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Lalor A, Callaway L, Koritsas S, Curran-Bennett A, Wong R, Zannier R, Hill K. Interventions to reduce falls in community-dwelling adults with intellectual disability: a systematic review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1073-1095. [PMID: 37435852 DOI: 10.1111/jir.13066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/10/2023] [Accepted: 06/16/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND People with intellectual disability have a high risk of falls and falls-related injuries. Although people with intellectual disability are at increased risk of falls, there is a need to better understand the efficacy of interventions that can help reduce falls and address risk factors in this population. This systematic review aimed to evaluate the type, nature and effectiveness of interventions undertaken to reduce falls with community-dwelling adults with intellectual disability and the quality of this evidence. METHOD Four electronic databases were searched: Ovid MEDLINE, PsycINFO, CINAHL Plus and the Cochrane Library. Studies were included if they involved people aged 18 years or over, at least 50% of study participants had intellectual disability, participants were community-dwelling, and the study evaluated any interventions aiming to reduce falls. Study quality was assessed using the National Institutes of Health study quality assessment tools. Reporting of the review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Seven studies were eligible for review, with a total of 286 participants and mean age of 50.4 years. As only one randomised trial was identified, a narrative synthesis of results was undertaken. Five studies evaluated exercise interventions, one evaluated a falls clinic programme, and one evaluated stretch fabric splinting garments. Methodological quality varied (two studies rated as good, four as fair, and one as poor). Exercise interventions varied in terms of exercise type and dosage, frequency and intensity, and most did not align with recommendations for successful falls prevention exercise interventions reported for older people. While the majority of studies reported reduced falls, they differed in methods of reporting falls, and most did not utilise statistical analyses to evaluate outcomes. CONCLUSION This review identified a small number of falls prevention intervention studies for people with intellectual disability. Although several studies reported improvements in fall outcomes, ability to draw conclusions about intervention effectiveness is limited by small sample sizes and few studies. Further large-scale research is required to implement and evaluate falls prevention interventions specifically for adults with intellectual disability.
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Affiliation(s)
- A Lalor
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
- Department of Occupational Therapy, Monash University, Melbourne, Victoria, Australia
| | - L Callaway
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
- Department of Occupational Therapy, Monash University, Melbourne, Victoria, Australia
| | - S Koritsas
- Department of Strategy and Transformation, Scope, Melbourne, Australia, Australia
| | - A Curran-Bennett
- Department of Strategy and Transformation, Scope, Melbourne, Australia, Australia
| | - R Wong
- Department of Strategy and Transformation, Scope, Melbourne, Australia, Australia
- IDEAS Therapy Services, Victoria, Australia
| | - R Zannier
- Department of Strategy and Transformation, Scope, Melbourne, Australia, Australia
| | - K Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
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Doherty AJ, O'Donoghue A, Harrison J. Developing an understanding of the risk factors for falls among adults with intellectual disabilities: a commentary. Br J Community Nurs 2023; 28:238-242. [PMID: 37130713 DOI: 10.12968/bjcn.2023.28.5.238] [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: 05/04/2023]
Abstract
Commentary on: Pope J, Truesdale M, Brown M. Risk factors for falls among adults with intellectual disabilities: A narrative review. J Appl Res Intellect Disabil. 2021; 34: 274-285. 10.1111/jar.12805 Falls are a serious and common problem for people with intellectual disabilities (ID). Whilst there is available evidence on falls risk factors for the general population, there is a lack of awareness and understanding of the contributing risk factors for this population. This commentary critically appraises a recent narrative review which sought to identify the risk factors for falls among people with ID. Clinical practice implications: Community nurses may identify people with ID at risk of falls, and work alongside other healthcare professionals and carers to provide tailored multidisciplinary falls-prevention interventions for individuals with ID living in the community.
