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Ickert EC, Hughes T, Berg-Carramusa CA, Dudash S, Kerns L. Overestimation of Balance Ability Among Older Adults at Risk for Falls. J Aging Health 2024; 36:286-298. [PMID: 37358257 DOI: 10.1177/08982643231186630] [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] [Indexed: 06/27/2023]
Abstract
Objective: This study examined alignment of subjective balance confidence with Stopping Elderly Accidents, Deaths and Injuries (STEADI) fall risk. Methods: Cross-sectional analysis of 155 community-dwelling adults (60 + y/o) from 2016 to 2018 who completed a STEADI fall assessment. Descriptive statistics, Chi-Square analysis, and biserial point correlations were applied. Results: Adults who overestimate balance confidence, 55.6% (n = 50) reported a fall in the past year, 62.2% (n = 56) were worried about falling, 48.9% (n = 44) felt unsteady when standing/walking, and 70.0% (n = 63) had a score of ≥4 on the Stay Independent Questionnaire (SIQ). Physical performance for these adults were mean TUG score 10.9s (SD = 3.4), mean 30 second chair stands 10.8 (SD = 3.5), and mean 4-stage balance score 3.1 (SD = .76). Discussion: Older adults are more likely to overestimate their subjective balance confidence. Individuals are equally likely to have reported a fall in the past year if they were "at fall risk," regardless of their subjective balance confidence.
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Affiliation(s)
- Edmund C Ickert
- Department of Graduate Studies in Rehabilitation Sciences, Youngstown State University, Youngstown, OH, USA
| | - Tiffany Hughes
- Department of Graduate Studies in Rehabilitation Sciences, Youngstown State University, Youngstown, OH, USA
| | - Cara A Berg-Carramusa
- Department of Graduate Studies in Rehabilitation Sciences, Youngstown State University, Youngstown, OH, USA
| | - Shannon Dudash
- Department of Graduate Studies in Rehabilitation Sciences, Youngstown State University, Youngstown, OH, USA
| | - Lucy Kerns
- Department of Mathematics and Statistics, Youngstown State University, Youngstown, OH, USA
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Huynh E, Wiley E, Park S, Sakakibara BM, Tang A. Examining the association between balance self-efficacy and virtual balance performance in individuals with stroke: a cross-sectional study. Top Stroke Rehabil 2024:1-9. [PMID: 38785298 DOI: 10.1080/10749357.2024.2356407] [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: 11/08/2023] [Accepted: 04/27/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Balance self-efficacy is a strong predictor of fall risk after stroke and is related to performance on balance and walking tests. The use of telerehabilitation for delivering stroke rehabilitation has increased in recent years and there is a need to adapt common clinical assessments to be administered in virtual formats, but the association between balance self-efficacy and virtually administered clinical tests of balance performance has yet to be established. This study examined the association between the Activities-specific Balance Confidence (ABC) Scale and virtually administered Timed Up and Go (TUG), Tandem Stand, and Functional Reach tests (FRT) in individuals with stroke. METHODS This was a secondary analysis of baseline data from two telerehabilitation trials with individuals with stroke. All assessments were administered by trained physical therapists through videoconferencing software. Multivariate regression analyses were used to examine the associations between the ABC scale and TUG test, Tandem Stand test, and FRT, adjusted for age and number of comorbidities. RESULTS Data from 51 participants (n = 11 female, median age = 64 [IQR: 18] years, 9.3 ± 4.6 months poststroke) were analyzed. The ABC scores were associated with TUG (R2 = 0.56, F(3,47) = 20.26, p < 0.01), but not Tandem Stand (R2 = 0.18, F(5,45) = 1.93, p = 0.11) or FRT (R2 = 0.14, F(3,47) = 2.55, p = 0.07) tests. CONCLUSION We observed associations between the ABC scores and virtual TUG, but not with Tandem Stand or FRT, which may be attributed to the context-specificity of balance self-efficacy. As virtual administration of outcomes assessments becomes part of common practice in stroke rehabilitation, our study supports the use of virtually administered TUG in stroke.
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Affiliation(s)
- Eric Huynh
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Elise Wiley
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Sarah Park
- Centre for Chronic Disease Prevention and Management, Faculty of Medicine, The University of British Columbia, Kelowna, Canada
| | - Brodie M Sakakibara
- Centre for Chronic Disease Prevention and Management, Faculty of Medicine, The University of British Columbia, Kelowna, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
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Mochizuki G, Dang N, Inness EL, Chandra T, Foster E, Comper P, Bayley MT, Danells C. Measurement Properties of the Activities-Specific Balance Confidence Scale in Adults From the General Population With Concussion: A Report From the Toronto Concussion Study. Arch Phys Med Rehabil 2024:S0003-9993(24)00991-2. [PMID: 38719165 DOI: 10.1016/j.apmr.2024.05.003] [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: 10/03/2023] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE The aim of this study was to establish the internal consistency and construct validity of the Activities-specific Balance Confidence (ABC) Scale and ABC-6 in adults from the general population with concussion. DESIGN Prospective analysis. SETTING Outpatient concussion care clinic. PARTICIPANTS Adults from the general population with concussion referred to a concussion care clinic within 7 days of injury (N=511). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Balance confidence was assessed with the Activities-specific Balance Confidence (ABC) Scale and the ABC-6. Concussion symptoms were characterized using the Sport Concussion Assessment Tool version 5 (SCAT5) symptom checklist. Instrumented measures of balance and gait included center of pressure velocity and double support time, respectively. Balance was also assessed using the mBESS. RESULTS The ABC and ABC-6 were strongly correlated (ρ=0.980, P<.001). Cronbach α for ABC and ABC-6 was 0.966 and 0.940, respectively. Factor analysis verified the existence of 2 components of the ABC, 1 including all items of the ABC-6 as well as 3 additional items. ABC and ABC-6 were moderately significantly correlated with SCAT5 symptom number, severity, and symptom domain (ρ=-0.350 to -0.604). However, correlations between ABC and ABC-6 with instrumented measures of balance and gait were not statistically significant, except for double support time during dual-task gait with ABC-6 (ρ=-0.218). CONCLUSIONS In community-dwelling adults with concussion, the ABC and ABC-6 have good internal consistency. Convergent validity is stronger for symptom endorsement measures within SCAT5 domains, which has a similar construct (subjectivity) to balance confidence. Both the ABC and ABC-6 are valid measures of balance self-efficacy in adults from the general population with concussion. The ABC-6 may be a useful tool for characterizing the effect of concussion on perceptions of the ability to perform functional tasks that challenge balance and mobility.
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Affiliation(s)
- George Mochizuki
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada; UHN-Toronto Rehabilitation Institute, Toronto, Canada.
| | - Norman Dang
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada
| | - Elizabeth L Inness
- UHN-Toronto Rehabilitation Institute, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - Evan Foster
- UHN-Toronto Rehabilitation Institute, Toronto, Canada
| | - Paul Comper
- UHN-Toronto Rehabilitation Institute, Toronto, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Mark T Bayley
- UHN-Toronto Rehabilitation Institute, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Cynthia Danells
- UHN-Toronto Rehabilitation Institute, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Suprawesta L, Chen SJ, Liang HY, Hwang HF, Yu WY, Lin MR. Factors affecting cognitive frailty improvement and progression in Taiwanese older adults. BMC Geriatr 2024; 24:105. [PMID: 38287238 PMCID: PMC10823623 DOI: 10.1186/s12877-024-04700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Knowledge of predictors of cognitive frailty (CF) trajectories is required to develop preventive strategies to delay or reverse the progression from CF to dementia and other adverse outcomes. This 2-year prospective study aimed to investigate factors affecting the progression and improvement of CF in older Taiwanese adults. METHODS In total, 832 community-dwelling people aged ≥ 65 years were eligible. Fried's five frailty criteria were used to measure prefrailty and frailty, while cognitive performance was assessed by the Clinical Dementia Rating and Mini-Mental State Examination. Each component of reversible CF and potentially reversible CF was assigned a score, with a total score ranging 0 to 5 points. Two annual follow-up CF assessments were conducted. The group-based trajectory model was applied to identify latent CF trajectory groups, and a multinomial logistic regression was used to examine relationships of explanatory variables with CF trajectories. RESULTS According to data on 482 subjects who completed the two annual follow-ups, three CF trajectories of robust, improvement, and progression were identified. After adjusting for the baseline CF state, CF progression was significantly associated with an older age (odds ratio [OR] = 1.08; 95% confidence interval [CI], 1.02 ~ 1.14), a lower Tinetti balance score (OR = 0.72; 95% CI, 0.54 ~ 0.96), a slower gait (OR = 0.98; 95% CI, 0.97 ~ 0.99), and four or more comorbidities (OR = 2.65; 95% CI, 1.19 ~ 5.90), while CF improvement was not significantly associated with any variable except the baseline CF state. In contrast, without adjusting for the baseline CF state, CF progression was significantly associated with an older age, female sex, balance scores, gait velocity, regular exercise, the number of comorbidities, and depression, while CF improvement was significantly associated with female sex, balance scores, and the number of comorbidities. CONCLUSIONS The baseline CF state, an older age, poorer balance, slower gait, and a high number of comorbidities may contribute to CF progression, while the baseline CF state may account for associations of engaging in regular exercise and depression with CF development.
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Affiliation(s)
- Lalu Suprawesta
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan, ROC
- Department of Sport and Health Education, Faculty of Sport Science and Public Health, Universitas Pendidikan Mandalika, Mataram, West Nusa Tenggara, Indonesia
| | - Sy-Jou Chen
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Hui-Yu Liang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Hei-Fen Hwang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Wen-Yu Yu
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC
| | - Mau-Roung Lin
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan, ROC.
- Programs in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC.
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Li DE, Chiang JL, Loh ZHM, Zainuldin R. Taekwondo Poomsae practise in slow motion and the balance of healthy older adults: A Pre-Experimental Study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e2027. [PMID: 37313781 DOI: 10.1002/pri.2027] [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: 01/14/2023] [Revised: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND PURPOSE Poor balance confidence and functional balance can lead to falls in community-dwelling older adults. Exercises utilising slow movements have been shown to improve balance in this population. It is hypothesised that by superimposing the use of slow movements onto Taekwondo Poomsae, there could be similar benefits in improving balance confidence and functional balance in older adults. METHODS This was a pre - experimental study. Fifteen community-dwelling older adults received 11 weeks of Slow Poomsae (SP) training using a proposed 50-min protocol. Pre- and post-intervention scores of the Activities-Specific Balance Confidence Simplified Scale (ABC-S), Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and 'Timed Up and Go' test (TUG) assessments were recorded and compared. RESULTS Fifteen eligible participants with mean and standard deviation (SD) of age 73.8 (6.05) years completed the study. Significant improvements (p < 0.05) were seen in the pre-post differences between ABC-S, BBS, DGI, and TUG, with median score changes of 15 points (Z = -3.408), 3 points (Z = -3.306), 3 points (Z = -2.852), and 3.5 s (Z = -3.296) respectively. CONCLUSION The preliminary findings support the efficacy of SP as a potential balance training programme that is safe for healthy older adults to improve their balance confidence and functional balance. More research is required on this topic that leans towards a large population blinded randomised controlled trial with a longer intervention period and inclusion of a follow-up to further elucidate the effects of long-term practice and novelty of SP.
