Sciences, PO Box 1797, Penrith, NSW 2751 Australia
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11
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Resilience in relation to older adults with multimorbidity: A scoping review. Geriatr Nurs 2022; 48:85-93. [PMID: 36155314 DOI: 10.1016/j.gerinurse.2022.08.017] [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: 05/05/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 12/14/2022]
Abstract
The purpose of this scoping review is to identify conceptual and theoretical resilience models, types of resilience measures, and outcomes regarding resilience in relation to older adults with multimorbidity. PubMed, Embase, CINAHL, and PsycINFO were searched, and we identified 14 studies to July 2021. Most models operationalize resilience as dependent on the social and environmental context of older adults. Three of the five resilience measures in the included studies are used to evaluate general resilience. They are primarily psychological or psychosocial in nature, and measuring physical resilience therefore may help to better understand individuals' ability to cope with the physical challenges associated with various chronic diseases. Quality of life and physical activity were common outcomes in studies of resilience. Findings highlight the need for studies that incorporate physiological measures or physical properties of resilience and longitudinal studies that capture the dynamic process of resilience in older adults with multimorbidity.
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Soliman G, Fortinsky RH, Mangione K, Beamer BA, Magder L, Binder EF, Craik R, Gruber-Baldini A, Orwig D, Resnick B, Wakefield DB, Magaziner J. Impact of psychological resilience on walking capacity in older adults following hip fracture. J Am Geriatr Soc 2022; 70:3087-3095. [PMID: 35856155 PMCID: PMC9669123 DOI: 10.1111/jgs.17930] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/22/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Community-dwelling older adults experiencing hip fracture often fail to achieve adequate walking capacity following surgery and rehabilitation. Effects of psychological factors on post-fracture walking capacity are poorly understood. Accordingly, this paper investigates effects of psychological resilience on observed walking capacity measures in older adults following hip fracture, controlling for important covariates. METHODS Data were drawn from the Community Ambulation Project, a clinical trial of 210 community-dwelling adults aged ≥60 years who experienced a minimal trauma hip fracture and were randomized to one of two 16-week home-based physical therapist-guided interventions. Psychological resilience was measured at study baseline using the 6-item Brief Resilience Scale (BRS); scores were classified into groups in order to distinguish levels of self-reported resilience. Walking capacity was assessed at study baseline and 16 weeks later using 4-Meter Gait Speed (4MGS), 50-Foot Walk Test (50FWT), and 6-Minute Walk Distance (SMWD). In multivariate analyses of covariance in which 16-week follow-up values of each walking measure were outcomes, covariates included clinical trial arm, gender, age, and baseline values of: walking measure corresponding to the outcome; body mass index; depressive symptom severity; degree of psychological optimism; cognitive status; informal caregiver need; and days from hospital admission to randomization. RESULTS Increases between baseline and 16 weeks later in mean gait speed in meters/sec (m/s) and walking distance in meters (m) in 4MGS, 50FWT and SMWD were 0.06 m/s (p = 0.061), 0.11 m/s (p < 0.01), and 25.5 m (p = 0.056) greater, respectively, in the most resilient BRS group compared to the least resilient BRS group. CONCLUSION Higher levels of psychological resilience were associated with greater walking speed and distance. Psychological resilience represents a potentially clinically important pathway and intervention target, toward the goal of improving walking capacity among older adults known to have substantial residual disability following hip fracture.