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Affiliation(s)
- Alison J Doherty
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, Health Technology Assessment Unit, Applied Health Research Hub, University of Central Lancashire
| | | | - Joanna Harrison
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, Health Technology Assessment Unit, Applied Health Research Hub, University of Central Lancashire
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Alves JE, Pelegrini LNDC, Porcatti LR, Ansai JH, Candanedo MJBL, Gramani-Say K. Effects of a cognitive stimulation program on physical and cognitive dimensions in community-dwelling faller older adults with cognitive impairment: study protocol. BMC Neurol 2023; 23:107. [PMID: 36932354 PMCID: PMC10020753 DOI: 10.1186/s12883-023-03154-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/08/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Cognitive functioning is an important dimension among the elderly. Cognitive maintenance is vital for aging due to its association with autonomy and independence. Considering the importance of preventive programs in older adults' health, this study aims to share an intervention protocol of a falls prevention program for community-dwelling faller older adults with cognitive impairment. METHODS This is the protocol of an experimental and longitudinal study, consisting of cognitive stimulation associated with physical exercise in a 16-week fall prevention program. For cognitive intervention, the APG Cognitive Training Protocol will be used. Participants will be assessed pre-and post-intervention and will be randomly allocated to experimental or control groups. The screening protocol is composed of the TUG, FES-I, LAWTON & BRODY, ACE-R, GAI and fall survey instruments, focusing on the assessment of balance and mobility, fear of falling, performance on IADL, cognitive and anxiety tracking, respectively. DISCUSSION This study can determine the long-term effects of multimodal cognitive training, providing evidence for its replication in the provision of care for the elderly. The objective is to promote improvements in the cognitive performance, mobility and balance of the elderly, with a focus on reducing the number of falls, fractures, hospitalizations and institutionalization, serving as an alternative to interrupt the cycle of falls. TRIAL REGISTRATION The research was approved by the Research Ethics Committee with Human Beings at the Federal University of São Carlos, CAAE: 3654240.9.0000.5504 and Brazilian Registry of Clinical Trials (REBEC) RBR-3t85fd, registered on the 25th of September, 2020.
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Affiliation(s)
- José Emanuel Alves
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Lucas N. de Carvalho Pelegrini
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Luana Rafaela Porcatti
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Juliana Hotta Ansai
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Maria Juana Beatriz Lima Candanedo
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Karina Gramani-Say
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
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Flannery C, Dennehy R, Riordan F, Cronin F, Moriarty E, Turvey S, O'Connor K, Barry P, Jonsson A, Duggan E, O'Sullivan L, O'Reilly É, Sinnott SJ, McHugh S. Enhancing referral processes within an integrated fall prevention pathway for older people: a mixed-methods study. BMJ Open 2022; 12:e056182. [PMID: 35985777 PMCID: PMC9396121 DOI: 10.1136/bmjopen-2021-056182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Multifactorial interventions, which involve assessing an individual's risk of falling and providing treatment or onward referral, require coordination across settings. Using a mixed-methods design, we aimed to develop a process map to examine onward referral pathways following falls risk assessment in primary care. SETTING Primary care fall risk assessment clinics in the South of Ireland. PARTICIPANTS Focus groups using participatory mapping techniques with primary care staff (public health nurses (PHNs), physiotherapists (PT),and occupational therapists (OT)) were conducted to plot the processes and onward referral pathways at each clinic (n=5). METHODS Focus groups were analysed in NVivo V.12 using inductive thematic analysis. Routine administrative data from January to March 2018 included details of client referrals, assessments and demographics sourced from referral and assessment forms. Data were analysed in Stata V.12 to estimate the number, origin and focus of onward referrals and whether older adults received follow-up interventions. Quantitative and qualitative data were analysed separately and integrated to produce a map of the service. RESULTS Nine staff participated in three focus groups and one interview (PHN n=2; OT n=4; PT n=3). 85 assessments were completed at five clinics (female n=69, 81.2%, average age 77). The average number of risk factors was 5.4 out of a maximum of 10. Following assessment, clients received an average of three onward referrals. Only one-third of referrals (n=135/201, 33%) had data available on intervention receipt. Primary care staff identified variations in how formally onward referrals were managed and barriers, including a lack of client information, inappropriate referral and a lack of data management support. CONCLUSION Challenges to onward referral manifest early in an integrated care pathway, such as clients with multiple risk factors sent for initial assessment and the lack of an integrated IT system to share information across settings.