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Affiliation(s)
- Derong Eric Li
- Physiotherapy, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Ji Long Chiang
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Zhi Hao Melvin Loh
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Rahizan Zainuldin
- Physiotherapy, Ng Teng Fong General Hospital, Singapore, Singapore
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
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Tiernan C, Goldberg A. The Original and Short Versions of the Activities-Specific Balance Confidence (ABC) Scale in Community-Dwelling Older Adults: Clinical Implications Based on Scale Agreement, Internal Consistencies, and Associations With Self-Rated Health. J Geriatr Phys Ther 2023; 46:132-138. [PMID: 36935463 DOI: 10.1519/jpt.0000000000000345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Balance confidence assessment in older adults has implications for falls prevention and quality of life. It remains unclear whether the original Activities-specific Balance Confidence Scale (ABC-16) or the shortened 6-item scale (ABC-6) is recommended clinically. This study examined ABC-16 and ABC-6 association and agreement, internal consistencies, and relationships with self-rated health (SRH) in community-dwelling older adults. METHODS Secondary analysis of an existing dataset (N = 77) was performed. Scale association and agreement were assessed with a Spearman ρ correlation (rs), intraclass correlation coefficient, 95% limits of agreement (LoA), and Bland-Altman plot. Cronbach α values were calculated to determine internal consistencies. Separate multiple linear regression models with SRH as the outcome and ABC-6 and ABC-16 scores as primary predictors were estimated and subsequently used to conduct Hotelling t test. RESULTS AND DISCUSSION Participants were primarily female (80.5%) with a median age of 68 years living in the metro Detroit area. The ABC-6 and ABC-16 were closely associated [rs = 0.97, P < .001; intraclass correlation coefficient (2,1) = 0.80] but demonstrated discrepancy (95% LoA range of -3.9 to +18.2; mean difference = 7.2 points in the direction of the ABC-16). Cronbach α values were 0.95 (ABC-16) and 0.89 (ABC-6). Regression model 1 (ABC-6 = primary predictor) explained more of the variance (R2 = 0.36) in SRH compared with model 2 (ABC-16 = primary predictor; R2 = 0.29). Hotelling t test [t(74) = 2.4, P = .008] found that the predicted values from the ABC-6 model were significantly more highly correlated with SRH than those from the ABC-16 model. CONCLUSIONS Despite a high correlation between the ABC-16 and ABC-6, the 2 scales showed limited agreement and should not be considered interchangeable. Given that the ABC-16 takes longer to administer, does not relate to SRH as strongly, and could have redundant items, the ABC-6 may be preferable to the ABC-16 for balance confidence assessment in older adults living in cold weather, urban, or well-resourced areas.
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Affiliation(s)
- Chad Tiernan
- Physical Therapy Department, University of Michigan-Flint, Flint
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Alsubaie SF, Whitney SL, Furman JM, Marchetti GF, Sienko KH, Sparto PJ. Rating of perceived difficulty scale for measuring intensity of standing balance exercises in individuals with vestibular disorders. J Vestib Res 2022; 32:529-540. [PMID: 36120749 DOI: 10.3233/ves-210146] [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: 01/07/2023]
Abstract
BACKGROUND A method for prescribing the difficulty or intensity of standing balance exercises has been validated in a healthy population, but requires additional validation in individuals with vestibular disorders. OBJECTIVE This study validated the use of ratings of perceived difficulty for estimation of balance exercise intensity in individuals with vestibular disorders. METHODS Eight participants with a confirmed diagnosis of a vestibular disorder and 16 healthy participants performed two sets of 16 randomized static standing exercises across varying levels of difficulty. Root Mean Square (RMS) of trunk angular velocity was recorded using an inertial measurement unit. In addition, participants rated the perceived difficulty of each exercise using a numerical scale ranging from 0 (very easy) to 10 (very difficult). To explore the concurrent validity of rating of perceived difficulty scale, the relationship between ratings of perceived difficulty and sway velocity was assessed using multiple linear regression for each group. RESULTS The rating of perceived difficulty scale demonstrated moderate positive correlations RMS of trunk velocity in the pitch (r = 0.51, p < 0.001) and roll (r = 0.73, p < 0.001) directions in participants with vestibular disorders demonstrating acceptable concurrent validity. CONCLUSIONS Ratings of perceived difficulty can be used to estimate the intensity of standing balance exercises in individuals with vestibular disorders.
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Affiliation(s)
- Saud F Alsubaie
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Susan L Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Joseph M Furman
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gregory F Marchetti
- Department of Physical Therapy, Duquesne University, Pittsburgh, PA, United States
| | - Kathleen H Sienko
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Patrick J Sparto
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, United States
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Lea A, Collett J, Cribb L, Zheng Z, Podugu PSDV. A Cross-Sectional Study of Factors associated with Psychosocial Wellbeing Among Older Tai Chi Practitioners. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Chen PH, Yang YY, Liao YY, Cheng SJ, Wang PN, Cheng FY. Factors Associated with Fear of Falling in Individuals with Different Types of Mild Cognitive Impairment. Brain Sci 2022; 12:brainsci12080990. [PMID: 35892431 PMCID: PMC9332262 DOI: 10.3390/brainsci12080990] [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: 07/05/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022] Open
Abstract
Mild cognitive impairment (MCI) is considered an intermediate state between normal aging and early dementia. Fear of falling (FOF) could be considered a risk indicator for falls and quality of life in individuals with MCI. Our objective was to explore factors associated with FOF in those with MCI due to Alzheimer’s disease (AD-MCI) and mild cognitive impairment in Parkinson’s disease (PD-MCI). Seventy-one participants were separated into two groups, AD-MCI (n = 37) and PD-MCI (n = 34), based on the disease diagnosis. FOF was assessed using the Activities-specific Balance Confidence scale. The neuropsychological assessment and gait assessment were also measured. FOF was significantly correlated with global cognitive function, attention and working memory, executive function, Tinetti assessment scale scores, gait speed, and stride length in the AD-MCI group. Moreover, attention and working memory were the most important factors contributing to FOF. In the PD-MCI group, FOF was significantly correlated with gait speed, and time up and go subtask performance. Furthermore, turn-to-walk was the most important factor contributing to FOF. We noted that FOF in different types of MCI was determined by different factors. Therapies that aim to lower FOF in AD-MCI and PD-MCI populations may address attention and working memory and turn-to-walk, respectively.
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Affiliation(s)
- Pei-Hao Chen
- Department of Neurology, MacKay Memorial Hospital, Taipei 104, Taiwan; (P.-H.C.); (S.-J.C.)
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan
- Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei 106, Taiwan
| | - Ya-Yuan Yang
- Institute of Long-Term Care, MacKay Medical College, New Taipei City 252, Taiwan;
- Kaifeng Minquan Day Care Center, Taipei 104, Taiwan
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
| | - Shih-Jung Cheng
- Department of Neurology, MacKay Memorial Hospital, Taipei 104, Taiwan; (P.-H.C.); (S.-J.C.)
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Pei-Ning Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Department of Neurology, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Fang-Yu Cheng
- Institute of Long-Term Care, MacKay Medical College, New Taipei City 252, Taiwan;
- Correspondence: ; Tel.: +886-226-360-303
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Alsubheen SA, Beauchamp MK, Ellerton C, Goldstein R, Alison JA, Dechman G, Haines KJ, Harrison SL, Holland AE, Lee AL, Marques A, Spencer L, Stickland M, Skinner EH, Brooks D. Validity of the Activities-specific Balance Confidence Scale in individuals with chronic obstructive pulmonary disease. Expert Rev Respir Med 2022; 16:689-696. [DOI: 10.1080/17476348.2022.2099378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sanaa A. Alsubheen
- School of Rehabilitation Science, Faculty of Health Science, McMaster University,Hamilton, ON, Canada
| | - Marla K. Beauchamp
- School of Rehabilitation Science, Faculty of Health Science, McMaster University,Hamilton, ON, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
| | - Cindy Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto ON, Canada
| | - Jennifer A. Alison
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney NSW, Australia
- Allied Health, Sydney Local Health District, Sydney, Australia
| | - Gail Dechman
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax NS, Canada
- Department of Medicine, Respirology, Dalhousie University and Nova Scotia Health Authority, Halifax NS, Canada
| | | | - Samantha L. Harrison
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Anne E. Holland
- Department of Physiotherapy, Alfred Health, Melbourne VIC, Australia
- Respiratory Research, Monash University, Melbourne VIC, Australia
- Institute for Breathing and Sleep, Melbourne VIC, Australia
| | - Annemarie L. Lee
- Institute for Breathing and Sleep, Melbourne VIC, Australia
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne VIC, Australia
- Department of Allied Health Research, Cabrini Health, Malvern VIC, Australia
| | - Alda Marques
- Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, ESSUA) and Institute of Biomedicine, iBiMED), University of Aveiro, Aveiro, Portugal
| | - Lissa Spencer
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney NSW, Australia
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown NSW, Australia
| | - Michael Stickland
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton AB, Canada
- G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada
| | - Elizabeth H. Skinner
- Physiotherapy Department, Western Health, Melbourne VIC, Australia
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne VIC, Australia
| | - Dina Brooks
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Respiratory Research, Monash University, Melbourne VIC, Australia
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Ge L, Su TT, An Y, Mejía ST. The effectiveness of exergames on fear of falling in community-dwelling older adults: a systematic review. Aging Ment Health 2022; 26:1306-1317. [PMID: 34291684 DOI: 10.1080/13607863.2021.1950615] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ObjectivesFear of falling is common among older adults and can increase fall-risk through premature activity restriction. Exergames, an emerging tool in fall prevention, combine exercise with interactive and adaptive game elements. This review examines the extent to which exergame interventions reduce fear of falling among community-dwelling older adults. Method: Guided by the PRISMA methodology, we reviewed peer-reviewed studies that were published in English between 2006 and 2019 and employed a comparative design to test the effect of exergames on fear of falling in community-dwelling older adults. Two reviewers screened the literature and extracted data on the exergame platform, participants, study design, and results. A modified PEDro scale was used to assess study quality. Disagreements were resolved through discussion with the third reviewer. Results: Our literature search resulted in 23 eligible studies on exergame interventions where fear of falling was the primary or secondary outcome. Most interventions (35%) occurred within hospitals and were delivered via a Wii-based system (61%). Fear of falling was most commonly measured using the Falls Efficacy Scale, the Activities-specific Balance Scale and their modified versions. A total of 15 of the 23 studies reported statistically significant changes in fear of falling. Quality assessment showed 10 studies to be rated as 'good.' Conclusion: This review showed that exergame may have a positive effect in reducing fear of falling in community-dwelling older adults. The finding provides a direction for clinical practice in the research area of intervention on fear of falling in older adults.
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Affiliation(s)
- Lanying Ge
- School of Physical Education and Training, Shanghai University of Sport, Shanghai, China
| | - Tai-Te Su
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Yu An
- College of P.E and Sports, Beijing Normal University, Beijing, China
| | - Shannon T Mejía
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Chien TY, Chern JS, Wang SP, Yang Y. Effects of multitask training on cognition and motor control in people with schizophrenia spectrum disorders. PLoS One 2022; 17:e0264745. [PMID: 35771832 PMCID: PMC9246115 DOI: 10.1371/journal.pone.0264745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/11/2022] [Indexed: 11/19/2022] Open
Abstract
Schizophrenia spectrum disorder (SSD) is a disabling mental illness that causes considerable deficits in motor and cognitive functions. The purpose of this study was to examine the effects of combining traditional multitask training (TMT) and video games--a new form of multitask training (video game multitask training VGMT)--on cognition and motor control performance in people with SSD. This was a quasi-experimental, pretest-posttest design study. A total of 25 patients participated in this study voluntarily (13 males and 12 females, average age = 59.61 years, SD– 11.46 years). All participants underwent two stages of training. The first stage involved TMT, and the second stage involved VGMT. Each training stage was 12 weeks long, with sessions twice a week that lasted for 40 minutes. Cognition, upper extremity motor and postural control performance, and functional mobility and subjective balance confidence were measured at three times: before and after the first-stage training and after the second-stage training. The results revealed that TMT and the combination of TMT and VGMT improved SSD patient’s cognition, upper extremity motor control, functional mobility and postural control performance. The subjective confidence of balance during the performance of daily activities was also mildly improved. Training with multitasks in the form of video games tended to further improve the outcome measures. Patients with SSD could benefit from regular participation in various forms of multitasking activities. Whether video games training are better than TMT in improving the functional ability of people with SSD needs further investigation. Study protocol registration: Clinicaltrials.gov, ID: NCT04629898. Registered brief title: Level of Immersion of Virtual Reality and Cognition and Motor Performance in Patients of Schizophrenia Spectrum Disorder.
