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Onizuka N, Sinvani L, Quatman C. Matters We Metric Vs. Metrics that Matter. Geriatr Orthop Surg Rehabil 2024; 15:21514593241277737. [PMID: 39184133 PMCID: PMC11344255 DOI: 10.1177/21514593241277737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/04/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction Geriatric fracture is a pressing global health issue, marked by elevated mortality and morbidity rates and escalating health care costs. The evolving health care system from fee-for-service to quality-based reimbursement has led to externally driven reward and reimbursement systems that may not account for the complexity of caring for older adults with fracture. Significance The aim of this review is to highlight the need for a shift towards meaningful metrics that impact geriatric fracture care and to issue a call to action for all medical societies to advocate for national reimbursement and ranking systems that focus on metrics that truly matter. Results Traditional metrics, while easier to capture, may not necessarily represent high quality care and may even have unintentional adverse consequences. For example, the focus on reducing length of stay may lead to older patients being discharged too early, without adequately addressing pain, constipation, or delirium. In addition, a focus on mortality may miss the opportunity to deliver compassionate end-of-life care. Existing geriatric fracture care metrics have expanded beyond traditional metrics to include assessment by geriatricians, fracture prevention, and delirium assessments. However, there is a need to further consider and develop patient-focused metrics. The Age-Friendly Health Initiative (4 Ms), which includes Mobility, Medication, Mentation, and what Matters is an evidence-based framework for assessing and acting on critical issues in the care of older adults. Additional metrics that should be considered include an assessment of nutrition and secondary fracture prevention. Conclusion In the realm of geriatric fracture care, the metrics currently employed often revolve around adherence to established guidelines and are heavily influenced by financial considerations. It is crucial to shift the paradigm towards metrics that truly matter for geriatric fracture patients, recognizing the multifaceted nature of their care and the profound impact these fractures have on their lives.
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Affiliation(s)
- Naoko Onizuka
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
- TRIA Orthopedics, Park Nicollet Methodist Hospital, Saint Louis Park, MN, USA
- International Geriatric Fracture Society Research Fellowship, Apopka, FL, USA
| | - Liron Sinvani
- Northwell, New Hyde Park, NY, USA
- Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Carmen Quatman
- International Geriatric Fracture Society Research Fellowship, Apopka, FL, USA
- Division of Trauma, Department of Orthopaedics, College of Medicine, The Ohio State University, Columbus, OH, USA
- Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
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Na C, Ao D, Chen H. MiR-331-3p facilitates osteoporosis and may promote osteoporotic fractures by modulating NRP2 expression. J Orthop Surg Res 2024; 19:487. [PMID: 39154011 PMCID: PMC11330005 DOI: 10.1186/s13018-024-04959-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 07/29/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Osteoporosis (OP) is a high-incidence bone disease that is prone to osteoporotic fractures (OF), so it has attracted widespread attention. AIM This study investigated the specific expression and role of miR-331 in patients with OP and OF. The findings have profound implications for the clinical prevention and treatment of these conditions. METHODS The study included 60 OP patients, 46 OF patients, and 40 healthy controls. The expression level of miR-331-3p was detected using RT-qPCR. BMP2 was used to stimulate differentiation in MC3T3-E1 cells. After induction, the expression activity of osteogenic differentiation-related gene markers was detected using RT-qPCR. The target gene analysis was conducted using a luciferase reporter assay. RESULTS The levels of miR-331-3p were significantly elevated, while NRP2 levels were significantly reduced in OF patients. Post-surgery, miR-331-3p levels decreased over time. MiR-331-3p was found to negatively regulate the luciferase activity of NPR2 in MC3T3-E1 cells. Furthermore, overexpression of miR-331-3p inhibited cell proliferation and decreased the levels of osteoblast differentiation markers. CONCLUSION The up-regulation of miR-331-3p can promote OP and might also encourage the occurrence of OF by regulating NRP2. However, this needs further verification.
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Affiliation(s)
- Cikedaoerji Na
- Sports Medicine Department of The Sixth Affiliated Hospital of Xinjiang Medical University, No.39, Wuxing South Road, Urumqi City, 830000, China
| | - Denggaowa Ao
- Oncology Department of The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, China
| | - Hongtao Chen
- Sports Medicine Department of The Sixth Affiliated Hospital of Xinjiang Medical University, No.39, Wuxing South Road, Urumqi City, 830000, China.
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Abd El-Kafy EM, Alayat MS, Subahi MS, Badghish MS. C-Mill Virtual Reality/Augmented Reality Treadmill Training for Reducing Risk of Fall in the Elderly: A Randomized Controlled Trial. Games Health J 2024; 13:258-267. [PMID: 38563663 DOI: 10.1089/g4h.2023.0162] [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: 04/04/2024] Open
Abstract
Objective: Falling is considered one of the major problems that may affect the elderly, leading to multiple health issues. Walking adaptability to environmental demands is essential for safe walking in the elderly. The aim of this study was to evaluate the efficacy of virtual reality (VR)/augmented reality (AR) treadmill training on balance performance and the risk of falls in the elderly. Materials and Methods: Sixty Saudi elderly individuals of both genders, aged between 60 and 70 years, participated in the study. The participants were categorized into two groups: the experimental and the control groups. Both groups received 1 hour of training: 30 minutes of conventional exercises and 30 minutes of gait training on the C-Mill VR/AR treadmill. The experimental group used the C-Mill treadmill with VR and AR games therapy. The control group had gait training on the C-Mill treadmill without VR and AR. The training for both groups was conducted for 6 successive weeks/three times a week. The changes in the scores of the following variables were recorded at baseline, after 6 weeks of training, and 4 weeks after the completion of training. These variables involved the time needed for completing the Timed Up and Go (TUG) test, overall stability indices of the Fall Risk (FR) test and Limit of Stability (LOS) test evaluated using the Biodex Balance System (BBS), and the time required for completing the LOS test. Results: Both groups demonstrated significant improvement in all measured variables immediately post-training, and this improvement persisted for 4 weeks after completing the training. The experimental group exhibited greater improvement in the recorded values of all measured variables compared with the control group following the training. Conclusions: This study concluded that C-Mill VR/AR treadmill training is effective in improving balance control and reducing the fall risk in the elderly.