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Affiliation(s)
- Caragh Flannery
- School of Public Health, University College Cork, Cork, Ireland
| | - Rebecca Dennehy
- School of Public Health, University College Cork, Cork, Ireland
| | - Fiona Riordan
- School of Public Health, University College Cork, Cork, Ireland
| | - Finola Cronin
- Corks Falls Prevention Service, Health Service Executive, Naas, Ireland
| | - Eileen Moriarty
- School of Public Health, University College Cork, Cork, Ireland
- National Services for Older Persons Team, Health Service Executive, Naas, Ireland
| | - Spencer Turvey
- Cork Kerry Community Healthcare, Health Service Executive, Naas, Ireland
| | - Kieran O'Connor
- Geriatric Medicine, Mercy University Hospital, Cork, Ireland
| | - Patrick Barry
- Acute Medicine and Geriatric Medicine, Cork University Hospital Group, Cork, Ireland
| | | | - Eoin Duggan
- Geriatric Medicine, Mercy University Hospital, Cork, Ireland
- Mercers Institute for Successful Ageing, Saint James's Hospital, Dublin, Ireland
| | - Liz O'Sullivan
- Cork Kerry Community Healthcare HSE South, Health Service Executive, Dublin, Ireland
| | - Éilis O'Reilly
- School of Public Health, University College Cork, Cork, Ireland
| | - Sarah-Jo Sinnott
- Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
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Kersten M, Taminiau E, Weggeman M, Embregts P. Motives and strategies of CEOs for stimulating sharing and application of knowledge in the care and support for people with intellectual disabilities. JOURNAL OF KNOWLEDGE MANAGEMENT 2022. [DOI: 10.1108/jkm-06-2021-0463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Within intellectual disability care organizations (IDCOs), it is vital that professionals share and apply knowledge to improve the quality of care for their service users. Given that chief executive officers (CEOs) play a pivotal role in enabling these processes, this paper aims to investigate both the underlying motives and strategies behind CEOs’ organizational knowledge leadership and their contribution to improving these knowledge processes.
Design/methodology/approach
In this exploratory qualitative study, 11 CEOs from IDCOs in the Netherlands who are actively involved in knowledge management within their organizations were interviewed. An inductive thematic analysis was conducted.
Findings
CEOs’ motives for stimulating knowledge processes among professionals in IDCOs arise from the internal (e.g. the CEOs themselves) and external (e.g. policy) contexts. This study also identified four strategies adopted by CEOs to stimulate sharing and application of knowledge: providing organizational conditions for effective knowledge processes; focused attention on talent development; acknowledgment and deployment of knowledge holders; and knowledge-driven participation in collaborative partnerships. These strategies are used in combination and have been shown to reinforce one another.
Practical implications
An overview of strategies for stimulating knowledge processes is now available.
Originality/value
The results display the leadership of CEOs in knowledge strategies. Insights into their perceptions and values are provided while elaborating on their motives to take this role.