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Affiliation(s)
- Germine Soliman
- Department of Geriatrics, St. Mary’s Hospital, Waterbury, CT
| | - Richard H. Fortinsky
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT
| | | | - Brock A. Beamer
- Geriatric Research, Education and Clinical Center (GRECC) at Baltimore Veterans Affairs Medical Center
- University of Maryland School of Medicine, Baltimore
| | - Larry Magder
- University of Maryland School of Medicine, Baltimore
| | - Ellen F. Binder
- Division of Geriatrics and Nutritional Science, Washington University in St. Louis, MO
| | | | | | - Denise Orwig
- University of Maryland School of Medicine, Baltimore
| | | | - Dorothy B. Wakefield
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT
| | - Jay Magaziner
- University of Maryland School of Medicine, Baltimore
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13
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Zhao Z, Fan W, Chu Q. Mapping knowledge structure and global status of sarcopenia in geriatric hip fractures: A bibliometric and visualized study. Front Surg 2022; 9:1019985. [PMID: 36277288 PMCID: PMC9581315 DOI: 10.3389/fsurg.2022.1019985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background Sarcopenia in geriatric hip fractures is attracting increased attention in recent years. This study aimed to explore the bibliometric characteristics and current status of sarcopenia research in hip fractures of older patients. Methods Publications related to sarcopenia in geriatric hip fracture published between January 2000 and July 2022 were extracted from the Science Citation Index Expanded, and bibliometric and visualized studies were performed by VOSviewer, Citespace, and R. Results The 1,223 articles used in our study were written by 6,326 authors from 1,879 organizations in 60 countries, published in 388 journals, and cited 37,198 references from 5,422 journals. The United States contributed the most publications (288 publications). The journal with the largest number of papers was Osteoporosis International (62 publications), and the Journals of Gerontology Series A - Biological Sciences and Medical Sciences had been more cited than any other journals in this field (3,302 citations). The University of Melbourne published the biggest number of papers (72 publications) focusing on sarcopenia in geriatric hip fractures while the California Pacific Medical Center Research Institute had the largest citations (4,239 citations). Cawthon PM was the most productive and influential author in the field. keywords were classified into 6 clusters: Cluster 1 (sarcopenia in aging), Cluster 2 (osteoporosis), Cluster 3 (bone density), Cluster 4 (body composition), Cluster 5 (physical performance), and Cluster 6 (risk factor). Conclusion Geriatric hip fracture is one of the most significant health issues in the aging society. In the past 20 years, an increasing number of studies were performed to explore the relationship between sarcopenia and hip fracture in older adults. The United States showed the strongest influence in this field, including publication numbers, citations, institutions, funding agencies, and authorship. Sarcopenia in aging, osteoporosis, bone density, body composition, physical performance, and risk factors may become the future hotspots in this field.
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Peters S, Cosco TD, Mackey DC, Sarohia GS, Leong J, Wister A. Quantifying Physical Resilience in Ageing Using Measurement Instruments: A Scoping Review. Physiother Can 2022. [DOI: 10.3138/ptc-2020-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The capacity to recover motor function with pathology or age-related decline is termed physical resilience. It is unknown what outcome domains are captured with existing measurement instruments. Thus, this scoping review aimed to identify measurement instruments for physical resilience, identify research gaps, and make recommendations for future research. Methods: Articles were included from the search when their subject matter included the term resilience in relation to the physical health of older adults. Data on physical resilience measurement instruments were extracted using the outcome domains: body function or structure, activity and participation, and societal impact. Results: The majority of the 33 included articles involved older adults with fractures, cardiac conditions, and cancer. Many measurement instruments quantified body function or structure, and some instruments captured activity and participation, and societal impact of physical resilience. Measurement instruments were pooled into 4 categories: psychological, physiological, motor function, and psychosocial scales. No studies combined all areas of measurement. Conclusions: A potential gap of a measurement instrument capturing social aspects of physical resilience was identified. Comprehensive measurement could identify which outcome domains could be targeted to foster resilience. This knowledge might be useful across many health disciplines and contribute to therapeutic decision-making and rehabilitation strategies.
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Affiliation(s)
- Sue Peters
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Theodore D. Cosco
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
- Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
| | - Dawn C. Mackey
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Gurkaran S. Sarohia
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey Leong
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Wister
- Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
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15
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Peng J, Yin L, Wang K, Zhang T, Liu H, Yang J, Luo J. A Study on the Relationship Between Adolescent Health Behavior, BMI, and Blood Physical and Chemical Properties. Front Public Health 2022; 10:766101. [PMID: 35372227 PMCID: PMC8964522 DOI: 10.3389/fpubh.2022.766101] [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] [Received: 08/28/2021] [Accepted: 01/27/2022] [Indexed: 11/28/2022] Open
Abstract
In this study, the blood test index, demographic data, and health promotion behavior of adolescents were analyzed to provide a reference for early prevention and treatment of physical decline and abnormal biochemical indexes of adolescents. Using a cross-sectional study design, 1,436 valid samples were obtained by stratified random sampling, and the data were processed by SPSS21.0 statistical analysis software. The results showed that the overall health-promoting lifestyle of adolescents was good, and the interpersonal support behavior was the best, and the health responsibility and sports participation behavior were the worst; the interpersonal support and sports participation behavior of adolescents with normal weight were significantly better than those with overweight or light weight, while the overall health-promoting behavior of adolescents with high fasting blood glucose (FBG) before meals was poor, those with high glutamate pyruvate transaminase (GPT) had poor nutritional behavior and health responsibility behavior, while those with high uric acid (UA) had poor interpersonal support and stress coping behavior. The overweight rate and abnormal detection rate of UA and triglyceride (TG) in boys were significantly higher than those in girls, and the higher BMI of teenagers, the higher abnormal detection rate of GPT, UA, and TG, the better nutritional behavior, health responsibility behavior, and sports participation behavior, the lower abnormal detection rate of GPT, UA, and TG; the higher education level of parents, the better teenagers' sports participation and health responsibility behavior, the lower the incidence of overweight, the more time they spend playing online games and drinking sugary drinks on weekdays (or holidays), the higher the incidence of overweight.