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Affiliation(s)
- Ehab Mohamed Abd El-Kafy
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohamad Salaheldien Alayat
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Moayad Saleh Subahi
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
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López-García M, Jiménez-Rejano JJ, Suárez-Serrano CM. Telerehabilitation: Vestibular Physiotherapy vs. Multicomponent Exercise for Functional Improvement in Older Adults: Randomized Clinical Trial. J Clin Med 2024; 13:4279. [PMID: 39064319 PMCID: PMC11277823 DOI: 10.3390/jcm13144279] [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: 05/31/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
The loss of vestibular and motor function can occur naturally with aging. Vestibular physiotherapy exercises (VE) specifically address vestibular rehabilitation to reduce imbalances and improve physical condition, like therapeutic exercise (TE). During COVID-19, technology was used with the elderly for implementation. Objective: to determine if vestibular exercises are as effective as multicomponent exercises in improving functional capacity using technological tools. Methods: A randomized clinical trial compared two intervention groups of 21 subjects with functional limitations and frailty (average age 76.11 years). The intervention involved multicomponent exercise for the control group (Vivifrail protocol) and vestibular exercises for the experimental group (Cawthorne and Cooksey exercises) for 6 weeks with five sessions per week both groups. Two professionals implemented the exercises, and participants received tailored exercise videos. Primary outcomes were gait speed, dynamic balance, and physical capacity. Results: Both groups showed significant improvements. For physical function measured by SPPB (0-12 points), the multicomponent exercise group improved by 1.97 (0.91; 3.03), p < 0.001, and the vestibular exercise group improved by 1.63 (0.65; 2.60), p = 0.002. For dynamic balance measured by the Timed Up and Go (TUG) test, the multicomponent exercise group improved by -0.88 (-1.33; -0.42), p < 0.001, and the vestibular exercise group improved by -0.79 (-1.21; -0.37), p < 0.001. There were no significant differences between groups. Finally, regarding gait speed, there were no differences in either group between pretest and post-test (p > 0.05). Conclusions: Both multicomponent exercise and vestibular exercises improve functional capacities via telerehabilitation as measured by the SPPB, although vestibular physiotherapy does not show superior outcomes compared to the control group.
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Affiliation(s)
- Marina López-García
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (J.J.J.-R.); (C.M.S.-S.)
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Igusa T, Uchida H, Tsuchiya K, Sema S, Kaneko S, Yoshita T, Nagai S, Kobayashi T, Akiba T, Tanaka Y, Kikuchi S, Hirao K. Effects of rhythmic auditory stimulation on gait speed in older adult inpatients in a convalescent rehabilitation ward: a pilot randomized controlled trial. Eur Geriatr Med 2024:10.1007/s41999-024-01010-0. [PMID: 38890234 DOI: 10.1007/s41999-024-01010-0] [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: 03/13/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE To assess the impact of gait training with rhythmic auditory stimulation (RAS) on enhancing gait speed in older people admitted to a convalescent rehabilitation ward (CRW), compared to conventional gait training methods. METHODS The study was designed as a single-center, open-label, pilot, randomized, parallel-group study. Thirty older people admitted to CRW were divided into two groups: the experimental group, which received gait training with RAS (n = 15, females = 53.3%, mean age = 83.9, SD = 6.5), and the control group, which underwent usual gait training (n = 15, females = 60.0%, mean age = 81.3, SD = 8.4). Regardless of their assigned group, all participants underwent 30 min training sessions, five times a week, for 3 weeks. The primary outcome was the 10 m walk test (10mWT), and the secondary outcomes included the Medical Outcome Study 8-Item Short-Form Health Survey and the Japanese version of the modified Gait Efficacy Scale. All measurements were taken at baseline and again at week 3. RESULTS Results indicated that older people in CRWs in the experimental group showed significant improvements in their 10mWT (effect size - 1.02) compared to the control group. None of the secondary outcomes were significant. CONCLUSIONS This study suggests the preliminary effectiveness and feasibility of a gait practice intervention using RAS in a CRW. TRIAL REGISTRATION The University Hospital Medical Information Network (UMIN) Registered 1 October 2022 (UMIN000049089).
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Affiliation(s)
- Takumi Igusa
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Hiroyuki Uchida
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Shota Sema
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Shunsuke Kaneko
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Taiki Yoshita
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Sakyo Nagai
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Takuya Kobayashi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Takanari Akiba
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Yukiko Tanaka
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan.