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Kersten MCO, Taminiau EF, Weggeman MCDP, Embregts PJCM. Contextual factors related to the execution of knowledge strategies in intellectual disabilities organizations. KNOWLEDGE AND PROCESS MANAGEMENT 2022. [DOI: 10.1002/kpm.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Marion C. O. Kersten
- Department of Tranzo Tilburg School of Social and Behavioural Sciences, Tilburg University Tilburg The Netherlands
- Department of quality policy Dutch Association of Healthcare Providers for People with Disabilities (VGN) Utrecht The Netherlands
| | - Elsbeth F. Taminiau
- Department of Tranzo Tilburg School of Social and Behavioural Sciences, Tilburg University Tilburg The Netherlands
| | - Mathieu C. D. P. Weggeman
- Industrial Engineering & Innovation Sciences Technical University Eindhoven Eindhoven The Netherlands
| | - Petri J. C. M. Embregts
- Department of Tranzo Tilburg School of Social and Behavioural Sciences, Tilburg University Tilburg The Netherlands
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Ho P, Bulsara M, Downs J, Patman S, Bulsara C, Hill AM. Incidence and prevalence of falls in adults with intellectual disability living in the community: a systematic review. ACTA ACUST UNITED AC 2020; 17:390-413. [PMID: 30870331 DOI: 10.11124/jbisrir-2017-003798] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of the review was too synthesize the best available evidence on the incidence and prevalence of falls among adults with intellectual disability (ID). INTRODUCTION Falls among adults with ID frequently cause physical injury and may negatively impact on their quality of life. Studies investigating falls among people with ID have used differing methods and populations, making it difficult to determine the scope and extent of this problem. INCLUSION CRITERIA This review considered all studies that included adults with ID aged 18 years and over and which reported percentage/numbers of individuals who fell, and the total number of falls and injurious falls sustained from a fall. Studies were included if they were conducted within community or residential settings. Studies that were conducted in hospitals were excluded. Cohort studies, case-control and cross-sectional studies were included. Studies that used an experimental design, both randomized controlled and quasi experimental design, were also included. METHODS A three-step search strategy was undertaken for published and unpublished literature in English from 1990 to 2017. An initial search of MEDLINE and CINAHL was undertaken before a more extensive search was conducted using keywords and index terms across 11 electronic databases. Two independent reviewers assessed the methodological quality of the included studies using the Joanna Briggs Institute standardized critical appraisal instrument for prevalence studies (Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data).Data was extracted using the Joanna Briggs Institute's standardized extraction tool. Data that directly reported or could be used to calculate the incidence and prevalence of falls were extracted. Quantitative data for the number (proportion) of people who fell were pooled in statistical meta-analysis using STATA version 14 (Stata Corp LLC, Texas, USA). Data measuring incidence of falls (rate of falls for the duration of the study) and incidence of injurious falls (rate of falls resulting in one or more injuries for the duration of the study) could not be pooled in meta-analysis, hence results have been presented in a narrative form including tables. Standard GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence assessment of outcomes is also reported. RESULTS Nine studies were eligible for inclusion in this review. Eight articles were observational cohort studies which reported on the incidence/prevalence of falls as outcome measures, and one article was a quasi-experimental study design. Overall the methodological quality of the included studies was considered moderate. The pooled proportion of people with ID who fell (four studies, 854 participants) was 39% (95% CI [0.35%-0.43%], very low GRADE evidence). The rate of falls (eight studies, 782 participants) ranged from 0.54 to 6.29 per person year (very low GRADE evidence). The rate of injurious falls (two studies, 352 participants) ranged from 0.33 to 0.68 per person year (very low GRADE evidence). CONCLUSIONS Synthesized findings demonstrate that people with ID, who live in community or residential settings, may fall more frequently, and at a younger age, compared to general community populations. Studies should take a consistent approach to measuring and reporting falls outcomes. Further research is recommended to identify the impact of falls on health related outcomes for people with ID and subsequently evaluate falls interventions for their efficacy.
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Affiliation(s)
- Portia Ho
- School of Physiotherapy, the University of Notre Dame Australia, Fremantle, Australia.,The Western Australian Group for Evidence Informed Healthcare Practice: a Joanna Briggs Institute Centre of Excellence
| | - Max Bulsara
- Institute for Health Research, the University of Notre Dame Australia, Fremantle, Australia
| | - Jenny Downs
- Telethon Kids Institute, Subiaco, Western Australia, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Shane Patman
- School of Physiotherapy, the University of Notre Dame Australia, Fremantle, Australia
| | - Caroline Bulsara
- Institute for Health Research, the University of Notre Dame Australia, Fremantle, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
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Ho P, Bulsara C, Patman S, Downs J, Hill AM. Exploring enablers and barriers to accessing health services after a fall among people with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:604-617. [PMID: 32039539 DOI: 10.1111/jar.12704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/09/2019] [Accepted: 01/15/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Adults with intellectual disability experience high rates of falls making falls prevention an important health need. The purpose of the study was to seek perspectives of older adults with intellectual disability and their caregivers to (a) explore the experiences of older adults with intellectual disability when seeking healthcare services after a fall and (b) identify enablers and barriers when taking up evidence-based falls recommendations. METHOD A qualitative exploratory study was undertaken as part of a prospective observational cohort study. Semi-structured interviews were conducted with a purposeful sample. Data were analysed thematically using Colaizzi's method. RESULTS Seventeen interviews were conducted (n = 21). Emergent themes demonstrated that participants had limited knowledge about falls prevention. Enablers included individualizing falls prevention strategies. Barriers included not being offered access to established falls prevention pathways. CONCLUSION There is an urgent need to develop high-quality falls prevention services for older adults with intellectual disability.