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Affiliation(s)
- Jie Peng
- School of Physical Education, Liupanshui Normal University, Liupanshui, China
| | - Lian Yin
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Kun Wang
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Tingran Zhang
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Hengxu Liu
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Jinxin Yang
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
| | - Jiong Luo
- Research Centre for Exercise Detoxification, College of Physical Education, Southwest University, Chongqing, China
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Auais M, Sousa TAC, Feng C, Gill S, French SD. Understanding the relationship between psychological factors and important health outcomes in older adults with hip fracture: A structured scoping review. Arch Gerontol Geriatr 2022; 101:104666. [DOI: 10.1016/j.archger.2022.104666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/02/2022] [Accepted: 02/21/2022] [Indexed: 11/25/2022]
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Peiris WL, Cicuttini FM, Hussain SM, Estee MM, Romero L, Ranger TA, Fairley JL, McLean EC, Urquhart DM. Is adiposity associated with back and lower limb pain? A systematic review. PLoS One 2021; 16:e0256720. [PMID: 34520462 PMCID: PMC8439494 DOI: 10.1371/journal.pone.0256720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/27/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Back and lower limb pain have a major impact on physical function and quality of life. While obesity is a modifiable risk factor for musculoskeletal pain, the role of adiposity is less clear. This systematic review aimed to examine the relationship between both adiposity and its distribution and back and lower limb pain. METHODS A systematic search of electronic databases was conducted to identify studies that examined the association between anthropometric and/or direct measures of adiposity and site specific musculoskeletal pain. Risk of bias was assessed and a best evidence synthesis was performed. RESULTS A total of 56 studies were identified which examined 4 pain regions, including the lower back (36 studies), hip (two studies), knee (13 studies) and foot (eight studies). 31(55%) studies were assessed as having low to moderate risk of bias. 17(30%) studies were cohort in design. The best evidence synthesis provided evidence of a relationship between central adiposity and low back and knee pain, but not hip or foot pain. There was also evidence of a longitudinal relationship between adiposity and the presence of back, knee and foot pain, as well as incident and increasing foot pain. CONCLUSIONS This systematic review provides evidence of an association between both body fat and its central distribution and low back and knee pain, and a longitudinal relationship between adiposity and back, knee and foot pain. These results highlight the potential for targeting adiposity in the development of novel treatments at these sites.