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Affiliation(s)
- Tzu-Yun Chien
- Department of Occupational Therapy, Ministry of Health and Welfare Yuli Hospital, Hwa-lien, Taiwan
| | - Jen-Suh Chern
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal University, Taipei, Taiwan
- * E-mail:
| | - San-Ping Wang
- Department of Occupational Therapy, Ministry of Health and Welfare Yuli Hospital, Hwa-lien, Taiwan
| | - Yu Yang
- Department of Occupational Therapy, Tri-Service General Hospital Beitou Branch, Taipei, Taiwan
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13
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Mantel A, Zuluaga E, Keough J, Suarez L, Dawson N. Group Differences in Fall Risk Assessment among Community-Dwelling Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2021.2002997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Alison Mantel
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida, USA
| | - Estefania Zuluaga
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida, USA
| | - Joanna Keough
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida, USA
| | - Lara Suarez
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida, USA
| | - Nicole Dawson
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida, USA
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14
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Ogihara H, Kamo T, Tanaka R, Azami M, Kato T, Endo M, Tsunoda R, Fushiki H. Factors affecting the outcome of vestibular rehabilitation in patients with peripheral vestibular disorders. Auris Nasus Larynx 2022; 49:950-955. [PMID: 35307238 DOI: 10.1016/j.anl.2022.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/10/2022] [Accepted: 03/04/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Previous studies have reported that developmental, environmental, medical, psychological, visual, and other sensory-related factors can influence the outcome of vestibular rehabilitation. However, only a few studies have used patient's daily lives as the main outcome. In addition, in some studies, rehabilitation was not supervised by a physical therapist. This study aimed to determine the factors associated with the outcome of physical-therapist-supervised vestibular rehabilitation in patients with peripheral vestibular disorders, with the impact of dizziness on quality of life as the main outcome. METHODS This retrospective cohort study included 47 patients with peripheral vestibular disorders. A physical therapist provided 40 min of vestibular rehabilitation once a week for 4 weeks. Age, sex, disease duration, Dizziness Handicap Inventory (DHI), Timed Up-and-Go test (TUG), Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), Activity-Specific Balance Confidence Scale (ABC scale), and Hospital Anxiety and Depression Scale (HADS) were investigated. Multiple regression analysis was performed, with the DHI rate of change before and after the intervention as the objective variable. RESULTS Vestibular rehabilitation improved all outcomes. In the multiple regression analysis, the ABC scale was identified as a factor that significantly influenced the DHI rate of change (β = -0.428, p < 0.01). CONCLUSION A higher ABC scale score was associated with a lower DHI rate of change (i.e., better improvement). Therefore, it may be important to assess psychological aspects, especially confidence in balance, when implementing vestibular rehabilitation in patients with peripheral vestibular disorders.
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Affiliation(s)
- Hirofumi Ogihara
- Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, 11-1, Imaihara, Kawanakajima-machi, Nagano-City, Nagano, 381-2227 Japan; Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan.
| | - Tomohiko Kamo
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan; Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte-city, Saitama, 340-0145 Japan
| | - Ryozo Tanaka
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan; Department of Physical Therapy, Faculty of Health Sciences, Mejiro University, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
| | - Masato Azami
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan; Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte-city, Saitama, 340-0145 Japan
| | - Takumi Kato
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
| | - Mayumi Endo
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
| | - Reiko Tsunoda
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
| | - Hiroaki Fushiki
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
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15
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Mansson L, Pettersson B, Rosendahl E, Skelton DA, Lundin-Olsson L, Sandlund M. Feasibility of performance-based and self-reported outcomes in self-managed falls prevention exercise interventions for independent older adults living in the community. BMC Geriatr 2022; 22:147. [PMID: 35193495 PMCID: PMC8862529 DOI: 10.1186/s12877-022-02851-9] [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: 09/10/2021] [Accepted: 02/17/2022] [Indexed: 11/11/2022] Open
Abstract
Background Little is known about associations between performance-based measurements and self-reported scales, nor about ceiling effects or sensitivity to change to evaluate effects in the target population for self-managed exercise interventions. This study aimed to explore the feasibility of using performance-based outcomes for gait speed, functional leg strength and balance, and self-reported outcomes of falls-efficacy and functional ability in two self-managed falls prevention exercise interventions for community dwelling older adults. Methods Independent living, community-dwelling older adults (n = 67) exercised with one of two self-managed falls prevention exercise programmes, a digital programme (DP) or a paper booklet (PB) in a 4-month participant preference trial. Pre- and post-assessments, by blinded assessors, included Short Physical Performance Battery (SPPB) and 30s Chair stand test (30s CST). Participants completed self-reported questionnaires: Activities-specific and Balance Confidence scale (ABC), Iconographical Falls Efficacy Scale (Icon-FES), Late-Life Function and Disability Instrument Function Component (LLFDI-FC). In addition, improvement in balance and leg strength was also self-rated at post-assessment. Participants’ mean age was 76 ± 4 years and 72% were women. Results Ceiling effects were evident for the balance sub-component of the SPPB, and also indicated for ABC and Icon-FES in this high functioning population. In SPPB, gait speed, 30s CST, and LLFDI-FC, 21–56% of participants did not change their scores beyond the Minimal Clinically Important Difference (MCID). At pre-assessment all performance-based tests correlated significantly with the self-reported scales, however, no such significant correlations were seen with change-scores. Improvement of performance-based functional leg strength with substantial effect sizes and significant correlations with self-reported exercise time was shown. There were no differences in outcomes between the exercise programmes except that DP users reported improved change of leg strength to a higher degree than PB users. Conclusion The LLFDI-FC and sit-to-stand tests were feasible and sensitive to change in this specific population. The balance sub-component of SPPB and self-reported measures ABC and Icon-FES indicated ceiling effects and might not be suitable as outcome measures for use in a high functioning older population. Development and evaluation of new outcome measures are needed for self-managed fall-preventive interventions with high functioning community-dwelling older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02851-9.
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Affiliation(s)
- Linda Mansson
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Beatrice Pettersson
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lillemor Lundin-Olsson
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden.
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Lieberz D, Borgeson H, Dobson S, Ewings L, Johnson K, Klaysmat K, Schultz A, Tasson R, Borstad AL. A Physical Therapy Mobility Checkup for Older Adults: Feasibility and Participant Preferences From a Discrete Choice Experiment. J Patient Cent Res Rev 2022; 9:24-34. [PMID: 35111880 PMCID: PMC8772607 DOI: 10.17294/2330-0698.1874] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024] Open
Abstract
PURPOSE Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment. METHODS Adults over 55 years of age were recruited from the community. In the study's first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the second phase, a new sample of older adults (>55 years old) were educated about the Mobility Checkup and then completed a discrete choice experiment to determine their preferences regarding 4 attributes of this care model: cost, visit duration, desired education topic, and style of educational graphic. RESULTS Each study phase was completed by 31 participants. Of the 6 feasibility criteria, 5 were met. Visit duration exceeded the 60-minute criteria for 13 of the 31 participants. Still, 91% of participants were very satisfied with the Mobility Checkup. Ability to transition positions identified preclinical mobility disability most frequently. A 30-minute visit with no out-of-pocket cost was deemed preferred. CONCLUSIONS Older adults value knowing what physical performance measurements predict about their general health. Transitions should be evaluated as part of a Mobility Checkup for older adults. Clearly conveyed cost of health care service is important to older adult consumers.
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Affiliation(s)
- Dalerie Lieberz
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
| | | | | | - Lindsey Ewings
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
| | | | - Kori Klaysmat
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
| | - Abby Schultz
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
| | - Rachel Tasson
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
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Are weight shifting and dynamic control strategies different in postmenopausal women with and without type-I osteoporosis? Exp Gerontol 2021; 154:111529. [PMID: 34450234 DOI: 10.1016/j.exger.2021.111529] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/06/2021] [Accepted: 08/18/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Tracking postural control processes at dynamic conditions might help develop an appropriate rehabilitation program in osteoporotic women. This study aimed to investigate the differences in center of pressure (COP) control at weight shifting and dynamic tasks between postmenopausal women with and without type-I osteoporosis. Also, we investigated the correlations between bone mineral density (BMD), the activity-specific balance confidence questionnaire (ABC-Q) score, and postural control parameters. METHOD A total of 62 volunteer postmenopausal women participated in this study. The participants were classified into non-osteoporotic (NOP, T-score >1, n = 35, age = 60.04± 5.33 years) and osteoporotic (OP, T-score < -2.5, n = 27, age = 61.88 ± 5.34 years) groups. The COP sway was recorded using a Kistler force plate during performance-based Limits of Stability (LOS), Curve Tracking (CT), Sit to Stand (STS), and Turn tasks. In addition, the level of balance confidence in daily activities was evaluated by ABC-Q. RESULTS In the LOS task, COP sway velocity in the anterior direction (P = 0.02) and COP maximum excursion in the side-to-side direction (right-side P = 0.027 and left-side P = 0.044) were significantly lower in the OP than the NOP group. In the CT task, all the quantified parameters, including errors and area, showed significantly lower values in the OP group than the NOP group (P < 0.05). In the STS task, the rising index score was significantly higher in the OP group than the NOP group (P = 0.014). The two groups had an equal ABC-Q score (P = 0.175). The COP sway variables correlated significantly with the lumbar and femoral neck T-score (P < 0.05). CONCLUSION BMD decline can change weight shifting and dynamic postural control in postmenopausal women.
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18
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Association Between Inspiratory Muscle Function and Balance Ability in Older People: A Pooled Data Analysis Before and After Inspiratory Muscle Training. J Aging Phys Act 2021; 30:421-433. [PMID: 34530401 DOI: 10.1123/japa.2020-0507] [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: 03/20/2021] [Revised: 05/10/2021] [Accepted: 07/06/2021] [Indexed: 11/18/2022]
Abstract
Inspiratory muscle training (IMT) improved balance ability and respiratory muscle function in healthy older adults. The current study is a retrospective analysis to explore the relationship between inspiratory muscle function, balance ability, and adaptation to IMT. All participants (total = 129; IMT = 60; age range = 65-85 years) performed inspiratory and balance assessments, including the mini-balance evaluation system test, maximal inspiratory pressure, and peak inspiratory flow tests. Baseline inspiratory muscle function was positively related to balance ability (p < .05), and IMT-induced improvements in inspiratory function (23.3% in maximal inspiratory pressure, 8.0% in peak inspiratory flow rate, 14.9% in maximal peak inspiratory power) were related to improvements in balance (10.6% in mini-balance evaluation system test), with the greatest improvements (17.0%) observed in the oldest participants (76-85 years old, p < .05). In conclusion, with or without IMT, positive associations between inspiratory function and balance ability exist, with greater improvements in inspiratory muscle function related to greater improvements in balance ability.