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Hakami IA. An Outline on the Advancements in Surgical Management of Osteoporosis-Associated Fractures. Cureus 2024; 16:e63226. [PMID: 39070522 PMCID: PMC11280975 DOI: 10.7759/cureus.63226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
Osteoporosis significantly impairs bone density and increases fracture risk, representing a substantial global health challenge. The effectiveness of traditional treatments such as calcium supplementation and exercise in completely preventing fractures is limited. This review explores recent advancements in surgical techniques and treatment modalities to manage osteoporotic fractures better and improve patient outcomes. Osteoporotic fractures demand specialized surgical techniques due to compromised bone quality. Vertebroplasty and kyphoplasty are minimally invasive procedures that provide rapid pain relief and structural support using bone cement. While vertebroplasty is effective, it carries risks of cement leakage and new fractures. Kyphoplasty, with added balloon inflation, reduces leakage risk and improves vertebral height restoration but is costlier. Cement-augmented screws enhance fixation but can increase adjacent fracture risk and pose long-term complications. Surgical advancements encompass robotic-assisted surgery, offering precision and accelerated recovery, alongside biologic agents like bone morphogenetic proteins (BMPs), which enhance bone healing while reducing secondary interventions and eliminating donor site morbidity. Bone graft substitutes such as calcium phosphate cements enhance biomechanical compatibility, decrease morbidity, and reduce fracture loss and pain. Balloon kyphoplasty aids in height restoration and pain relief and diminishes the risk of subsequent vertebral fractures. Bioglass scaffolds promote bone regeneration by improving bone mineral density and lowering the incidence of new fractures. Optimal perioperative care, including patient selection, nutritional management, and early mobilization strategies, is crucial for mitigating risks in vulnerable populations. While current surgical interventions provide significant pain relief and functional benefits, ongoing research and multidisciplinary collaboration are crucial to prospectively refine these techniques and reduce the burden of osteoporosis. New technologies, such as tissue engineering and gene editing, hold potential for future treatment paradigms.
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Affiliation(s)
- Ibrahim A Hakami
- Department of Orthopedic Surgery, College of Medicine, Shaqra University, Dawadmi, SAU
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Misaghian K, Lugo JE, Faubert J. Immediate fall prevention: the missing key to a comprehensive solution for falling hazard in older adults. Front Aging Neurosci 2024; 16:1348712. [PMID: 38638191 PMCID: PMC11024377 DOI: 10.3389/fnagi.2024.1348712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
The world is witnessing an unprecedented demographic shift due to increased life expectancy and declining birth rates. By 2050, 20% of the global population will be over 60, presenting significant challenges like a shortage of caregivers, maintaining health and independence, and funding extended retirement. The technology that caters to the needs of older adults and their caregivers is the most promising candidate to tackle these issues. Although multiple companies and startups offer various aging solutions, preventive technology, which could prevent trauma, is not a big part of it. Trauma is the leading cause of morbidity, disability, and mortality in older adults, and statistics constitute traumatic fall accidents as its leading cause. Therefore, an immediate preventive technology that anticipates an accident on time and prevents it must be the first response to this hazard category to decrease the gap between life expectancy and the health/wellness expectancy of older adults. The article outlines the challenges of the upcoming aging crisis and introduces falls as one major challenge. After that, falls and their mechanisms are investigated, highlighting the cognitive functions and their relation to falls. Moreover, since understanding predictive cognitive mechanisms is critical to an effective prediction-interception design, they are discussed in more detail, signifying the role of cognitive decline in balance maintenance. Furthermore, the landscape of available solutions for falling and its shortcomings is inspected. Finally, immediate fall prevention, the missing part of a wholesome solution, and its barriers are introduced, and some promising methodologies are proposed.
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Affiliation(s)
- Khashayar Misaghian
- Sage-Sentinel Smart Solutions, Kunigami-gun, Okinawa, Japan
- OIST Innovation, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
- Faubert Lab, School of Optometry, Université de Montréal, Montreal, QC, Canada
| | - Jesus Eduardo Lugo
- Sage-Sentinel Smart Solutions, Kunigami-gun, Okinawa, Japan
- Faubert Lab, School of Optometry, Université de Montréal, Montreal, QC, Canada
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Jocelyn Faubert
- Sage-Sentinel Smart Solutions, Kunigami-gun, Okinawa, Japan
- Faubert Lab, School of Optometry, Université de Montréal, Montreal, QC, Canada
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Lee-Confer J. Strength in arms: empowering older adults against the risk of slipping and falling-a theoretical perspective. Front Sports Act Living 2024; 6:1371730. [PMID: 38523707 PMCID: PMC10957654 DOI: 10.3389/fspor.2024.1371730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/01/2024] [Indexed: 03/26/2024] Open
Abstract
Background Slips and falls are a serious health concern, particularly among older adults. Current physical therapy protocols strengthen the legs to improve balance. However, arm movements help maintain balance during a slip incident. Understanding how arm movements improve balance may help clinicians develop more comprehensive fall-prevention protocols to improve patient outcomes. Clinical question What limitations exist in current fall prevention protocols for reducing falls in older adults during slip incidents, and what new strategies can enhance these outcomes? Key results Slip incidents often result in a sideways loss of balance, leading to hip fractures in older adults. During a slip, the legs do not produce sideways motion and are less effective in regaining balance in this direction. Contrary, the arms produce 100 + degrees of abduction and this motion reduces falls by 200%+ during a slip incident. Notably, older adults exhibit 35.7% decreased arm abduction acceleration responses compared to younger adults during a slip incident. This delay may be attributed to age-related decreases in type II fibers of the deltoid. High-velocity and ballistic training have been shown to improve the proportion and size of type II fibers as well as improve fall outcomes when focused on the lower extremities. Clinical application Therefore, I propose incorporating arm abductor training, alongside leg exercises, as a cost-effective and low-risk intervention to enhance the slip responses in older adults. In light of its minimal risk and considerable potential benefits, starting arm abductor exercises with older adults is a sensible move.