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Affiliation(s)
- Waruna L. Peiris
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Flavia M. Cicuttini
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sultana Monira Hussain
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mahnuma M. Estee
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lorena Romero
- The Ian Potter Library, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Tom A. Ranger
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jessica L. Fairley
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Emily C. McLean
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Donna M. Urquhart
- Department Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Baattaiah BA, Alharbi MD, Alqahtani AS, Aldhahi MI. Physical activity patterns among adults population during the coronavirus pandemic: consideration of the role of resilience. J Sports Med Phys Fitness 2021; 62:538-546. [PMID: 34256534 DOI: 10.23736/s0022-4707.21.12228-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aims to characterize patterns of physical activity (PA) and resilience levels, and to examine whether resilience contributes to PA participation among adults during COVID-19 pandemic. METHODS This cross-sectional study was conducted during the quarantine period. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Brief Resilience Scale (BRS) questionnaires were used to assess the study's outcomes. The Kruskal-Wallis test was used to examine the difference in PA across resilience levels. Spearman's correlation coefficient was used to assess the relationship between resilience and PA. Data were reported as medians and interquartile ranges. RESULTS A sample of 1859 were included in the study (40% aged 26-35 yrs). The findings show that 85% of the respondents engaged in PA and 15% were physically inactive. The majority participated in moderate-intensity PA (71%). The median score was 3.50(0.85), which indicates a medium level of resilience. The positive correlation coefficient was shown between the average score of resilience and both walking (rs =0.01, p<0.001) and vigorous- intensity PA (rs =0.08, p=.007). Data did not show a significant correlation between moderate-intensity PA and resilience score. CONCLUSIONS Greater emphasis on PA engagement after the period of quarantine is needed. Resilience may play an important role in buffering the deleterious impact of quarantine on PA. Key words: Exercise; Physical Activity; Rehabilitation; Mental Health; COVID-19.
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Affiliation(s)
- Baian A Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mutasim D Alharbi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abdulfattah S Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Monira I Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia -
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19
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DI Monaco M, Castiglioni C, Bardesono F, Milano E, Massazza G. Sarcopenic obesity and function in women with subacute hip fracture: a short-term prospective study. Eur J Phys Rehabil Med 2021; 57:940-947. [PMID: 33759440 DOI: 10.23736/s1973-9087.21.06720-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The prognostic role exerted by the concurrent presence of sarcopenia and obesity after hip fracture has not been elucidated. AIM To assess the effect of sarcopenic obesity on ability to function in women with subacute hip fracture. DESIGN Short-term prospective study. SETTING Rehabilitation hospital. POPULATION Women with subacute hip fracture. METHODS At admission, grip strength, by a Jamar dynamometer, and body composition by dual-energy x-ray absorptiometry were assessed. Sarcopenia was defined according to the criteria released by the European Working Group for Sarcopenia in Older People in 2019, with both grip strength < 16kg and appendicular lean mass (aLM) < 15kg. Alternatively, aLM/(height)2 < 5.5kg/m2 was substituted for aLM < 15kg to confirm sarcopenia in the women with grip strength < 16kg. Obesity was diagnosed with fat mass exceeding 40% of total body mass. Function was assessed by the Barthel index. RESULTS We assessed 183 of 200 women. Sarcopenic women had lower Barthel index scores assessed at the end of subacute inpatient rehabilitation (U=300,0; z=-4.3; P<0.001) and lower Batrhel index effectiveness (U=310,0; z=-4.2; P<0.001) than non-sarcopenic women. Conversely, we found no significant differences in function between obese and non-obese women. The concurrent presence of sarcopenia and obesity did not worsen the functional prognosis versus the presence of isolated sarcopenia. After adjustment for Barthel index scores before rehabilitation, age, hip-fracture type and cognitive impairment, sarcopenia was significantly associated with Barthel index scores (P=0.001) and Barthel index effectiveness (P<0.001), whereas obesity was not. The results did not materially change when aLM/(height)2 < 5.5kg/m2 was substituted for aLM <15kg to confirm sarcopenia in the women whose handgrip strength was < 16kg. CONCLUSIONS The concurrent presence of obesity did not worsen the negative prognostic role of sarcopenia in the short-term recovery of ability to function after hip fracture in women. CLINICAL REHABILITATION IMPACT In women with subacute hip fracture, sarcopenia but not obesity should be assessed to contribute to the prediction of the short-term functional outcome.