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19
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Lapierre N, Um Din N, Igout M, Chevrier J, Belmin J. Effects of a Rehabilitation Program Using a Patient-Personalized Exergame on Fear of Falling and Risk of Falls in Vulnerable Older Adults: Protocol for a Randomized Controlled Group Study. JMIR Res Protoc 2021; 10:e24665. [PMID: 34435968 PMCID: PMC8430847 DOI: 10.2196/24665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/16/2020] [Accepted: 03/05/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Older adults often experience physical, sensory, and cognitive decline. Therefore, they have a high risk of falls, which leads to severe health and psychological consequences and can induce fear of falling. Rehabilitation programs using exergames to prevent falls are being increasingly studied. Medimoov is a movement-based patient-personalized exergame for rehabilitation in older adults. A preliminary study showed that its use may influence functional ability and motivation. Most existing studies that evaluate the use of exergames do not involve an appropriate control group and do not focus on patient-personalized exergames. OBJECTIVE This study aims to evaluate the effects of Medimoov on risk of falls and fear of falling in older adults compared with standard psychomotor rehabilitation. METHODS This is a serial, comparative, randomized controlled group study. Both groups (n=25 in each) will receive psychomotor rehabilitation care. However, the methods of delivery will be different; one group will be exposed to the Medimoov exergame platform, and the other only to traditional means of psychomotor rehabilitation. The selection criteria will be (1) age of 65 years or older, (2) ability to answer a questionnaire, (3) ability to stand in a bipedal position for at least 1 minute, (4) score of 13 or greater on the Short Fall Efficacy Scale, and (5) stable medical condition. An evaluation will be made prior to starting the intervention, after 4 weeks of intervention, and at the end of the intervention (after 8 weeks), and it will focus on (1) risk of falls, (2) fear of falling, and (3) cognitive evaluations. Physical activity outside the session will also be assessed by actimetry. The outcome assessment will be performed according to intention-to-treat analysis. RESULTS The protocol (2019-11-22) has been approved by the Comité de Protection des Personnes Nord-Ouest I-Université de Rouen (2019-A00395-52), which is part of the French national ethical committee. The study received funding in February 2020. As of October 2020 (submission date), and due to the context of the COVID-19 pandemic, a total of 10 participants out of 50 had been enrolled in the study. The projected date for the end of the data collection is December 2021. Data analyses have not been started yet, and publication of the results is expected for Spring 2022. CONCLUSIONS The effects of psychomotor rehabilitation using the Medimoov exergame platform on the risk and fear of falls will be evaluated. This pilot study will be the basis for larger trials. TRIAL REGISTRATION ClinicalTrials.gov NCT04134988; https://clinicaltrials.gov/ct2/show/NCT04134988. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24665.
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Affiliation(s)
- Nolwenn Lapierre
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France.,Centre de Recherches Interdisciplinaires, Université Paris Descartes, Paris, France
| | - Nathavy Um Din
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France
| | - Manuella Igout
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France
| | - Joël Chevrier
- Centre de Recherches Interdisciplinaires, Université Paris Descartes, Paris, France
| | - Joël Belmin
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France.,Faculté de Médecine Sorbonne, Sorbonne Université, Paris, France
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Herssens N, Swinnen E, Dobbels B, Van de Heyning P, Van Rompaey V, Hallemans A, Vereeck L. The Relationship Between the Activities-Specific Balance Confidence Scale and Balance Performance, Self-perceived Handicap, and Fall Status in Patients With Peripheral Dizziness or Imbalance. Otol Neurotol 2021; 42:1058-1066. [PMID: 33859139 DOI: 10.1097/mao.0000000000003166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Describe the relationship between the Activities-Specific Balance Confidence (ABC) scale and Dizziness Handicap Inventory (DHI) with balance performance, as well as fall status in patients with peripheral vestibular disorders. STUDY DESIGN Retrospective. SETTING Outpatient balance clinic, tertiary referral center. PATIENTS Data from 97 patients (age: 54.8 ± 12.3 yrs; 48 women) with dizziness or imbalance symptoms of peripheral vestibular origin were used for analysis. INTERVENTIONS /. MAIN OUTCOME MEASURES ABC-scores, DHI-scores, static and dynamic balance tests, and fall status of the past 4 weeks, 2 months, and 6 months before the time of measurement were collected. Spearman's rho correlations, χ2 with post-hoc testing, and Kruskal-Wallis with post-hoc Mann-Whitney U test results were interpreted. RESULTS The ABC- and DHI-scores show moderate correlations with static balance (ABC: r = 0.44; DHI: r = -0.34) and dynamic balance tests (ABC: r = [-0.47;0.56]; DHI: r = [-0.48;0.39]) and a strong inverse correlation with each other (ABC: 70 ± 25; DHI: 33 ± 26; r = -0.84). Related to fall status, weak correlations were found (ABC: r = [-0.29;-0.21]; DHI: r = [0.29;0.33]). Additional results show that subjects in the low-level functioning (ABC) or severe self-perceived disability (DHI) categories have a poorer balance assessed by standing balance, Timed-Up-and-Go and Functional Gait Assessment and are more likely to have experienced multiple falls. CONCLUSIONS The ABC-scale and DHI showed a strong convergent validity, additionally the ABC-scale showed a better concurrent validity with balance performances and the DHI with fall history. In general, patients with peripheral vestibular impairments reporting a lower self-confidence or a more severe self-perceived disability show worse balance performances and a higher fall incidence.
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Affiliation(s)
- Nolan Herssens
- Department of Rehabilitation Sciences, Ghent University, Ghent
- Research group MOVANT, Department of Rehabilitation Sciences and Physiotherapy
| | - Eva Swinnen
- Rehabilitation Research group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
| | - Bieke Dobbels
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem
| | - Paul Van de Heyning
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem
| | - Vincent Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem
| | - Ann Hallemans
- Research group MOVANT, Department of Rehabilitation Sciences and Physiotherapy
| | - Luc Vereeck
- Research group MOVANT, Department of Rehabilitation Sciences and Physiotherapy
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21
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Boyce MJ, McCambridge AB, Bradnam LV, Canning CG, Mahant N, Chang FCF, Fung VSC, Verhagen AP. A cross-sectional study of walking, balance and upper limb assessment scales in people with cervical dystonia. J Neural Transm (Vienna) 2021; 128:1663-1675. [PMID: 34333693 DOI: 10.1007/s00702-021-02388-y] [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: 05/19/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
Cervical dystonia (CD) is a neurological movement disorder causing the neck to move involuntarily away from the neutral position. CD is a network disorder, involving multiple brain areas and, therefore, may impair movement in parts of the body other than the neck. This study used clinical assessments to investigate walking, balance and upper limb function (UL) in people with CD; the reliability of scoring these assessments and examined for relationship between CD severity, usual exercise and clinical assessments. We conducted a prospective observational cohort study of participants with isolated, focal, idiopathic CD. Participants were assessed by experienced physiotherapists and completed three questionnaires and eight clinical assessments of fear of falling, balance confidence, walking, balance, UL function and usual exercise. Results were compared to published data from healthy adults and other neurological populations. Twenty-two people with mild to moderate CD participated. Fear of falling, gross UL function and usual exercise were worse in people with CD compared with healthy adults, while walking, balance and distal UL function were similar to healthy populations. All assessments were reliably performed by physiotherapists, and we found no correlations between the severity of dystonia or usual exercise and performance on the physical assessments. Routine performance of clinical assessment of walking and balance are likely not required in people with mild to moderate CD; however, fear of falling and gross upper limb function should be assessed to determine any problems which may be amenable to therapy.
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Affiliation(s)
- M J Boyce
- Graduate School of Health, University of Technology Sydney, Sydney, Australia. .,Physiotherapy Department, Westmead Hospital, Hawkesbury Road, Westmead, NSW, 2145, Australia.
| | - A B McCambridge
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - L V Bradnam
- Department of Exercise Sciences, The University of Auckland, Auckland, New Zealand
| | - C G Canning
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - N Mahant
- Movement Disorders Unit, Westmead Hospital, Sydney, Australia
| | - F C F Chang
- Movement Disorders Unit, Westmead Hospital, Sydney, Australia
| | - V S C Fung
- Movement Disorders Unit, Westmead Hospital, Sydney, Australia
| | - A P Verhagen
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
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22
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Hoppes CW, Lambert KH, Harvard OD, Whitney SL. Vestibular Physical Therapy Evaluation of Individuals Exposed to Directed Energy. Mil Med 2020; 187:e122-e129. [PMID: 33367739 DOI: 10.1093/milmed/usaa562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/19/2020] [Accepted: 12/11/2020] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Directed energy has been described as exposure to a unique sound/pressure phenomenon such as infrasonic or ultrasonic acoustic or electromagnetic energy. Following suspected sonic attacks on U.S. Embassies, a subset of individuals presented with a unique cluster of symptoms believed to have resulted from exposure to directed energy. The Joint Force does not have an established protocol to guide the vestibular physical therapy evaluation of individuals exposed to directed energy. Therefore, we sought to provide evidence-based guidance for conducting a comprehensive vestibular physical therapy evaluation in persons exposed to directed energy. MATERIALS AND METHODS A comprehensive search of relevant databases was performed from 2018 to the present. Four seminal articles were used to inform suggestions for clinical best practice. RESULTS The physical therapist should ask open-ended questions to understand what the individual is experiencing and use key questions to focus attention on the mechanism of injury, symptom report, and symptom timeline. The physical therapist should perform an evaluation to determine if the peripheral vestibular apparatus (semicircular canals and otoliths), vestibular nerve, and/or central pathways have been affected by directed energy exposure. Components of the quantitative examination were selected because they provide information on health condition(s), body structure and function impairments, and activity limitations but require little to no specialized equipment. CONCLUSIONS Evidence-based guidance for conducting a comprehensive vestibular physical therapy evaluation in individuals exposed to directed energy may aid in the identification and diagnosis of unconventional brain injury. This standardized approach can help physical therapists to evaluate complaints that do not match any previously known medical conditions but resemble brain injury or vestibular pathology.
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Affiliation(s)
- Carrie W Hoppes
- U.S. Army Medical Center of Excellence, Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX 78234, USA
| | | | - Orlando D Harvard
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Susan L Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA 15219, USA
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BALANCE TRAINING: DOES ANTICIPATED BALANCE CONFIDENCE CORRELATE WITH ACTUAL BALANCE CONFIDENCE FOR DIFFERENT UNSTABLE OBJECTS? Int J Sports Phys Ther 2020; 15:977-984. [PMID: 33344014 DOI: 10.26603/ijspt20200977] [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] [Indexed: 01/12/2023] Open
Abstract
Background Sports rehabilitation professionals often prescribe unstable objects for balance training. Unfortunately, there is a lack of measurement of balance confidence when incorporating these objects. Currently, there is no consensus on the optimal balance confidence measure or proposed progression of unstable objects. Understanding the influence of balance confidence on task performance using unstable objects may help professionals better prescribe a balance training program. Purpose The primary purpose of this investigation was to explore the correlation between anticipated and actual balance confidence on different unstable objects during static double leg and single leg stance. The secondary purpose was to explore the correlation between anticipated and actual unstable object difficulty rankings. Study Design Repeated measure observational, controlled trial. Methods Sixty-five active, healthy adults (M = 35, F = 30) (mean age = 24.38 ± 3.56) underwent two testing sessions. During session one, participants took an online survey, rating their anticipated balance confidence after observing images of different unstable objects. During session two, participants stood on each unstable object under two conditions (static double leg stance and single leg stance) and rated their actual balance confidence. The main outcome measure was an ordinal balance confidence score adapted from the activities-specific balance confidence scale. Statistical analysis included subject demographic calculations and appropriate non-parametric tests. Results For the double leg stance and single leg stance conditions, there was a very strong correlation between anticipated and actual balance confidence scores on the stable surface (ρ = 1.0, p = <.001). There was a weak correlation between scores for foam pad, air-filled discs, Bosu® (dome up), Bosu® (dome down), and wobble board for both conditions. For unstable object rankings, there was a very strong correlation between scores (ρ=1.0, p = <.001). The objects were ranked by perceived difficulty as follows: Level 1 (easy)- ground, Level 2- foam pad, Level 3- air-filled discs, Level 4- Bosu®, and Level 5 (difficult)- wobble board. Conclusion Study findings suggest that actual measures of balance confidence may provide insight into a patient's confidence level and may help with prescribing and progressing their program. The suggested unstable object difficulty rankings may help professionals better match the objects to their patients to produce optimal outcomes. Level of Evidence 2c.