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Affiliation(s)
- Jonathan Lee-Confer
- Department of Physical Therapy, University of Arizona, Tucson, AZ, United States
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Xu Y, Du Z, Cheng A, Lin R, Wang K, Jin Y, Dai C, Xu L. Functional force stimulation alters motor neuron discharge patterns. Front Neurosci 2023; 17:1293017. [PMID: 38116068 PMCID: PMC10728294 DOI: 10.3389/fnins.2023.1293017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/15/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Beneficial effects have been observed for mechanical vibration stimulation (MVS), which are mainly attributed to tonic vibration reflex (TVR). TVR is reported to elicit synchronized motor unit activation during locally applied vibration. Similar effects are also observed in a novel vibration system referred to as functional force stimulation (FFS). However, the manifestation of TVR in FFS is doubted due to the use of global electromyography (EMG) features in previous analysis. Our study aims to investigate the effects of FFS on motor unit discharge patterns of the human biceps brachii by analyzing the motor unit spike trains decoded from the high-density surface EMG. Methods Eighteen healthy subjects volunteered in FFS training with different amplitudes and frequencies. One hundred and twenty-eight channel surface EMG was recorded from the biceps brachii and then decoded after motion-artifact removal. The discharge timings were extracted and the coherence between different motor unit spike trains was calculated to quantify synchronized activation. Results and discussion Significant synchronization within the vibration cycle and/or its integer multiples is observed for all FFS trials, which increases with increased FFS amplitude. Our results reveal the basic physiological mechanism involved in FFS, providing a theoretical foundation for analyzing and introducing FFS into clinical rehabilitation programs.
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Affiliation(s)
- Yaodan Xu
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
- Shanghai Advanced Research Institute, Chinese Academy of Science, Shanghai, China
- University of Chinese Academy of Science, Beijing, China
| | - Zuyu Du
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Anyi Cheng
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
- Shanghai Advanced Research Institute, Chinese Academy of Science, Shanghai, China
- University of Chinese Academy of Science, Beijing, China
| | - Runwei Lin
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Kaichen Wang
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Yibin Jin
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Chenyun Dai
- School of Information Science and Technology, Fudan University, Shanghai, China
| | - Lin Xu
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
- Shanghai Engineering Research Center of Energy Efficient and Custom AI IC, Shanghai, China
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Sadaqa M, Németh Z, Makai A, Prémusz V, Hock M. Effectiveness of exercise interventions on fall prevention in ambulatory community-dwelling older adults: a systematic review with narrative synthesis. Front Public Health 2023; 11:1209319. [PMID: 37601180 PMCID: PMC10435089 DOI: 10.3389/fpubh.2023.1209319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Objective To present a systematic review of randomized controlled trials which summarizes the effects of community-based resistance, balance, and multi-component exercise interventions on the parameters of functional ability (e.g., lower extremities muscle strength, balance performance and mobility). Methods This PROSPERO-registered systematic review (registration no. CRD42023434808) followed the PRISMA guidelines. Literature search was conducted in Cochrane, Embase, Ovid Medline, PEDro, Pubmed, Science Direct, Scopus and Web of Science. We included RCTs that investigated the following interventions: lower extremity strengthening, balance and multi-component exercise interventions on ambulatory community-dwelling adults aged ≥65 years. Results Lower extremity strengthening exercises revealed significant effects on the strength of lower extremity, balance outcomes and mobility. Balance exercises reduce the rate of injurious falls, improve static, dynamic and reactive balance, lower extremity strength as well as mobility. Multi-component exercise training reduces medically-attended injurious falls and fallers, incidence of falls, fall-related emergency department visits as well as improves mobility, balance, and lower extremity strength. Conclusion Physical exercises are effective in improving the components of balance, lower extremity strength, mobility, and reducing falls and fall-related injuries. Further research on fall prevention in low-income countries as well as for older adults in vulnerable context is needed.
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Affiliation(s)
- Munseef Sadaqa
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Zsanett Németh
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Alexandra Makai
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary
| | - Viktória Prémusz
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
- Physical Activity Research Group, Szentágothai Research Centre, Pécs, Hungary
| | - Márta Hock
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary
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Lee-Confer JS, Finley JM, Kulig K, Powers CM. Reactive responses of the arms increase the Margins of Stability and decrease center of mass dynamics during a slip perturbation. J Biomech 2023; 157:111737. [PMID: 37499431 DOI: 10.1016/j.jbiomech.2023.111737] [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: 10/13/2022] [Revised: 07/10/2023] [Accepted: 07/21/2023] [Indexed: 07/29/2023]
Abstract
Although reactive arm motions are important in recovering from a slip event, the biomechanical influences of upper extremity motions during slipping are not clear. The purpose of the current study was to determine whether reactive arm motions during slip recovery leads to increased margins of stability (MoS), and decreased center of mass (CoM) velocity and excursion. Thirty-two participants were randomized into 2 conditions: arms free and arms constrained. Participants traversed a 10-meter walkway and were exposed to an unexpected slip while wearing a protective harness. Anterior-posterior and medial-lateral MoS, as well as the CoM excursion and velocity during the slip perturbation was quantified using a three-dimensional motion capture system. In the frontal plane, individuals with their arms unconstrained demonstrated greater MoS (0.06 ± 0.03 vs -0.01 ± 0.02 m, p < 0.01), decreased CoM excursion (0.05 ± 0.02 vs 0.08 ± 0.01 m, p = 0.015), and a reduced CoM velocity (0.07 ± 0.03 vs. 0.14 ± 0.02 m/s, p < 0.01) compared to individuals with their arms constrained. In the sagittal plane, individuals with their arms unconstrained demonstrated, decreased CoM excursion (0.83 ± 0.13 vs 1.14 ± 0.20 m, p < 0.01) reduced CoM velocity (1.71 ± 0.08 vs. 1.79 ± 0.07 m/s, p = 0.02), but no differences in margins of stability (0.89 ± 0.13 vs 0.94 ± 0.10 m, p = 0.32). Our findings demonstrate that arm motions during a slip perturbation act to restore balance by minimizing displacement and velocity of the body CoM during a slip event in the frontal plane.