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Affiliation(s)
- Portia Ho
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Caroline Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Shane Patman
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Jenny Downs
- Telethon Kids Institute, Perth Children's Hospital, West Perth, WA, Australia.,Curtin University, Perth, WA, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
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Hale L, Vollenhoven E, Caiman L, Dryselius A, Buttery Y. Feasibility and acceptability of Otago Exercise Programme and Prevention of Falls for Adults with Intellectual Disability: a multiple case study design. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2018.0054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background/AimsMany people with intellectual disability fall frequently. Understanding fall prevention intervention characteristics will assist efficacy trials to target appropriate people. An exploration of two exercise-based fall prevention interventions is reported, focusing on viability and acceptability.MethodsA multiple case study of adults with intellectual disability completing either the group Otago Exercise Programme or the Prevention of Falls for Adults with Intellectual Disability intervention was performed. Integrated data sources were used: semi-structured interviews with participants and support workers, observations, attendance/adherence, falls, adverse events and balance measures.ResultsIn total, seven adults with varying intellectual disability levels participated. Overall, three themes enabled understanding of suitability of people to each intervention: suitability of the exercises; role of the environment; and benefits to participants.ConclusionsEducating adults with intellectual disability and their support workers of the importance of regular exercise is key to participation. Both programmes required high levels of support and prioritisation to ensure exercises occurred and were carried out safely.
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Affiliation(s)
- Leigh Hale
- Professor, Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Emile Vollenhoven
- Student, Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | | | | | - Yvette Buttery
- Assistant Research Fellow, Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Nissim M, Hutzler Y, Goldstein A. A walk on water: comparing the influence of Ai Chi and Tai Chi on fall risk and verbal working memory in ageing people with intellectual disabilities - a randomised controlled trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:603-613. [PMID: 30775818 DOI: 10.1111/jir.12602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 12/18/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Aquatic motor intervention has been found to be effective in reducing falls and improving verbal working memory among the general population. However, effects among older adults with intellectual disabilities (ID) have never been explored. The aim of this study was to examine the effects of aquatic motor intervention on fall risk and verbal working memory among older adults with ID. METHODS Forty-one older adults with mild to moderate ID (age: 50-66 years) were randomly assigned to 14 weeks of aquatic motor intervention (Ai Chi: N = 19) or identical on-land motor intervention (Tai Chi: N = 22). Fall risk, measured with the Tinetti balance assessment tool (TBAT), and verbal working memory, measured with the digit span forward test, were assessed pre-intervention, after 7 weeks of intervention and post-intervention. RESULTS Study results indicate positive effects of both aquatic and on-land motor intervention on TBAT fall risk score, while the aquatic motor intervention group improved TBAT fall risk score quicker as compared with the on-land motor intervention group. Moreover, the lower the pre-intervention TBAT score was, the higher the improvement. In addition, study findings support the positive effects of aquatic motor intervention on verbal working memory ability as measured with the digit span forward test. CONCLUSIONS Motor intervention, and particularly in an aquatic environment, can potentially reduce fall risk. Aquatic motor intervention may help to improve verbal working memory among older adults with ID.