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Chewning B, Hallisy KM, Mahoney JE, Wilson D, Sangasubana N, Gangnon R. Disseminating Tai Chi in the Community: Promoting Home Practice and Improving Balance. THE GERONTOLOGIST 2020; 60:765-775. [PMID: 30811543 DOI: 10.1093/geront/gnz006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Falls among older adults is a pressing public health challenge. Considerable research documents that longer tai chi courses can reduce falls and improve balance. However, longer courses can be challenging to implement. Our goal was to evaluate whether a short 6-week modified tai chi course could be effective at reducing falls risk if older adults designed a personal home practice plan to receive a greater tai chi "dose" during the 6 weeks. DESIGN A 3-city wait-listed randomized trial was conducted. Habituation Intention and Social Cognitive Theories framed the "coaching" strategy by which participants designed practice plans. RE-AIM and Treatment Fidelity Frameworks were used to evaluate implementation and dissemination issues. Three advisory groups advised the study on intervention planning, implementation, and evaluation. To measure effectiveness, we used Centers for Disease Control and Prevention recommended measures for falls risk including leg strength, balance, and mobility and gait. In addition, we measured balance confidence and executive function. RESULTS Program Implementation resulted in large class sizes, strong participant retention, high program fidelity and effectiveness. Participants reported practicing an average of 6 days a week and more than 25 min/day. Leg strength, tandem balance, mobility and gait, balance confidence, and executive function were significantly better for the experimental group than control group. CONCLUSION The tai chi short course resulted in substantial tai chi practice by older adults outside of class as well as better physical and executive function. The course reach, retention, fidelity, and implementation across 3 cities suggest strong potential for implementation and dissemination of the 6-week course.
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Affiliation(s)
- Betty Chewning
- Social and Administrative Sciences Division, School of Pharmacy
| | - Kristine M Hallisy
- Doctor of Physical Therapy Program, Department of Family Medicine and Community Health
| | - Jane E Mahoney
- Division of Geriatrics, Department of Medicine, School of Medicine and Public Health
| | - Dale Wilson
- Social and Administrative Sciences Division, School of Pharmacy
| | | | - Ronald Gangnon
- Population Health, Department of Population Health Sciences.,Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison
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25
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Criminger C, Thompson M, Swank C, Medley A. Ankle motor strategy use in older and younger adults as assessed by a two-dimensional kinematic analysis smart device application. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2018.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims Motor strategies change with age, resulting in balance deficits. Clinical options for objectively measuring motor strategies are limited. The use of two-dimensional kinematic analysis through smart devices and applications may provide a cost-effective portable solution for measuring differences in motor strategy use between older and younger adults. The aims of this study were to investigate the concurrent validity of a two-dimensional software and two-dimensional application and to determine whether the application could capture the difference in ankle motor strategy use by older and younger adults (construct validity). Methods Video clips captured by Sony and iPad Air cameras were used to assess concurrent validity between the two-dimensional software and application. A total of 30 older (72.6 ± 4.0 years) and 30 younger (26.5±4.5 years) adults performed forward and backward stepping. A two-dimensional applicationmeasured the ankle position in degrees and time taken in seconds to initiate and complete a compensatory step. Results The two-dimensional software and app demonstrated excellent reliability (ICC2,1 ≥0.994). The ankle forward stop angle differed significantly between older and younger adults (P=0.012). No differences were observed in time taken to initiate and complete a compensatory step. Conclusions The two-dimensional application appears to be a valid alternative to two-dimensional software for measuring ankle motor strategies. Further investigation for clinical use is warranted.
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Affiliation(s)
- Christina Criminger
- Department of Physical Therapy, Winston-Salem State University, Winston-Salem, NC, USA
| | - Mary Thompson
- School of Physical Therapy, Texas Woman's University, Dallas, TX, USA
| | - Chad Swank
- Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA
| | - Ann Medley
- School of Physical Therapy, Texas Woman's University, Dallas, TX, USA
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26
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Fritz H, Hu YL, Tarraf W, Patel P. Feasibility of a Habit Formation Intervention to Delay Frailty Progression Among Older African Americans: A Pilot Study. THE GERONTOLOGIST 2020; 60:1353-1363. [PMID: 31688909 DOI: 10.1093/geront/gnz143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Older African Americans are at high risk for becoming frail in later life. Interventions can reverse or delay frailty, yet African Americans have largely been excluded from such research. Many interventions are also time- and resource-intensive, and thus inaccessible to socially disadvantaged older African Americans. We evaluated the feasibility of a low-dose frailty prevention intervention integrated with primary care among 60 community-dwelling, prefrail older African Americans aged 55+ recruited from a primary care clinic. RESEARCH DESIGN AND METHODS We conducted a 2-arm randomized control trial. Participants were assigned to a 4-session intervention (1 session per month), delivered by an occupational therapist, or enhanced usual care. Feasibility criteria were set a priori at 75% for participant retention (including attrition due to death/hospitalization), 80% for session engagement, 2 participants/week for mean participant accrual, and 90% for program satisfaction. RESULTS Participants were 65% female with an average age of 76.6 years, 51.7% lived alone and 39.1% reported <$10,000 in yearly income. Feasibility metrics were met. The study recruited, a mean of, 2.5 participants per week and retained 75% of participants who attended 95% of scheduled sessions. The mean satisfaction score was 29.75 (range = 0-32; SD .25). Changes in physical activity and dietary habit formation as well as changes in secondary outcomes were largely in the expected direction. DISCUSSION AND IMPLICATIONS The intervention was feasible to deliver. Qualitative findings from exit interviews suggested changes to the program dose, structure, and content that could improve it for future use.
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Affiliation(s)
- Heather Fritz
- Institute of Gerontology, Detroit, Michigan.,Eugene Applebaum College of Pharmacy and Health Care Sciences, Department of Health Care Sciences, Detroit, Michigan
| | - Yi-Ling Hu
- Institute of Gerontology, Detroit, Michigan.,Eugene Applebaum College of Pharmacy and Health Care Sciences, Department of Health Care Sciences, Detroit, Michigan
| | - Wassim Tarraf
- Institute of Gerontology, Detroit, Michigan.,Eugene Applebaum College of Pharmacy and Health Care Sciences, Department of Health Care Sciences, Detroit, Michigan
| | - Pragnesh Patel
- School of Medicine, Wayne State University, Detroit, Michigan
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27
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The Postural Stability Measures Most Related to Aging, Physical Performance, and Cognitive Function in Healthy Adults. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5301534. [PMID: 32908898 PMCID: PMC7463407 DOI: 10.1155/2020/5301534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/07/2020] [Accepted: 08/14/2020] [Indexed: 11/17/2022]
Abstract
Background Different measures have been used to quantify body balance; some of which use technology to measure postural sway, others are physical performance or self-reported. However, there is little information on the best postural sway measures associated with aging, physical performance, and cognitive function measures. Objective To evaluate the relationship between postural sway measures and aging, physical performance, and cognitive function measures. Methods A total of 51 subjects (53% female, mean age 53.2 ± 21 years) participated in this cross-sectional study. The participants completed the Activities-specific Balance Confidence (ABC) Scale questionnaire, the Functional Gait Assessment (FGA), the Montreal Cognitive Assessment (MoCA) test, and gait speed. Afterward, the participants performed 8 balance exercises, and their postural sway was measured using a force plate. Spearman's rank correlation coefficient was used to examine the relationship between the study variables. Results Age was negatively associated with cognitive function, gait speed, ABC scores, and FGA scores. In addition, cognitive ability was associated positively with ABC scores (r = 0.38, p ≤ 0.01). Age, FGA scores, and gait speed were significantly associated with the postural sway of the AP direction in some exercises and in all exercises in the ML directions (p < 0.05). The cognitive function and ABC scores were significantly associated with only postural sway measures in the ML direction (p < 0.05). Conclusion The postural sway measures in the lateral direction had more and stronger associations with age, physical performance, and cognitive function measures compared to those in the AP direction.
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Cuesta-Vargas A, Martin-Martin J, Gonzalez-Sanchez M, Merchan-Baeza JA, Perez-Cruzado D. Identification of Tools for the Functional and Subjective Assessment of Patients in an Aquatic Environment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165690. [PMID: 32781711 PMCID: PMC7460483 DOI: 10.3390/ijerph17165690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/16/2022]
Abstract
Aquatic therapy is one of the most common treatments for alleviating musculoskeletal pathologies. Its effectiveness has been evaluated with functional tests and questionnaires. Functional tests are used in aquatic therapy; however, in most cases, they are carried out in a non-aquatic environment and, as such, their results may differ from those of tests performed in an aquatic environment. A systematic review was performed to assess the accuracy of functional tests and patient-reported outcomes to assess aquatic therapy interventions. The authors conducted a literature search in July 2019. In total, 70,863 records were identified after duplicates removed. Of these, 14 records were included about functional tests assessment in aquatic environment and 725 records for questionnaires. The majority of the tests had also been assessed in a dry environment, allowing differences and similarities between the tests in the two environments to be observed. Different variables have been assessed in tests included in the present systematic review (cardiorespiratory, neuromuscular, kinematic, physiological, kinetic responses and rating of perceived exertion) which are included in the manuscript. Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and the 12-item Short Form Health Survey were the assessments most commonly used by the different authors.
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Affiliation(s)
- Antonio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Malaga, Spain; (A.C.-V.); (M.G.-S.)
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
| | - Jaime Martin-Martin
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Legal Medicine Area, Department of Human Anatomy, Legal Medicine and History of Science, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain
- Correspondence:
| | - Manuel Gonzalez-Sanchez
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Malaga, Spain; (A.C.-V.); (M.G.-S.)
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
| | - Jose Antonio Merchan-Baeza
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | - David Perez-Cruzado
- Institute of Biomedical Research in Malaga (IBIMA), 29071 Malaga, Spain; (J.A.M.-B.); (D.P.-C.)
- Department of Occupational Therapy, Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
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Cappleman AS, Thiamwong L. Fear of Falling Assessment and Interventions in Community-Dwelling Older Adults: A Mixed Methods Case-Series. Clin Gerontol 2020; 43:471-482. [PMID: 31805830 DOI: 10.1080/07317115.2019.1701169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES (1) assess fear of falling (FOF) in community-dwelling older adults using subjective and objective measures and, (2) explore older adults' perceptions of FOF assessments and interventions. METHODS A mixed methods case-series was utilized. It consisted of quantitative data collection by objective measures including the BTrackSTM Balance Test (BBT) and a dynamometer to assess physiological fall risk, and in-depth interviews from four older adults in Orlando, Florida. A single Fear of Falling Scale and Falls Efficacy Scale-International (FES-I) were used to assess FOF. To combine quantitative and qualitative data, a case-specific analysis was used and followed by a cross-case analysis to gain a more comprehensive understanding of FOF. RESULTS We found an incongruent fear of falling with physiological fall risk. Four themes emerged: (1) Fluctuating definitions of "fear" contribute to difficulty in assessments and interventions, (2) Fundamental assessments for fear of falling are missing, (3) Feedback from an objective measure is valuable, and (4) Family experiences with fear of falling drive personal interventions. CONCLUSIONS The integrated viewpoints from quantitative and qualitative data suggest a need for FOF assessment based on older adults' perceptive and physiological measures. CLINICAL IMPLICATIONS Healthcare providers should assess FOF using subjective and objective measures.