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Affiliation(s)
- Jonathan S Lee-Confer
- Musculoskeletal Biomechanics Research Laboratory, University of Southern California, Los Angeles, CA, USA; University of Arizona, Department of Physical Therapy, Tucson, AZ, USA; Verum Biomechanics, Tucson, AZ, USA
| | - James M Finley
- Locomotor Control Laboratory, University of Southern California, Los Angeles, CA, USA
| | - Kornelia Kulig
- Musculoskeletal Biomechanics Research Laboratory, University of Southern California, Los Angeles, CA, USA
| | - Christopher M Powers
- Musculoskeletal Biomechanics Research Laboratory, University of Southern California, Los Angeles, CA, USA.
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Feng F, Xu H, Sun Y, Zhang X, Li N, Sun X, Tian X, Zhao R. Exercise for prevention of falls and fall-related injuries in neurodegenerative diseases and aging-related risk conditions: a meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1187325. [PMID: 37534209 PMCID: PMC10393124 DOI: 10.3389/fendo.2023.1187325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
Introduction Neurodegenerative diseases often cause motor and cognitive deterioration that leads to postural instability and motor impairment, while aging-associated frailty frequently results in reduced muscle mass, balance, and mobility. These conditions increase the risk of falls and injuries in these populations. This study aimed to determine the effects of exercise on falls and consequent injuries among individuals with neurodegenerative diseases and frail aging people. Methods Electronic database searches were conducted in PubMed, Cochrane Library, SportDiscus, and Web of Science up to 1 January 2023. Randomized controlled trials that reported the effects of exercise on falls and fall-related injuries in neurodegenerative disease and frail aging people were eligible for inclusion. The intervention effects for falls, fractures, and injuries were evaluated by calculating the rate ratio (RaR) or risk ratio (RR) with 95% confidence interval (CI). Results Sixty-four studies with 13,241 participants met the inclusion criteria. Exercise is effective in reducing falls for frail aging people (RaR, 0.75; 95% CI, 0.68-0.82) and participants with ND (0.53, 0.43-0.65) [dementia (0.64, 0.51-0.82), Parkinson's disease (0.49, 0.39-0.69), and stroke survivors (0.40, 0.27-0.57)]. Exercise also reduced fall-related injuries in ND patients (RR, 0.66; 95% CI, 0.48-0.90) and decreased fractures (0.63, 0.41-0.95) and fall-related injuries (0.89, 0.84-0.95) among frail aging people. For fall prevention, balance and combined exercise protocols are both effective, and either short-, moderate-, or long-term intervention duration is beneficial. More importantly, exercise only induced a very low injury rate per participant year (0.007%; 95% CI, 0-0.016) and show relatively good compliance with exercise (74.8; 95% CI, 69.7%-79.9%). Discussion Exercise is effective in reducing neurodegenerative disease- and aging-associated falls and consequent injuries, suggesting that exercise is an effective and feasible strategy for the prevention of falls.
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Affiliation(s)
- Feifei Feng
- College of Physical Education, Yangzhou University, Yangzhou, China
- School of Humanities and Education, Guangzhou Nanyang Polytechnic College, Guangzhou, China
| | - Haocheng Xu
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Yu Sun
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Xin Zhang
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Nan Li
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Xun Sun
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Xin Tian
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Renqing Zhao
- College of Physical Education, Yangzhou University, Yangzhou, China
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13
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Ratnasamy PP, Rudisill KE, Oghenesume OP, Riedel MD, Grauer JN. Risk of Contralateral Hip Fracture Following Initial Hip Fracture Among Geriatric Fragility Fracture Patients. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202307000-00005. [PMID: 37428152 PMCID: PMC10332831 DOI: 10.5435/jaaosglobal-d-23-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/16/2023] [Accepted: 04/16/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Geriatric hip fractures are common and associated with high morbidity and mortality. This study aimed to evaluate the incidence, timing, and risk factors of contralateral hip fracture after initial hip fracture. METHODS Initial hip fractures in patients older than 65 years were abstracted from the national, administrative M91Ortho PearlDiver data set. Incidence and timing of contralateral hip fractures in the following 10 years were identified. Kaplan-Meier survival analysis until contralateral hip fracture was conducted. To account for patient mortality over the later years, 2-year univariate and multivariate analyses were used to determine factors predictive of contralateral hip fracture. RESULTS Of the initial 104,311 hip fractures identified, contralateral hip fracture in the 10 years that followed was identified for 7,186 (6.9%), of which 68.4% occurred in the first 2 years. Kaplan-Meier survival analysis until contralateral fracture revealed the 10-year incidence to be 12.9% when controlling for those lost from the data set during the study period. Multivariate logistic regression revealed independent predictors of contralateral hip fracture in the 2 years after index hip fracture, when the incidence was greatest, to be female sex (odds ratio [OR] 1.15), body mass index < 20 (OR 1.30), and percutaneous pinning surgery for initial hip fracture fixation (OR 1.58) (P < 0.0001 for each). CONCLUSIONS In a national cohort of 104,311 geriatric hip fractures, Kaplan-Meier analysis for contralateral hip fracture found the 10-year incidence to be 12.9%, of which nearly 70% were in the first 2 years, and predisposing factors were defined. As such, future research should aim to identify the cause and mitigate the risk of secondary contralateral hip fractures in geriatric patients.