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Affiliation(s)
- M Nissim
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Y Hutzler
- The Academic College at Wingate, Netanya, Israel
| | - A Goldstein
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
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11
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Enkelaar L, Overbeek M, van Wingerden E, Smulders E, Sterkenburg P. Insight into falls prevention programmes for people with visual impairments and intellectual disabilities: A scoping review. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2019. [DOI: 10.1177/0264619618823825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to review the current literature on falls prevention in people with visual impairment and to estimate the applicability of methods of fall prevention for people with visual impairment and intellectual disability. A scoping review was performed according to the Arksey and O’Malley framework. Relevant studies were collected from PubMed, Web of Science, and the Cochrane Register of Controlled Trials (CENTRAL). All records covering the time span from January 1980 until November 2017 were collected. Studies were included if the participants had a visual impairment according to objective ophthalmic assessments, the article described interventions to reduce falls or risk factors for falls, and the study was written in English and published in a peer-reviewed journal. The methodological quality of the studies were determined by consensus of the authors on the PEDro scale. Fifteen articles were included in this scoping review. Three articles focused on screening and intervention programmes, five articles addressed the effectiveness of environmental adjustments, and seven articles involved training programmes for physical improvement. Environmental adjustments emerged as having the best evidence for falls prevention for people with a visual impairment. Physical training programmes improved balance in those with a visual impairment but could not reduce the number of falls. Environmental adjustments also may be effective for persons with a visual impairment and intellectual disability. In addition, multifactorial screening and intervention programmes are recommended as an important new research direction with important clinical implications.
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Affiliation(s)
| | - Mathilde Overbeek
- Yulius Academy, The Netherlands; Vrije Universiteit Amsterdam, The Netherlands; Amsterdam Public Health Research Institute (APH), The Netherlands
| | - Evelien van Wingerden
- Vrije Universiteit Amsterdam, The Netherlands; Amsterdam Public Health Research Institute (APH), The Netherlands
| | - Ellen Smulders
- Radboud University Medical Center, The Netherlands; Avans+, The Netherlands
| | - Paula Sterkenburg
- Bartiméus, The Netherlands; Vrije Universiteit Amsterdam, The Netherlands; Amsterdam Public Health Research Institute (APH), The Netherlands
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Ho P, Bulsara C, Patman S, Bulsara M, Downs J, Hill AM. Investigating falls in adults with intellectual disability living in community settings and their experiences of post-fall care services: protocol for a prospective observational cohort study. BMC Geriatr 2018; 18:171. [PMID: 30060735 PMCID: PMC6065066 DOI: 10.1186/s12877-018-0862-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 07/16/2018] [Indexed: 11/17/2022] Open
Abstract
Background Falls among older adults with intellectual disability (ID) are recognised as a serious health problem potentially resulting in reduced health-related quality of life and premature placement in residential care. However there are limited studies that have investigated this problem and thus falls rates among older adults with ID remain uncertain. Furthermore, people with ID rely heavily on familial and professional care support to address health problems, such as after having a fall. No studies have explored the post-fall care that people with ID receive. Method This research will be carried out in two phases using a convergent mixed methods design. The aim of Phase 1 is to estimate the falls rate by prospectively observing a cohort of older adults (≥ 35 years) with ID (n = 90) for six months. Phase 1 will be conducted according to STROBE guidelines. In Phase 2, participants from Phase 1 who have experienced a fall(s) will be asked to participate in a semi-structured interview to explore their post-fall experience. Discussion This study will determine the rate of falls among older adults with ID living in community based settings, which will assist to identify the extent of this problem. Data collected from the study will also aid in understanding the circumstance of falls and related falls risk factors in this cohort. This will include exploring any barriers that older adults with ID may encounter when seeking or undertaking recommended post-fall care advice. Findings from this research will potentially inform future development of falls prevention services for older adults with ID. This study has been approved by the University Human Research Ethics Committee. Trial registration The protocol for this study is registered with the Australian New Zealand Clinical Trial Registry (ACTRN12615000926538) on 7 September 2015. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368990&isReview=true
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Affiliation(s)
- Portia Ho
- School of Physiotherapy, The University of Notre Dame Australia, 19 Mouat St, PO Box 1225, Fremantle, WA, 6959, Australia.