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Affiliation(s)
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida , Orlando, FL, USA.,Disability, Aging and Technology Research Cluster, University of Central Florida , Orlando, FL, USA
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Pischke CR, Voelcker-Rehage C, Peters M, Ratz T, Pohlabeln H, Meyer J, von Holdt K, Lippke S. Implementation and Effects of Information Technology-Based and Print-Based Interventions to Promote Physical Activity Among Community-Dwelling Older Adults: Protocol for a Randomized Crossover Trial. JMIR Res Protoc 2020; 9:e15168. [PMID: 32338622 PMCID: PMC7215507 DOI: 10.2196/15168] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/13/2019] [Accepted: 01/27/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. OBJECTIVE We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. METHODS Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants' intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. RESULTS The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. CONCLUSIONS Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. TRIAL REGISTRATION German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15168.
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Affiliation(s)
- Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Manuela Peters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tiara Ratz
- Jacobs University Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Jochen Meyer
- OFFIS - Institute for Information Technology, Oldenburg, Germany
| | - Kai von Holdt
- OFFIS - Institute for Information Technology, Oldenburg, Germany
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Kafri M, Hutzler Y, Korsensky O, Laufer Y. Functional Performance and Balance in the Oldest-Old. J Geriatr Phys Ther 2020; 42:183-188. [PMID: 28574916 DOI: 10.1519/jpt.0000000000000133] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The group of individuals 85 years and over (termed oldest-old) is the fastest-growing population in the Western world. Although daily functional abilities and balance capabilities are known to decrease as an individual grows older, little is known about the balance and functional characteristics of the oldest-old population. The aims of this study were to characterize balance control, functional abilities, and balance self-efficacy in the oldest-old, to test the correlations between these constructs, and to explore differences between fallers and nonfallers in this age group. METHODS Forty-five individuals living in an assisted living facility who ambulated independently participated in the study. The mean age was 90.3 (3.7) years. Function was tested using the Late-Life Function and Disability Instrument (LLFDI). Balance was tested with the mini-Balance Evaluation System Test (mini-BESTest) and the Timed Up and Go (TUG) test. Balance self-efficacy was tested with the Activities-Specific Balance Confidence (ABC) scale. RESULTS The mean total function LLFDI score was 63.2 (11.4). The mean mini-BESTest score was 69.8% (18.6%) and the mean TUG time was 12.6 (6.9) seconds. The mean ABC score was 80.2% (14.2%). Good correlation (r > 0.7) was observed between the ABC and the function component of the LLFDI, as well as with the lower extremity domains. Correlations between the mini-BESTest scores and the LLFDI were fair to moderate (r's range: 0.38-0.62). Age and ABC scores were significant independent explanators of LLFDI score (P = .0141 and P = .0009, respectively). Fallers and nonfallers differed significantly across all outcome measures scores, except for TUG and for the "Reactive Postural Control" and "Sensory Orientation" domains of the mini-BESTest. DISCUSSION AND CONCLUSIONS The results of this study provide normative data regarding the balance and functional abilities of the oldest-old, and indicate a strong association between self-efficacy and function. These results emphasize the importance of incorporating strategies that maintain and improve balance self-efficacy in interventions aimed at enhancing the functional level of this cohort.
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Affiliation(s)
- Michal Kafri
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Yeshayahu Hutzler
- The Zinman College of Physical Education and Sport Sciences, Wingate Institute, Netanya, Israel
| | - Olga Korsensky
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.,The Zinman College of Physical Education and Sport Sciences, Wingate Institute, Netanya, Israel
| | - Yocheved Laufer
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Alghwiri AA, Khalil H, Al-Sharman A, El-Salem K. Psychometric properties of the Arabic Activities-specific Balance Confidence scale in people with multiple sclerosis: Reliability, validity, and minimal detectable change. NeuroRehabilitation 2020; 46:119-125. [DOI: 10.3233/nre-192900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alia A. Alghwiri
- The University of Jordan, School of Rehabilitation Sciences, Department of Physical Therapy, Amman, Jordan
| | - Hanan Khalil
- Jordan University of Science and Technology, Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Irbid, Jordan
| | - Alham Al-Sharman
- Jordan University of Science and Technology, Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Irbid, Jordan
| | - Khalid El-Salem
- Jordan University of Science and Technology, Faculty of Medicine, Department of Neurosciences, Irbid, Jordan
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Systematic Review of the Effects of Cognitive and Behavioral Interventions on Fall-Related Psychological Concerns in Older Adults. J Aging Phys Act 2020; 28:155-168. [DOI: 10.1123/japa.2017-0408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This systematic review aims to evaluate the efficacy of cognitive and behavioral interventions for improving fall-related psychological concerns. A systematic search yielded eight randomized controlled trials eligible for inclusion. All studies compared a cognitive and behavioral intervention with a control. The meta-analysis showed that cognitive and behavioral treatments had beneficial effects on fear of falling outcomes (lower score better) immediately after treatment (random-effects standardized mean difference [SMD]: −0.3, 95% confidence interval [CI] [−0.50, −0.10]) and at the longer term follow-up (random-effects SMD: −0.29, 95% CI [−0.49, −0.09]). Cognitive and behavioral treatments also showed a positive effect on falls efficacy outcomes (higher score better) immediately after treatment (fixed-effects SMD: 0.19, 95% CI [0.04, 0.34]) and over the longer term (fixed-effects SMD: 0.13, 95% CI [−0.00, 0.25]). However, the clinical significance of these effects on fear of falling and falls efficacy was unclear. Further work is required with best-practice comparators over a longer follow-up period.
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Ohtsu H, Yoshida S, Minamisawa T, Katagiri N, Yamaguchi T, Takahashi T, Yomogida SI, Kanzaki H. Does the balance strategy during walking in elderly persons show an association with fall risk assessment? J Biomech 2020; 103:109657. [PMID: 32035661 DOI: 10.1016/j.jbiomech.2020.109657] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/27/2019] [Accepted: 01/22/2020] [Indexed: 11/25/2022]
Abstract
The primary objective of this study was to clarify whether balance evaluation during walking in elderly people was related to fall risk assessment; the second objective was to clarify the difference in balance strategy between young and elderly people based on the balance evaluation through a gait cycle. Thirty healthy young adults and 25 healthy elderly adults participated. All participants performed walking at their preferred speed and at a fast speed. Based on the margin of stability (MoS), balance during a gait cycle was divided into medial/lateral and anterior/posterior direction (ML/AP-MoS). Positive/negative integral values of ML-MoS were defined as ML-MoSPOS/ML-MoSNEG, and the average of AP-MoS over the gait cycle was defined as AP-MoSmean. The fast/preferred ratio of AP-MoSmean/ML-MoSPOS (AP-MoSmean (Fast/Preferred)/ML-MoSPOS (Fast/Preferred)) and the fast-preferred difference of ML-MoSNEG (ML-MoSNEG (Fast-Preferred)) were compared between groups. ML/AP-MoS at the preferred/fast gait was also compared between 12 gait events and groups. The Japanese version of the Mini-Balance Evaluation Systems Test (J-Mini-BESTest), the Japanese version of the Activities-specific Balance Confidence Scale (J-ABC scale), and the number of falls in the past year were obtained from all subjects. ML-MoSPOS (Fast/Preferred), ML-MoSNEG (Fast-Preferred), and AP-MoSmean (Fast/Preferred) were significantly correlated with J-Mini-BESTest. Gait balance evaluation based on MoS may reflect an individual's balance function. In fast gait, ML-MoS at foot flat and toe off and AP-MoS at just before heel strike were highly likely to be gait events to identify elderly adults with balance disorders.
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Affiliation(s)
- Hajime Ohtsu
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-city, Yamagata 990-2212, Japan.
| | - Shinya Yoshida
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-city, Yamagata 990-2212, Japan
| | - Tadayoshi Minamisawa
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-city, Yamagata 990-2212, Japan
| | - Natsuki Katagiri
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-city, Yamagata 990-2212, Japan
| | - Tomofumi Yamaguchi
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-city, Yamagata 990-2212, Japan
| | - Toshiaki Takahashi
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-city, Yamagata 990-2212, Japan
| | - Shin-Ichi Yomogida
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-city, Yamagata 990-2212, Japan
| | - Hideto Kanzaki
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-city, Yamagata 990-2212, Japan
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Gordt K, Mikolaizak AS, Taraldsen K, Bergquist R, Van Ancum JM, Nerz C, Pijnappels M, Maier AB, Helbostad JL, Vereijken B, Becker C, Schwenk M. Creating and Validating a Shortened Version of the Community Balance and Mobility Scale for Application in People Who Are 61 to 70 Years of Age. Phys Ther 2020; 100:180-191. [PMID: 31581286 DOI: 10.1093/ptj/pzz132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 04/30/2019] [Accepted: 06/14/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND The Community Balance and Mobility Scale (CBM) has been shown to be reliable and valid for detecting subtle balance and mobility deficits in people who are 61 to 70 years of age. However, item redundancy and assessment time call for a shortened version. OBJECTIVE The objective was to create and validate a shortened version of the CBM (s-CBM) without detectable loss of psychometric properties. DESIGN This was a cross-sectional study. METHODS Exploratory factor analysis with data from 189 young seniors (aged 61-70 years; mean [SD] age = 66.3 [2.5] years) was used to create the s-CBM. Sixty-one young seniors (aged 61-70 years; mean [SD] age = 66.5 [2.6] years) were recruited to assess construct validity (Pearson correlation coefficient) by comparing the CBM versions with Fullerton Advance Balance Scale, Timed Up-and-Go, habitual and fast gait speed, 8 Level Balance Scale, 3-m tandem walk, and 30-second chair stand test. Internal consistency (Cronbach α), ceiling effects, and discriminant validity (area under the curve [AUC]) between fallers and nonfallers, and self-reported high and low function (Late-Life Function and Disability Index) and balance confidence (Activities-Specific Balance Confidence Scale), respectively, were calculated. RESULTS The s-CBM, consisting of 4 items, correlated excellently with the CBM (r = 0.97). Correlations between s-CBM and other assessments (r = 0.07-0.72), and CBM and other assessments (r = 0.06-0.80) were statistically comparable in 90% of the correlations. Cronbach α was .84 for the s-CBM, and .87 for the CBM. No CBM-version showed ceiling effects. Discriminative ability of the s-CBM was statistically comparable with the CBM (AUC = 0.66-0.75 vs AUC = 0.65-0.79). LIMITATIONS Longitudinal studies with larger samples should confirm the results and assess the responsiveness for detecting changes over time. CONCLUSIONS The psychometric properties of the s-CBM were similar to those of the CBM. The s-CBM can be recommended as a valid and quick balance and mobility assessment in young seniors.