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Affiliation(s)
- Philip P. Ratnasamy
- From the Department of Orthopedics & Rehabilitation, Yale School of Medicine, New Haven, CT
| | - Katelyn E. Rudisill
- From the Department of Orthopedics & Rehabilitation, Yale School of Medicine, New Haven, CT
| | | | - Matthew D. Riedel
- From the Department of Orthopedics & Rehabilitation, Yale School of Medicine, New Haven, CT
| | - Jonathan N. Grauer
- From the Department of Orthopedics & Rehabilitation, Yale School of Medicine, New Haven, CT
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14
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Ryan M, Gibbs LM, Sehgal SR. Health Support for At-Risk Older Adults during COVID-19. Healthcare (Basel) 2023; 11:1856. [PMID: 37444693 DOI: 10.3390/healthcare11131856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Older adults are highly susceptible to COVID-19 infection and at the highest risk for severe disease and death. Yet, older adults lacked access to accurate and easy-to-use COVID-19 information and support early in the pandemic. This prospective, experimental cohort study sought to examine whether older adults could be engaged during the pandemic through a community partner and if a low-touch intervention, designed with health literacy best practices, could positively impact COVID-19 knowledge, mitigation behaviors, telehealth/doctor visits, exercise, and loneliness. A senior resource kit was distributed to older adults sheltering at home through food assistance program agents from October 2020 to February 2021; the kit was developed using health literacy best practices. Simple random assignment was used to divide program participants into treatment and control groups. Both groups received senior kits, but the treatment group also received telephonic health coaching. The primary outcome was COVID-19 knowledge and mitigation behaviors as derived from self-reported surveys at baseline and after four months. Secondary outcomes included a telehealth or doctor visit, exercise frequency, and a loneliness score (3-Item Loneliness Scale). Health literacy was assessed using the BRIEF screening tool. Ninety-eight older adults consented to participate in the study and 87 completed the study (88.7% completion rate). Participants had moderate clinical risk, one-third preferred the Spanish language, and 52% were categorized as having inadequate or marginal health literacy. Significant changes were found for increasing COVID-19 mitigation behaviors and the frequency of exercise across the cohort, but not for COVID-19 knowledge, telehealth visits, or decreasing loneliness. Conclusions: Partnering with a trusted entity in the community is a feasible and important strategy to reach older adults during a lockdown and provide them with easy-to-read health information and resources. If the time horizon had been longer, improvements in other outcome variables may have been achieved.
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Affiliation(s)
- Marian Ryan
- Institute for Healthcare Advancement, La Habra, CA 90631, USA
| | - Lisa M Gibbs
- Division of Geriatric Medicine and Gerontology, Department of Family Medicine, University of California, Irvine (UCI), Irvine, CA 92697, USA
| | - Sonia R Sehgal
- Division of Geriatric Medicine and Gerontology, Department of Family Medicine, University of California, Irvine (UCI), Irvine, CA 92697, USA
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15
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Salis F, Mandas A. Physical Performance and Falling Risk Are Associated with Five-Year Mortality in Older Adults: An Observational Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050964. [PMID: 37241196 DOI: 10.3390/medicina59050964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
Background: Falls in older people have a significant impact on public health. The scientific literature has provided evidence about the necessity for older adults to be physically active, since it reduces the incidence of falls, several diseases, and deaths, and can even slow down some effects of aging. The primary aim of our study is to identify if physical performances and risk of falling are related to 1-, 2-, 3-, 4-, and 5-year mortality. Its secondary aim is to establish if people with both severely impaired physical performance and a high risk of falling also present impairment in other geriatric domains. Methods: In this prospective study, we enrolled subjects aged 65 years or more, subjected them to comprehensive assessment (including assessment of risk of falling, physical capacities, comorbidities, autonomies in daily living, cognitive abilities, mood, and nutritional status), and followed them for 5 years. Results: We included 384 subjects, 280 of whom were women (72.7%), with a median age of 81 years. Our results showed that physical performances and risk of falling are highly correlated to each other (rho = 0.828). After divided the sample into three groups (people without augmented risk of falling and able to perform adequate physical activity; people with moderate risk of falling and/or disability; people with severe risk of falling and/or disability), we found that the more severe the disability and risk of falling were, the more compromised the other geriatric domains were. Moreover, the survival probability progressively increased following the same trend, amounting to only 41% in severely compromised people, 51.1% in moderately compromised people, and 62.8% in people without physical compromise nor an augmented falling risk (p = 0.0124). Conclusions: Poor physical performance combined with a high risk of falling, correlated with each other, are associated with higher mortality and impairment in multiple domains in older adults.