| | - Caroline Bulsara
- Institute for Health Research, The University of Notre Dame Australia, 19 Mouat St, PO Box 1225, Fremantle, WA, 6959, Australia
| | - Shane Patman
- School of Physiotherapy, The University of Notre Dame Australia, 19 Mouat St, PO Box 1225, Fremantle, WA, 6959, Australia
| | - Max Bulsara
- Institute for Health Research, The University of Notre Dame Australia, 19 Mouat St, PO Box 1225, Fremantle, WA, 6959, Australia
| | - Jenny Downs
- Telethon Kids Institute, 100 Roberts Road, Subiaco, PO Box 855, West Perth, Western, 6872, Australia.,School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
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Kersten MCO, Taminiau EF, Schuurman MIM, Weggeman MCDP, Embregts PJCM. How to improve sharing and application of knowledge in care and support for people with intellectual disabilities? A systematic review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:496-520. [PMID: 29696724 DOI: 10.1111/jir.12491] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND To optimise care and support for people with intellectual disabilities (ID), sharing and application of knowledge is a precondition. In healthcare in general, there is a body of knowledge on bridging the 'know-do-gap'. However, it is not known to what extent the identified barriers and facilitators to knowledge sharing and application also hold for the care and support of people with ID, due to its specific characteristics including long-term care. Therefore, we conducted a systematic review to identify which organisational factors are enabling and/or disabling in stimulating the sharing and application of knowledge in the care and support of people with ID. METHOD A systematic review was conducted using five electronic databases of relevant articles published in English between January 2000 and December 2015. During each phase of selection and analysis a minimum of two independent reviewers assessed all articles according to PRISMA guidelines. RESULTS In total 2,256 articles were retrieved, of which 19 articles met our inclusion criteria. All organisational factors retrieved from these articles were categorised into three main clusters: (1) characteristics of the intervention (factors related to the tools and processes by which the method was implemented); (2) factors related to people (both at an individual and group level); and, (3) factors related to the organisational context (both material factors (office arrangements and ICT system, resources, time and organisation) and immaterial factors (training, staff, size of team)). CONCLUSION Overall analyses of the retrieved factors suggest that they are related to each other through the preconditional role of management (i.e., practice leadership) and the key role of professionals (i.e. (in)ability to fulfill new roles).
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Affiliation(s)
- M C O Kersten
- Tilburg School of Social and Behavioural Sciences, Tilburg University, The Netherlands
- Dutch Association of Healthcare Providers for People with Disabilities (VGN), Utrecht, The Netherlands
| | - E F Taminiau
- Tilburg School of Social and Behavioural Sciences, Tilburg University, The Netherlands
| | | | - M C D P Weggeman
- Industrial Engineering and Innovation Sciences, Technical University Eindhoven, The Netherlands
| | - P J C M Embregts
- Tilburg School of Social and Behavioural Sciences, Tilburg University, The Netherlands
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Ho P, Patman S, Bulsara C, Downs J, Bulsara M, Hill AM. Incidence and prevalence of falls in adults with intellectual disability living in the community: a systematic review protocol. ACTA ACUST UNITED AC 2017; 15:1819-1823. [DOI: 10.11124/jbisrir-2016-003155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Dijkhuizen A, Krijnen WP, van der Schans CP, Waninge A. Validity of the modified Berg Balance Scale in adults with intellectual and visual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 62:58-68. [PMID: 28113094 DOI: 10.1016/j.ridd.2017.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 12/15/2016] [Accepted: 01/04/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND A modified version of the Berg Balance Scale (mBBS) was developed for individuals with intellectual and visual disabilities (IVD). However, the concurrent and predictive validity has not yet been determined. AIM The purpose of the current study was to evaluate the concurrent and predictive validity of the mBBS for individuals with IVD. METHOD Fifty-four individuals with IVD and Gross Motor Functioning Classification System (GMFCS) Levels I and II participated in this study. The mBBS, the Centre of Gravity (COG), the Comfortable Walking Speed (CWS), and the Barthel Index (BI) were assessed during one session in order to determine the concurrent validity. The percentage of explained variance was determined by analyzing the squared multiple correlation between the mBBS and the BI, COG, CWS, GMFCS, and age, gender, level of intellectual disability, presence of epilepsy, level of visual impairment, and presence of hearing impairment. Furthermore, an overview of the degree of dependence between the mBBS, BI, CWS, and COG was obtained by graphic modelling. Predictive validity of mBBS was determined with respect to the number of falling incidents during 26 weeks and evaluated with Zero-inflated regression models using the explanatory variables of mBBS, BI, COG, CWS, and GMFCS. RESULTS The results demonstrated that two significant explanatory variables, the GMFCS Level and the BI, and one non-significant variable, the CWS, explained approximately 60% of the mBBS variance. Graphical modelling revealed that BI was the most important explanatory variable for mBBS moreso than COG and CWS. Zero-inflated regression on the frequency of falling incidents demonstrated that the mBBS was not predictive, however, COG and CWS were. CONCLUSIONS The results indicated that the concurrent validity as well as the predictive validity of mBBS were low for persons with IVD.