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Affiliation(s)
- Katharina Gordt
- Network Aging Research, Heidelberg University, Bergheimer Str 20, 69115 Heidelberg, Germany
| | | | - Kristin Taraldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ronny Bergquist
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology
| | - Jeanine M Van Ancum
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, the Netherlands
| | - Corinna Nerz
- Department of Clinical Gerontology, Robert Bosch Hospital
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, and Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology
| | - Clemens Becker
- Department of Clinical Gerontology, Robert Bosch Hospital
| | - Michael Schwenk
- Network Aging Research, and Institute of Sports and Sports Sciences, Heidelberg University
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Wingert JR, Corle CE, Saccone DF, Lee J, Rote AE. Effects of a Community-Based Tai Chi Program on Balance, Functional Outcomes, and Sensorimotor Function in Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2019.1709600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jason R. Wingert
- Department of Health and Wellness, One University Heights, University of North Carolina Asheville, Asheville, North Carolina, USA
| | - Caitlin E. Corle
- Department of Health and Wellness, One University Heights, University of North Carolina Asheville, Asheville, North Carolina, USA
| | - Diane F. Saccone
- Healthy Aging Initiatives, YMCA of Western North Carolina, Asheville, North Carolina, USA
| | - Jimin Lee
- Department of Mathematics, One University Heights, University of North Carolina Asheville, Asheville, North Carolina, USA
| | - Aubrianne E. Rote
- Department of Health and Wellness, One University Heights, University of North Carolina Asheville, Asheville, North Carolina, USA
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Cherup NP, Buskard AN, Strand KL, Roberson KB, Michiels ER, Kuhn JE, Lopez FA, Signorile JF. Power vs strength training to improve muscular strength, power, balance and functional movement in individuals diagnosed with Parkinson's disease. Exp Gerontol 2019; 128:110740. [DOI: 10.1016/j.exger.2019.110740] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
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Sun R, Hsieh KL, Sosnoff JJ. Fall Risk Prediction in Multiple Sclerosis Using Postural Sway Measures: A Machine Learning Approach. Sci Rep 2019; 9:16154. [PMID: 31695127 PMCID: PMC6834625 DOI: 10.1038/s41598-019-52697-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 10/21/2019] [Indexed: 11/09/2022] Open
Abstract
Numerous postural sway metrics have been shown to be sensitive to balance impairment and fall risk in individuals with MS. Yet, there are no guidelines concerning the most appropriate postural sway metrics to monitor impairment. This investigation implemented a machine learning approach to assess the accuracy and feature importance of various postural sway metrics to differentiate individuals with MS from healthy controls as a function of physiological fall risk. 153 participants (50 controls and 103 individuals with MS) underwent a static posturography assessment and a physiological fall risk assessment. Participants were further classified into four subgroups based on fall risk: controls, low-risk MS (n = 34), moderate-risk MS (n = 27), high-risk MS (n = 42). Twenty common sway metrics were derived following standard procedures and subsequently used to train a machine learning algorithm (random forest - RF, with 10-fold cross validation) to predict individuals' fall risk grouping. The sway-metric based RF classifier had high accuracy in discriminating controls from MS individuals (>86%). Sway sample entropy was identified as the strongest feature for classification of low-risk MS individuals from healthy controls. Whereas for all other comparisons, mediolateral sway amplitude was identified as the strongest predictor for fall risk groupings.
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Affiliation(s)
- Ruopeng Sun
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, USA.
- Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, USA.
| | - Katherine L Hsieh
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, USA
| | - Jacob J Sosnoff
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, USA
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Manderoos S, Wasenius NS, Laine MK, Kujala UM, Mälkiä EA, Kaprio J, Sarna S, Bäckmand HM, Kettunen JA, Aunola S, Eriksson JG. Power of lower extremities and age were the main determinants on the agility test for adults in a cohort of men aged 66–91 years. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1650395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sirpa Manderoos
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Public Health Solutions, The National Institute for Health and Welfare, Turku, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Niko S. Wasenius
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Merja K. Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Vantaa Health Center, Vantaa, Finland
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Esko A. Mälkiä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute of Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - Seppo Sarna
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Heli M. Bäckmand
- Joint Authority Administration, The Hospital District of Helsinki and Uusimaa, Helsinki, Finland
| | | | - Sirkka Aunola
- Department of Welfare, The National Institute for Health and Welfare, Turku, Finland
| | - Johan G. Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
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Chua CHM, Jiang Y, Lim DS, Wu VX, Wang W. Effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling among community‐dwelling older adults: A systematic review and meta‐analysis. J Adv Nurs 2019; 75:3299-3315. [DOI: 10.1111/jan.14150] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/10/2019] [Accepted: 07/02/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Claris Hui Min Chua
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Der Shin Lim
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
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Mathis RA, Taylor JD, Odom BH, Lairamore C. Reliability and Validity of the Patient-Specific Functional Scale in Community-Dwelling Older Adults. J Geriatr Phys Ther 2019; 42:E67-E72. [DOI: 10.1519/jpt.0000000000000188] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Santos SCAD, Figueiredo DMPD. [Predictors of the fear of falling among community-dwelling elderly Portuguese people: an exploratory study]. CIENCIA & SAUDE COLETIVA 2019; 24:77-86. [PMID: 30698242 DOI: 10.1590/1413-81232018241.29932016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/18/2017] [Indexed: 11/22/2022] Open
Abstract
The fear of falling constitutes a real risk factor for falls. It has also been associated with functional decline, decreased quality of life and increased social isolation among the elderly population. This study analyzed predictors of the fear of falling in elderly Portuguese people that live in the community. A cross-sectional study with a convenience sample of 98 participants (57.1% women; mean age 74.07 ± 8.74 years) was conducted. Data were collected with a protocol which includes a questionnaire for sociodemographic and health information, the Activity Specific Balance Confidence Scale, the Hospital Anxiety and Depression Scale, the Lubben Social Network Scale-6, the Timed Up and Go, and Five Times Sit to Stand Test. Data were analyzed using descriptive and inferential statistics. The results showed that female gender (p = 0.01), the perception of good (p = 0.01) and moderate (p = 0.02) physical health and the symptoms of depression (p ≈ 0.00) are predictors of fear of falling. Controlling these predictors is a fundamental aspect for promoting the independence of elderly people minimizing the consequences that are associated with the fear of falling.
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Affiliation(s)
- Sónia Cristina Antunes Dos Santos
- Departamento de Educação e Psicologia, Escola Superior de Saúde, Universidade de Aveiro (ESSUA). Campus Universitário de Santiago Edifício 30, Agras do Crasto. 3810-193 Aveiro Portugal.
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Hopewell S, Adedire O, Copsey BJ, Boniface GJ, Sherrington C, Clemson L, Close JCT, Lamb SE. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2018; 7:CD012221. [PMID: 30035305 PMCID: PMC6513234 DOI: 10.1002/14651858.cd012221.pub2] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Falls and fall-related injuries are common, particularly in those aged over 65, with around one-third of older people living in the community falling at least once a year. Falls prevention interventions may comprise single component interventions (e.g. exercise), or involve combinations of two or more different types of intervention (e.g. exercise and medication review). Their delivery can broadly be divided into two main groups: 1) multifactorial interventions where component interventions differ based on individual assessment of risk; or 2) multiple component interventions where the same component interventions are provided to all people. OBJECTIVES To assess the effects (benefits and harms) of multifactorial interventions and multiple component interventions for preventing falls in older people living in the community. SEARCH METHODS We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature, trial registers and reference lists. Date of search: 12 June 2017. SELECTION CRITERIA Randomised controlled trials, individual or cluster, that evaluated the effects of multifactorial and multiple component interventions on falls in older people living in the community, compared with control (i.e. usual care (no change in usual activities) or attention control (social visits)) or exercise as a single intervention. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, assessed risks of bias and extracted data. We calculated the rate ratio (RaR) with 95% confidence intervals (CIs) for rate of falls. For dichotomous outcomes we used risk ratios (RRs) and 95% CIs. For continuous outcomes, we used the standardised mean difference (SMD) with 95% CIs. We pooled data using the random-effects model. We used the GRADE approach to assess the quality of the evidence. MAIN RESULTS We included 62 trials involving 19,935 older people living in the community. The median trial size was 248 participants. Most trials included more women than men. The mean ages in trials ranged from 62 to 85 years (median 77 years). Most trials (43 trials) reported follow-up of 12 months or over. We assessed most trials at unclear or high risk of bias in one or more domains.Forty-four trials assessed multifactorial interventions and 18 assessed multiple component interventions. (I2 not reported if = 0%).Multifactorial interventions versus usual care or attention controlThis comparison was made in 43 trials. Commonly-applied or recommended interventions after assessment of each participant's risk profile were exercise, environment or assistive technologies, medication review and psychological interventions. Multifactorial interventions may reduce the rate of falls compared with control: rate ratio (RaR) 0.77, 95% CI 0.67 to 0.87; 19 trials; 5853 participants; I2 = 88%; low-quality evidence. Thus if 1000 people were followed over one year, the number of falls may be 1784 (95% CI 1553 to 2016) after multifactorial intervention versus 2317 after usual care or attention control. There was low-quality evidence of little or no difference in the risks of: falling (i.e. people sustaining one or more fall) (RR 0.96, 95% CI 0.90 to 1.03; 29 trials; 9637 participants; I2 = 60%); recurrent falls (RR 0.87, 95% CI 0.74 to 1.03; 12 trials; 3368 participants; I2 = 53%); fall-related hospital admission (RR 1.00, 95% CI 0.92 to 1.07; 15 trials; 5227 participants); requiring medical attention (RR 0.91, 95% CI 0.75 to 1.10; 8 trials; 3078 participants). There is low-quality evidence that multifactorial interventions may reduce the risk of fall-related fractures (RR 0.73, 95% CI 0.53 to 1.01; 9 trials; 2850 participants) and may slightly improve health-related quality of life but not noticeably (SMD 0.19, 95% CI 0.03 to 0.35; 9 trials; 2373 participants; I2 = 70%). Of three trials reporting on adverse events, one found none, and two reported 12 participants with self-limiting musculoskeletal symptoms in total.Multifactorial interventions versus exerciseVery low-quality evidence from one small trial of 51 recently-discharged orthopaedic patients means that we are uncertain of the effects on rate of falls or risk of falling of multifactorial interventions versus exercise alone. Other fall-related outcomes were not assessed.Multiple component interventions versus usual care or attention controlThe 17 trials that make this comparison usually included exercise and another component, commonly education or home-hazard assessment. There is moderate-quality evidence that multiple interventions probably reduce the rate of falls (RaR 0.74, 95% CI 0.60 to 0.91; 6 trials; 1085 participants; I2 = 45%) and risk of falls (RR 0.82, 95% CI 0.74 to 0.90; 11 trials; 1980 participants). There is low-quality evidence that multiple interventions may reduce the risk of recurrent falls, although a small increase cannot be ruled out (RR 0.81, 95% CI 0.63 to 1.05; 4 trials; 662 participants). Very low-quality evidence means that we are uncertain of the effects of multiple component interventions on the risk of fall-related fractures (2 trials) or fall-related hospital admission (1 trial). There is low-quality evidence that multiple interventions may have little or no effect on the risk of requiring medical attention (RR 0.95, 95% CI 0.67 to 1.35; 1 trial; 291 participants); conversely they may slightly improve health-related quality of life (SMD 0.77, 95% CI 0.16 to 1.39; 4 trials; 391 participants; I2 = 88%). Of seven trials reporting on adverse events, five found none, and six minor adverse events were reported in two.Multiple component interventions versus exerciseThis comparison was tested in five trials. There is low-quality evidence of little or no difference between the two interventions in rate of falls (1 trial) and risk of falling (RR 0.93, 95% CI 0.78 to 1.10; 3 trials; 863 participants) and very low-quality evidence, meaning we are uncertain of the effects on hospital admission (1 trial). One trial reported two cases of minor joint pain. Other falls outcomes were not reported. AUTHORS' CONCLUSIONS Multifactorial interventions may reduce the rate of falls compared with usual care or attention control. However, there may be little or no effect on other fall-related outcomes. Multiple component interventions, usually including exercise, may reduce the rate of falls and risk of falling compared with usual care or attention control.