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Affiliation(s)
- Francesco Salis
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, 09124 Cagliari, Italy
| | - Antonella Mandas
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, 09124 Cagliari, Italy
- University Hospital "Azienda Ospedaliero-Universitaria" of Cagliari, 09042 Monserrato, Italy
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16
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Igusa T, Kobayashi T, Uchida H, Tsuchiya K, Akiba T, Sema S, Kaneko S, Yoshita T, Nagai S, Tanaka Y, Kikuchi S, Hirao K. Effect of gait training using rhythmic auditory stimulation on gait speed in older adults admitted to convalescent rehabilitation wards: A study protocol for a pilot randomized controlled clinical trial. Contemp Clin Trials Commun 2023; 33:101125. [PMID: 37091510 PMCID: PMC10119504 DOI: 10.1016/j.conctc.2023.101125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Background Decreased walking speed in older patients admitted to convalescent rehabilitation wards (CRWs) is one of the factors that inhibit home discharge. Therefore, interventions to improve gait speed in older patients admitted to CRWs are important, and rhythmic auditory stimulation (RAS) may be an effective intervention strategy. However, the effect of RAS on gait speed in older patients admitted to CRWs is not well known. Therefore, this study protocol aims to determine the feasibility of the RAS-based gait practice for older patients admitted to the CRW. Methods The study is designed as a single-center, open-label, pilot, randomized, parallel-group study. Participants will be 30 patients aged ≥65 years admitted to the CRW and randomly assigned to the experimental group (RAS-based gait practice; n = 15) or the control group (normal gait practice; n = 15). In both groups, interventions will be conducted for 30 min per session, 5 times per week for 3 weeks. The primary outcome is the change in the 10-m walk test 3 weeks after the baseline assessment. Secondary outcome is the change in the score of the Medical Outcome Study 8-Item Short-Form Health Survey and the Japanese version of the modified Gait Efficacy Scale from baseline assessment to 3 weeks later. Discussion This exploratory RCT was developed using strict scientific standards and is based on defined protocols. Thus, this study will be used to assess the viability of a larger investigation into RAS-based gait practice. If our theory is accurate, this study could serve as a foundation for establishing RAS-based gait practice in CRWs as a common rehabilitation strategy. Trial registration This study was registered in the University Hospital Medical Information Network (UMIN) clinical trials registry in Japan (UMIN000049089).
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Affiliation(s)
- Takumi Igusa
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Takuya Kobayashi
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Takanari Akiba
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Shota Sema
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Shunsuke Kaneko
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Taiki Yoshita
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Sakyo Nagai
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Yukiko Tanaka
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- Corresponding author. Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan.
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Alshahrani F, Alsulaiman YA, Almashari YM, Alawad NK, Almousa SA, Allarakia Y, Aljaafri BA. Use of the Osteoporosis Self-Assessment Tool as a Screening Tool for Osteoporosis in Saudi Postmenopausal Women. Cureus 2023; 15:e37755. [PMID: 37213999 PMCID: PMC10193514 DOI: 10.7759/cureus.37755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Osteoporosis is commonly referred to as the "silent disease," as bone loss is gradual and asymptomatic. In older women and men, osteoporosis can lead to increased bone fragility, thus increasing the risk of fractures. These fractures are associated with healthcare costs, physical disabilities, impaired quality of life, and mortality. Therefore, the study's main objective was to assess the applicability of the osteoporosis self-assessment tool (OST) in predicting osteoporosis in Saudi postmenopausal women who are 60 years of age and older and to give a thorough understanding of how such a method can aid in the early diagnosis of osteoporosis in Saudi Arabia and give physicians enough time to treat it. Methods: This study was done at King Abdulaziz Medical City, Riyadh, Saudi Arabia, where we included postmenopausal Saudi women 60 years of age and older who took the bone mineral density (BMD) test in the family medicine department. The approximate target population in this group, between the years 2016 and 2022, was 2969 patients. All data was taken from the BestCare database at King Abdulaziz Medical City in Riyadh. Data were typed in an Excel sheet (Redmond, USA), then transferred to the R Studio software. The data collection method was chart review, so no informed consent was needed from patients. Names and medical record numbers were not stored. Results: The study included 2969 participants. According to the bone mineral density (BMD) T score results, 490 participants (16.5%) were normal, 1746 participants (58.8%) had osteopenia, and 733 participants (24.7%) suffered from osteoporosis. BMD T scores for normal, osteopenia, and osteoporosis participants were -0.6 (-0.9, -.3), -1.8 (-2.1), and -3 (-3.5, -2.7), consecutively. Estimated OSTI scores for those patients were 2 (0, 4), 1 (-2, 3), and -1 (-4, 1), consecutively. According to the OSTI score for normal participants, 4.29% were classified as being at high risk of osteoporosis. A high risk of osteoporosis was identified in 0.74% of those with osteopenia. 27.83% of osteoporosis patients were classified as being at high risk of osteoporosis. To differentiate normal individuals from those with osteopenia, the cutoff value with optimal sensitivity was 3.5. At such a cutoff value, the test sensitivity was 81.04%. To differentiate normal participants from those with osteoporosis, the cutoff value with optimal sensitivity was 2.5. At such a cutoff value, the test sensitivity was 86.49%. To differentiate osteopenia from osteoporosis patients, the cutoff threshold with optimal sensitivity was 1.5. At such a threshold, sensitivity was 78.44%. Conclusion: OSTA is a simple and validated tool that can identify subjects at increased risk of osteoporosis. Its use could facilitate a more cost-effective use of BMD; by avoiding measurements in low-risk groups.