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Affiliation(s)
- Marco DI Monaco
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Torino, Italy -
| | - Carlotta Castiglioni
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Torino, Italy
| | - Francesca Bardesono
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University, Torino, Italy
| | - Edoardo Milano
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Torino, Italy
| | - Giuseppe Massazza
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University, Torino, Italy
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20
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Siltanen S, Tourunen A, Saajanaho M, Palmberg L, Portegijs E, Rantanen T. Psychological resilience and active aging among older people with mobility limitations. Eur J Ageing 2021; 18:65-74. [PMID: 33746682 PMCID: PMC7925737 DOI: 10.1007/s10433-020-00569-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Active aging refers to striving for well-being through preferred activity and may be restricted with declining mobility. We investigated whether psychological resilience, i.e., the ability to tolerate hardship, can aid older people in being active despite mobility limitations. Participants were 961 community-dwelling persons aged 75, 80, or 85 years living in Jyväskylä, Central Finland. Mobility limitations were indicated as self-reported difficulty in walking 2 km. Categories were no difficulty (reference), difficulty, and unable to walk. Resilience was assessed with the 10-item Connor-Davidson Resilience Scale and active aging with the University of Jyvaskyla Active Aging scale. Data were analyzed with OLS regression analyses, which were stratified by age. In all age-groups, having difficulties walking or being unable to walk 2 km was associated with lower active aging scores. Resilience moderated this association especially among the 75-year-olds, but not among the 85-year-olds: The higher the resilience score, the higher the active aging score among those reporting no or some walking difficulties. Those unable to walk 2 km had lower active aging scores irrespective of resilience level. Psychological resilience may alleviate the negative effects of early phase walking difficulties on active aging but may be insufficient to compensate for more severe walking limitations that restrict not only function but also autonomy.
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Affiliation(s)
- Sini Siltanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Anu Tourunen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Milla Saajanaho
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Lotta Palmberg
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
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21
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Otlans PT, Szukics PF, Bryan ST, Tjoumakaris FP, Freedman KB. Resilience in the Orthopaedic Patient. J Bone Joint Surg Am 2021; 103:549-559. [PMID: 33470590 DOI: 10.2106/jbjs.20.00676] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Resilience is a dynamic psychological construct that refers to the ability to adapt and improve when facing adversity or other stressors. ➤ Recent investigations in various orthopaedic subspecialties have demonstrated that resilience may contribute to favorable mental health and physical function after a surgical procedure. ➤ More research, using well-designed prospective studies, is necessary to better define the role that resilience and other factors play in the health and outcomes of patients with orthopaedic conditions. ➤ Orthopaedic surgeons can consider incorporating resilience assessments into their practices to aid in identifying patients who will do well with a surgical procedure and those who may benefit from specialized therapy to optimize their health and function.
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Affiliation(s)
- Peters T Otlans
- The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Patrick F Szukics
- Division of Orthopaedic Surgery, Rowan University, Stratford, New Jersey
| | - Sean T Bryan
- The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Fotios P Tjoumakaris
- The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kevin B Freedman
- The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania
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22
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Di Monaco M, Castiglioni C, Bardesono F, Milano E, Massazza G. The handgrip strength threshold of 16 kg discriminates successful rehabilitation: A prospective short-term study of 258 women with hip fracture. Arch Gerontol Geriatr 2020; 91:104190. [PMID: 32721661 DOI: 10.1016/j.archger.2020.104190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 01/06/2023]
Abstract
AIM In 2019 the European Working Group on Sarcopenia in Older People (EWGSOP) indicated weakness as the key characteristic of sarcopenia and released the threshold of 16 kg for handgrip strength to define weakness in women. We aimed to externally validate the 16 kg cut-off point for predicting functional recovery in 258 women with subacute hip fracture admitted to our rehabilitation ward. METHODS We assessed handgrip strength by a hand-grip Jamar dynamometer at admission to inpatient rehabilitation and functional ability in activities of daily living by the Barthel index at the end of the rehabilitation course. Successful rehabilitation was defined with a Barthel index score ≥85 and highest possible recovery with a Barthel index effectiveness = 100 %. RESULTS A handgrip strength ≥16 kg significantly predicted both successful rehabilitation (χ2 = 23.5, P < 0.001) and highest possible recovery (χ2 = 31.05, P < 0.001). For the women with a handgrip strength ≥16 kg, the odds ratios to gain successful rehabilitation and highest possible recovery were 2.68 (95 % CI from 1.19 to 6.04; P = 0.018) and 2.81 (95 % CI from 1.47 to 5.37; P = 0.002), after adjustment for Barthel index scores before rehabilitation, age, hip-fracture type (either medial or lateral), cognitive impairment and 25-hydroxyvitamin D levels. CONCLUSION Our results provide an external validation of the 16 kg handgrip strength threshold recently released to discriminate functional outcomes: it significantly predicted the short-term ability to perform activities of daily living after hip fracture in women.