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Affiliation(s)
- Sally Hopewell
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Botnar Research Centre, Windmill RoadOxfordOxfordshireUKOX3 7LD
| | - Olubusola Adedire
- OxehealthBiomedical EngineeringThe Sadler Building, Oxford Science Park, OxfordOxfordUKOX4 4GE
| | - Bethan J Copsey
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Botnar Research Centre, Windmill RoadOxfordOxfordshireUKOX3 7LD
| | - Graham J Boniface
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of OxfordCentre for Rehabilitation Research in Oxford (RRIO)Botnar Research Centre, Windmill RoadOxfordUKOX3 7LD
| | - Catherine Sherrington
- School of Public Health, The University of SydneyMusculoskeletal Health SydneyPO Box 179Missenden RoadSydneyNSWAustralia2050
| | - Lindy Clemson
- The University of SydneyFaculty of Health SciencesEast St. LidcombeLidcombeNSWAustralia1825
| | - Jacqueline CT Close
- Neuroscience Research AustraliaFalls, Balance and Injury Research CentreBarker StRandwickAustraliaNSW 2031
| | - Sarah E Lamb
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Botnar Research Centre, Windmill RoadOxfordOxfordshireUKOX3 7LD
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Bobić Lucić L, Grazio S. Impact of Balance Confidence on Daily Living Activities of Older People with Knee Osteoarthritis with Regard to Balance, Physical Function, Pain, and Quality of Life - A Preliminary Report. Clin Gerontol 2018; 41:357-365. [PMID: 29617207 DOI: 10.1080/07317115.2018.1453907] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The objective of this study was to explore the impact of balance confidence on different activities of daily living (ADL) in older people with knee osteoarthritis (OA). METHODS Forty-seven consecutive participants with knee OA were included in this cross-sectional study. They were divided according to the results of the Activities-specific Balance Confidence (ABC) Scale into a group with a low level of confidence in physical functioning (ABC < 50, n = 22) and a group with moderate and high levels of confidence (ABC ≥ 50, n = 25). RESULTS In the ABC < 50 group, the effect of pain on ADL, the physician's global assessment of the disease, and the Western Ontario and McMaster Universities Osteoarthritis Index scores were significantly higher, while quality of life (Short form-36) was lower compared to the ABC ≥ 50 group. No significant difference was found between the two groups regarding the static and dynamic balance measurements. CONCLUSIONS Older people with knee OA who were less confident in their daily physical activities had more physical difficulties and a greater effect of pain on ADL, lower quality of life, and a higher physician's global assessment, but no differences were obtained in balance tests. CLINICAL IMPLICATIONS In people with knee OA, decreased balance confidence is associated with more physical difficulties, an increased effect of pain on ADL, and lower quality of life. An improved awareness of decreased balance confidence may lead to more effective management of older people with knee OA by improving their mobility and QOL through rehabilitation. Furthermore, future research in that direction is warranted.
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Affiliation(s)
- Lana Bobić Lucić
- a Clinic Department of Rheumatology, Physical Medicine and Rehabilitation , Special Hospital for Medical Rehabilitation Lipik , Lipik , Croatia
| | - Simeon Grazio
- b Clinical Hospital Center Sisters of Mercy , Zagreb , Croatia
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Rasch Analysis of the Activities-Specific Balance Confidence Scale in Older Adults Seeking Outpatient Rehabilitation Services. J Orthop Sports Phys Ther 2018; 48:574-583. [PMID: 29602305 DOI: 10.2519/jospt.2018.8023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background The Activities-specific Balance Confidence (ABC) scale measures confidence in performing various ambulatory activities without falling or experiencing a sense of unsteadiness. Objectives This study (1) examined the ABC scale (0-100) using Rasch analysis, (2) assessed statistically reliable change, and (3) developed a functional staging to guide clinical interpretation of a patient's improvement. Methods The authors examined rating-scale structure, item difficulty hierarchy, item fit, person-item match, separation index, differential item functioning, test precision, and unidimensionality. Additionally, this cross-sectional study of 5012 older patients seeking outpatient rehabilitation therapy in 123 clinics estimated the minimal detectable change and developed a functional staging. Results The item "walk outside on icy sidewalks" was the most difficult item, while the item "reach for a small can off a shelf at eye level" was the easiest item. Overall, average patient ability estimates of 56.2 ± 20.3 were slightly higher than the average item difficulty estimates of 45.9 ± 7.8. With a separation index equal to 3.65, the ABC scale items can differentiate individuals into 5.2 statistically distinct strata. Most ABC scale items were free of differential item functioning. For example, "walk outside on icy sidewalks" was easier for patients who were underweight. Results supported unidimensionality of the ABC scale, with the first factor explaining 77% of the total variance. The estimated minimal detectable change was 15 points. The authors provided an example of functional staging application. Conclusion Results supported sound psychometric properties and clinical usage of the ABC scale for older adults seeking outpatient rehabilitation therapy. J Orthop Sports Phys Ther 2018;48(7):574-583. Epub 30 Mar 2018. doi:10.2519/jospt.2018.8023.
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Hetherington S, Henwood T, Swinton P, Keogh J, Gardiner P, Tuckett A, Rouse K. Engineering Improved Balance Confidence in Older Adults With Complex Health Care Needs: Learning From the Muscling Up Against Disability Study. Arch Phys Med Rehabil 2018; 99:1525-1532. [PMID: 29626427 DOI: 10.1016/j.apmr.2018.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 02/07/2018] [Accepted: 03/04/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change. DESIGN Intervention study. SETTING Community-based older adult-specific exercise clinic. PARTICIPANTS Older adults (N=245) with complex care needs who were receiving government-funded aged care support. INTERVENTIONS Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists. MAIN OUTCOME MEASURES The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level. RESULTS At baseline, better physical performance (r=.54; P<.01) and quality of life (r=.52; P<.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r=-.55; P<.01). Change in balance confidence after the exercise intervention was accompanied by improved physical performance (+12%) and reduced frailty (-11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention. CONCLUSIONS This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls in older adults.
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Affiliation(s)
| | - Tim Henwood
- School of Human Movement and Nutritional Sciences, The University of Queensland, Brisbane, Australia; Southern Cross Care (SA and NT), Adelaide, South Australia, Australia
| | - Paul Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond Institute of Health & Sport, Bond University, Gold Coast, Queensland, Australia; Human Potential Centre, AUT University, Auckland, New Zealand; Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Paul Gardiner
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia; Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Anthony Tuckett
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Kevin Rouse
- Burnie Brae Ltd, Brisbane, Queensland, Australia
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Prediction of Falls in Subjects Suffering From Parkinson Disease, Multiple Sclerosis, and Stroke. Arch Phys Med Rehabil 2018; 99:641-651. [PMID: 29102438 DOI: 10.1016/j.apmr.2017.10.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/26/2017] [Accepted: 10/05/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the risk of falls and fall predictors in patients with Parkinson disease (PD), multiple sclerosis (MS), and stroke using the same study design. DESIGN Multicenter prospective cohort study. SETTING Institutions for physical therapy and rehabilitation. PARTICIPANTS Patients (N=299) with PD (n=94), MS (n=111), and stroke (n=94) seen for rehabilitation. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Functional scales were applied to investigate balance, disability, daily performance, self-confidence with balance, and social integration. Patients were followed for 6 months. Telephone interviews were organized at 2, 4, and 6 months to record falls and fall-related injuries. Incidence ratios, Kaplan-Meier survival curves, and Cox proportional hazards models were used. RESULTS Of the 299 patients enrolled, 259 had complete follow-up. One hundred and twenty-two patients (47.1%) fell at least once; 82 (31.7%) were recurrent fallers and 44 (17.0%) suffered injuries; and 16%, 32%, and 40% fell at 2, 4, and 6 months. Risk of falls was associated with disease type (PD, MS, and stroke in decreasing order) and confidence with balance (Activities-specific Balance Confidence [ABC] scale). Recurrent fallers were 7%, 15%, and 24% at 2, 4, and 6 months. The risk of recurrent falls was associated with disease type, high educational level, and ABC score. Injured fallers were 3%, 8%, and 12% at 2, 4, and 6 months. The only predictor of falls with injuries was disease type (PD). CONCLUSIONS PD, MS, and stroke carry a high risk of falls. Other predictors include perceived balance confidence and high educational level.
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MacDowell SG, Wellons R, Bissell A, Knecht L, Naquin C, Karpinski A. The impact of symptoms of anxiety and depression on subjective and objective outcome measures in individuals with vestibular disorders. J Vestib Res 2018; 27:295-303. [DOI: 10.3233/ves-170627] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sara G. MacDowell
- Our Lady of the Lake Hearing and Balance Center, Baton Rouge, LA, USA
| | - Rachel Wellons
- Department of Physical Therapy, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA
| | - Ashlen Bissell
- Department of Physical Therapy, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA
| | - Lisa Knecht
- Department of Physical Therapy, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA
| | - Caitlin Naquin
- Department of Physical Therapy, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA
| | - Aryn Karpinski
- Department of Evaluation and Measurement, Kent State University, Kent, OH, USA
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Paker N, Bugdayci D, Demircioglu UB, Sabirli F, Ozel S. Reliability and validity of the Turkish version of Activities-specific Balance Confidence scale in symptomatic knee osteoarthritis. J Back Musculoskelet Rehabil 2017; 30:461-466. [PMID: 27858674 DOI: 10.3233/bmr-150335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Activities-specific Balance Confidence (ABC) scale is a well known tool to evaluate the functional balance. Balance impairment may accompany to knee osteoarthritis. OBJECTIVE The aim was to investigate the reliability and validity of the Turkish version of ABC in knee osteoarthritis. METHODS Forty-nine patients with knee osteoarthritis were included. All the participants were evaluated by ABC and Berg Balance Scale (BBS). Knee Injury and Osteoarthritis Outcome Score (KOOS) was used for the assessment of the knee related condition. RESULTS Mean age was 64.7 ± 9.2. Eighty-five percent was women. Mean ABC score was 53.5% and BBS score was 40. Interclass correlation coefficient was 0.95. There was a statistically significant positive correlation between the test-retest results (t= 1.90, p= 0.063). Correlation coefficient was high (p= 0.001, r= 0.953). Cronbach's alpha was 0.97. There was a significant positive correlation between ABC-T and BBS, the symptoms, daily living activities and quality of life subscales of KOOS (r= 0.555, p< 0.001; r= 0.424, r= 0.379, r= 0.621, p< 0.01). ABC-T correlated negatively with the radiological severity (r = -0.316, p< 0.05). CONCLUSIONS ABC-T is a reproducible test with excellent internal consistency and construct validity in knee osteoarthritis. Balance confidence was moderate and related with the symptoms, daily living activities, disease severity and quality of life.
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Affiliation(s)
- Nurdan Paker
- Istanbul Physical Medicine and Rehabilitation Training Hospital, Istanbul, Turkey
| | - Derya Bugdayci
- Istanbul Physical Medicine and Rehabilitation Training Hospital, Istanbul, Turkey
| | | | - Feride Sabirli
- Istanbul Physical Medicine and Rehabilitation Training Hospital, Istanbul, Turkey
| | - Sevda Ozel
- Public Health Department, University of Istanbul School of Medicine, Istanbul, Turkey
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Araya AX, Valenzuela E, Padilla O, Iriarte E, Caro C. [Fear of falling: Validation of a measurement tool in Chilean elderly living in the community]. Rev Esp Geriatr Gerontol 2017; 52:188-192. [PMID: 28559094 DOI: 10.1016/j.regg.2016.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 10/27/2016] [Accepted: 12/12/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCCIóN: Fear of falling, with or without previous falls history, is a risk factor for decreased mobility, disability, as well as a decreased quality of life, and can trigger the self-restriction of activities with loss of independence and functionality. Validated tools for measuring the fear of falling in the Chilean population is a needed to detect those at risk. There are currently no validated instruments to measure this phenomenon in Chile. The aim of this study is to validate the Spanish version of the short «Falls Efficacy Scale-International» (FES-I) in an elderly population living in the community in Chile. MATERIAL AND METHOD A cross-sectional study was performed using applications at baseline and 4 weeks. The short FES-I was translated using the back-translation method, evaluated by a panel of experts, and piloted in 10 older adults. After the pilot study, the final version was applied to a sample of 113 elderly persons. Data analysis used measures of central tendency, and reliability and confirmatory factor analysis was used. RESULTS The Spanish version of the short FES-I showed good reliability and validity in an elderly Chilean population. CONCLUSIONS This falls risks measurement tool can be used by clinicians and researchers in order to determine the magnitude of the problem and the impact of fear of falling on falls, functionality, and quality of life of the elderly who live in the community.
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Affiliation(s)
| | - Eduardo Valenzuela
- Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Oslando Padilla
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Evelyn Iriarte
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Caro
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile
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