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Affiliation(s)
- Annemarie Dijkhuizen
- Hanze University of Applied Sciences Groningen, Research and Innovation Group in Health Care and in Nursing, Groningen, The Netherlands.
| | - Wim P Krijnen
- Hanze University of Applied Sciences Groningen, Research and Innovation Group in Health Care and in Nursing, Groningen, The Netherlands
| | - Cees P van der Schans
- Hanze University of Applied Sciences Groningen, Research and Innovation Group in Health Care and in Nursing, Groningen, The Netherlands; University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Aly Waninge
- Hanze University of Applied Sciences Groningen, Research and Innovation Group in Health Care and in Nursing, Groningen, The Netherlands; Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, The Netherlands
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Petropoulou E, Finlayson J, Hay M, Spencer W, Park R, Tannock H, Galbraith E, Godwin J, Skelton DA. Injuries Reported and Recorded for Adults with Intellectual Disabilities Who Live with Paid Support in Scotland: a Comparison with Scottish Adults in the General Population. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:408-415. [PMID: 26864714 DOI: 10.1111/jar.12244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Providers of supported living services to adults with intellectual disabilities (IDs) in the United Kingdom have procedures in place to monitor injuries; this provides opportunity to learn about the injuries being reported and recorded. The aim was to determine the incidence, causes and types of injuries experienced by 593 adults with intellectual disabilities who live with paid support in a 12-month period. METHOD Injury data, collected via a standard electronic injury monitoring system, were compared with data collected for a matched sample of the general population in the same year. RESULTS The adults with intellectual disabilities experienced a higher rate of injury. Falls were the commonest cause of injury for both samples, but significantly more so for the adults with intellectual disabilities. CONCLUSIONS The higher rate of injuries, particularly minor injuries, being reported suggests a culture of injury reporting and recording within these supported living services. Electronic injury monitoring is recommended for organizations providing supported living services for adults with intellectual disabilities.
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Affiliation(s)
| | - Janet Finlayson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Margaret Hay
- Learning Disability Services, Community Integrated Care, Widnes, UK
| | - Wendy Spencer
- Learning Disability Services, Turning Point Scotland, Glasgow, UK
| | - Richard Park
- Health and Safety Management, Crossreach, Edinburgh, UK
| | - Hugh Tannock
- Health and Safety Management, Turning Point Scotland, Glasgow, UK
| | - Erin Galbraith
- Learning Disability Services, Turning Point Scotland, Glasgow, UK
| | - Jon Godwin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A Skelton
- Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
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Crockett J, Finlayson J, Skelton DA, Miller G. Promoting Exercise as Part of a Physiotherapy-Led Falls Pathway Service for Adults with Intellectual Disabilities: A Service Evaluation. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2014; 28:257-64. [DOI: 10.1111/jar.12119] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Jennifer Crockett
- Glasgow Learning Disability Services; NHS Greater Glasgow & Clyde; Glasgow UK
| | - Janet Finlayson
- Institute of Applied Health Research; Glasgow Caledonian University; Glasgow UK
| | - Dawn A. Skelton
- Institute of Applied Health Research; Glasgow Caledonian University; Glasgow UK
| | - Gillian Miller
- Glasgow Learning Disability Services; NHS Greater Glasgow & Clyde; Glasgow UK
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