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Affiliation(s)
- Marco Di Monaco
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Torino, Italy.
| | - Carlotta Castiglioni
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Torino, Italy
| | - Francesca Bardesono
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University, Torino, Italy
| | - Edoardo Milano
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Fondazione Opera San Camillo, Torino, Italy
| | - Giuseppe Massazza
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University, Torino, Italy
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23
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Lim KK, Matchar DB, Tan CS, Yeo W, Østbye T, Howe TS, Koh JS. The Association Between Psychological Resilience and Physical Function Among Older Adults With Hip Fracture Surgery. J Am Med Dir Assoc 2020; 21:260-266.e2. [DOI: 10.1016/j.jamda.2019.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/24/2019] [Accepted: 07/04/2019] [Indexed: 01/25/2023]
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Zheng K, Wang X. Publications on the Association Between Cognitive Function and Pain from 2000 to 2018: A Bibliometric Analysis Using CiteSpace. Med Sci Monit 2019; 25:8940-8951. [PMID: 31762442 PMCID: PMC6894366 DOI: 10.12659/msm.917742] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND This study aimed to use CiteSpace software to conduct a bibliometric analysis of published studies on the association between pain and cognitive function from 2000 to 2018. The study also aimed to determine publication patterns and authorship and to identify recent trends for research in this field. MATERIAL AND METHODS Publications on the association between cognitive function and pain between 2000 and 2018 were identified from the Web of Science database. Bibliographic information, including authorship, country, citation frequency, changes in citation, and interactive visualization were generated using CiteSpace software. Co-citation, or frequency of two publications cited together by another publication, was also studied. RESULTS On 8th January 2019, 4,889 publications were identified. The United States (1132 publications) and the University of Washington (87 publications) were the most productive country and institution, respectively. The journal, Pain (182 publications) had the largest number of publications and was the most frequently cited journal (citation counts, 1569) with the highest centrality (0.62). Author A had the largest number of publications (21). Author B had the greatest co-citation count (223). Author C tied with Author D as the first co-cited author in terms of centrality (0.18). Author E in 2011 (co-citation count, 96) and Author F in 2008 (centrality: 0.11) had the highest co-citation counts and centrality, respectively. The keyword 'empathy' ranked first for research developments with the highest citation burst (10.045). CONCLUSIONS Bibliometric analysis of the association between pain and cognitive function might identify new directions for future research.
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Affiliation(s)
- Kangyong Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland).,The Fifth Clinical College, Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland).,Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China (mainland)
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The relationship between muscle mass and function in cancer cachexia: smoke and mirrors? Curr Opin Support Palliat Care 2019; 12:439-444. [PMID: 30138131 DOI: 10.1097/spc.0000000000000381] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Randomized clinical trials of cancer cachexia interventions are based on the premise that an increase in the muscle mass of patients is associated with consequent improvements in muscle function, and ultimately, quality of life. However, recent trials that have succeeded in demonstrating increases in lean body mass have been unable to show associated increases in patient physical function. In this review, we examine the potential causes for this lack of association between muscle mass and function in cancer cachexia, paying particular attention to those factors that may be at play when using body composition analysis techniques involving cross-sectional imaging. Moreover, we propose a new population-specific model for the relationship between muscle mass and physical function in patients with cancer cachexia. RECENT FINDINGS The ROMANA 1 and 2 trials of anamorelin (a novel ghrelin agonist) and the POWER 1 and 2 trials of enobosarm (a selective androgen receptor modulator) were able to demonstrate improvements in patient lean body mass, but not the functional co-primary endpoints of handgrip strength and stair climb power, respectively. We report similar confirmatory findings in other studies, and describe potential reasons for these observations. SUMMARY The relationship between muscle mass and muscle function is complex and unlikely to be linear. Furthermore, the relationship is influenced by the techniques used to assess nutritional endpoints [e.g. computed tomography (CT)]; the nature of the chosen physical function outcome measures; and the sex and severity of the recruited cachectic patients. Such factors need to be considered when designing intervention trials for cancer cachexia with functional endpoints.
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Mareschal J, Achamrah N, Norman K, Genton L. Clinical Value of Muscle Mass Assessment in Clinical Conditions Associated with Malnutrition. J Clin Med 2019; 8:jcm8071040. [PMID: 31319519 PMCID: PMC6678556 DOI: 10.3390/jcm8071040] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/08/2019] [Accepted: 07/16/2019] [Indexed: 01/06/2023] Open
Abstract
Malnutrition results from a reduction of food intake or an alteration of nutrient assimilation and leads to decreased lean mass. Strong evidence shows that malnutrition associated with loss of muscle mass negatively impacts clinical outcomes. The preservation or improvement of muscle mass represents a challenge. This review aims to (1) describe current methods to assess muscle mass in clinical practice, (2) describe the associations between muscle mass and clinical outcomes, and (3) describe the impact of interventions aiming at increasing muscle mass on clinical outcomes. It highlights the importance of assessing muscle mass as part of the screening and the follow-up of malnutrition in clinical practice.
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Affiliation(s)
- Julie Mareschal
- Clinical Nutrition, Geneva University Hospitals, 1205 Geneva, Switzerland.
| | - Najate Achamrah
- Department of Clinical Nutrition, Rouen University Hospital, Normandie University, 76000 Rouen, France
| | - Kristina Norman
- Research Group on Geriatrics, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13347 Berlin, Germany
- Department of Nutrition and Gerontology, German Institute for Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany
| | - Laurence Genton
- Clinical Nutrition, Geneva University Hospital, 1205 Geneva, Switzerland.
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Taylor JL, Roberts L, Hladek MD, Liu M, Nkimbeng M, Boyd CM, Szanton SL. Achieving self-management goals among low income older adults with functional limitations. Geriatr Nurs 2019; 40:424-430. [PMID: 30799154 DOI: 10.1016/j.gerinurse.2019.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/20/2019] [Accepted: 01/25/2019] [Indexed: 11/29/2022]
Abstract
Although self-management interventions can improve symptoms and disease among older adults, there is a dearth of literature on how self-management behaviors may improve factors related to the older adults' physical function. To fill this gap in the literature, we describe the patient-directed self-management goals in nursing visits that relate to physical function as part of a multi-component program. We analyze the self-management goals and outcomes of 367 low- income older adults with functional limitations who participated in the CAPABLE program: a program to reduce the health effects of impaired physical function in low-income older adults. We focus on the following self-management goals that participants chose with the nurses: pain management, depressive symptoms, incontinence, fall prevention, and communication with healthcare providers. The majority of participants chose pain (50%) or fall prevention (51%) as goals and partially or fully met their goals. Improvements across these areas may lead to improved physical function.
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Affiliation(s)
- Janiece L Taylor
- Johns Hopkins School of Nursing, USA; Johns Hopkins School of Nursing Center of Innovative Care in Aging, USA.
| | | | | | - Minhui Liu
- Johns Hopkins School of Nursing, USA; Johns Hopkins School of Nursing Center of Innovative Care in Aging, USA
| | | | | | - Sarah L Szanton
- Johns Hopkins School of Nursing, USA; Johns Hopkins School of Nursing Center of Innovative Care in Aging, USA
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Taylor JL, Parker LJ, Szanton SL, Thorpe RJ. The association of pain, race and slow gait speed in older adults. Geriatr Nurs 2018; 39:580-583. [PMID: 29752144 DOI: 10.1016/j.gerinurse.2018.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/02/2018] [Accepted: 04/09/2018] [Indexed: 01/08/2023]
Abstract
Gait speed is an important indicator of mobility and quality of life in older adults. Pain is related to gait speed; however, it is unknown if this relationship varies by race in a population based national sample. The aim of this study was to examine if the association between slow gait speed and pain differed between 7,025 older African Americans and non Hispanic Whites in the National Health and Aging Trends Study. Those with pain in the last month had higher odds of slow gait speed (odds ratio = 1.38, 95% confidence interval = 1.10 - 1.73) than those without pain. The relationship between pain and slow gait speed did not vary by race (interaction p = 0.6). This is important because it points to the underlying racial disparities in pain and gait speed being factors such as disparate opportunities and living conditions, and healthcare rather than attributes intrinsic to race.
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Affiliation(s)
- Janiece L Taylor
- School of Nursing, Johns Hopkins University, 525 North Wolfe St., Baltimore, MD 21205, USA.
| | - Lauren J Parker
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205, USA
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, 525 North Wolfe St., Baltimore, MD 21205, USA; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205, USA
| | - Roland J Thorpe
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205, USA; Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205, USA
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