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Affiliation(s)
- Fahad Alshahrani
- Family Medicine, King Abdulaziz Medical City Riyadh-Ministry of the National Guard Health Affairs, Riyadh, SAU
- Collage of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Family Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Yazeed A Alsulaiman
- Family Medicine, King Abdulaziz Medical City Riyadh-Ministry of the National Guard Health Affairs, Riyadh, SAU
- Family Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Yasser M Almashari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Nawaf K Alawad
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Saad A Almousa
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Yazeed Allarakia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Bader A Aljaafri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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18
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Doré B, Gaudreault A, Everard G, Ayena JC, Abboud A, Robitaille N, Batcho CS. Acceptability, Feasibility, and Effectiveness of Immersive Virtual Technologies to Promote Exercise in Older Adults: A Systematic Review and Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 23:2506. [PMID: 36904709 PMCID: PMC10007244 DOI: 10.3390/s23052506] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
CONTEXT This review aimed to synthesize the literature on the acceptability, feasibility, and effectiveness of immersive virtual technologies to promote physical exercise in older people. METHOD We performed a literature review, based on four databases (PubMed, CINAHL, Embase, and Scopus; last search: 30 January 2023). Eligible studies had to use immersive technology with participants aged 60 years and over. The results regarding acceptability, feasibility, and effectiveness of immersive technology-based interventions in older people were extracted. The standardized mean differences were then computed using a random model effect. RESULTS In total, 54 relevant studies (1853 participants) were identified through search strategies. Concerning the acceptability, most participants reported a pleasant experience and a desire to use the technology again. The average increase in the pre/post Simulator Sickness Questionnaire score was 0.43 in healthy subjects and 3.23 in subjects with neurological disorders, demonstrating this technology's feasibility. Regarding the effectiveness, our meta-analysis showed a positive effect of the use of virtual reality technology on balance (SMD = 1.05; 95% CI: 0.75-1.36; p < 0.001) and gait outcomes (SMD = 0.7; 95% CI: 0.14-0.80; p < 0.001). However, these results suffered from inconsistency and the number of trials dealing with these outcomes remains low, calling for further studies. CONCLUSIONS Virtual reality seems to be well accepted by older people and its use with this population is feasible. However, more studies are needed to conclude its effectiveness in promoting exercise in older people.
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Affiliation(s)
- Benjamin Doré
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
| | - Alex Gaudreault
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
| | - Gauthier Everard
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec, QC G1M 2S8, Canada
| | - Johannes C. Ayena
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec, QC G1M 2S8, Canada
| | - Ahmad Abboud
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec, QC G1M 2S8, Canada
| | | | - Charles Sebiyo Batcho
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec, QC G1M 2S8, Canada
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Lee-Confer JS, Kulig K, Powers CM. Constraining the arms during a slip perturbation results in a higher fall frequency in young adults. Hum Mov Sci 2022; 86:103016. [DOI: 10.1016/j.humov.2022.103016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/13/2022] [Accepted: 10/03/2022] [Indexed: 11/04/2022]
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20
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Wang L, Jiang J, Li Y, Huang J, Wang R, Liang Y, He C, Liu S. Global trends and hotspots in research on osteoporosis rehabilitation: A bibliometric study and visualization analysis. Front Public Health 2022; 10:1022035. [PMID: 36530674 PMCID: PMC9748484 DOI: 10.3389/fpubh.2022.1022035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background The field of rehabilitation medicine plays an essential role in the comprehensive management of osteoporosis and its consequences. The benefits of therapeutic exercise are increasingly being recognized in this area, which receives an increasing number of publications. this study was designed to comprehensively identify collaborative networks, parse and track research trends, spotlight present hotspots, and accurately predict frontiers and focus on the health topics related to osteoporosis rehabilitation. Methods This research adopted computer retrieval of osteoporosis rehabilitation-related research published in the Web of Science Core Collection (WoSCC) from inception to June 14, 2022. The bibliometric visualization and comparative analysis involving countries, institutions, journals, authors, references, and keywords were performed using the CiteSpace and VOSviewer software. Results A total of 3,268 articles were included, and the number of articles published each year has demonstrated a steady increase. The United States and the University of Melbourne were the highest productive country and institution, with 1,325 and 87 articles, respectively. The journal of osteoporosis international has published the greatest number of articles, with 221 publications, and the journal of bone and mineral research ranked first in the co-citation counts (cited by 11,792 times). The most productive and highly-cited authors were Heinonen A and Cummings S, with 35 publications and 680 citations. Conclusions At present, "physical activity," "weight bearing exercise," "muscle strength," "whole body vibration," "postmenopausal women," "older women," children, men are the noteworthy research hot topics. Future research that focus on the major modes and parameters of physical activity/exercise for osteoporosis (including whole body vibration, weight bearing exercises, resistance training), targeted multicomponent training regimens, rehabilitation therapy for postmenopausal women, older women, children and men, osteoporosis related-sarcopenia and fractures, and mesenchymal stem cells are becoming frontiers and focus on the health topics related to osteoporosis rehabilitation in the upcoming years, which are worthy of further exploration.
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Affiliation(s)
- Liqiong Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaojiao Jiang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Li
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Jinming Huang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Renjie Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yuxiang Liang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Chengqi He
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Chengqi He
| | - Shaxin Liu
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,Shaxin Liu
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Cao YT, Wang JJ, Yang YT, Zhu SJ, Zheng LD, Lu WW, Zhu R, Wu T. Effect of home-based exercise programs with e-devices on falls among community-dwelling older adults: a meta-analysis. J Comp Eff Res 2022; 11:1201-1217. [PMID: 36148921 DOI: 10.2217/cer-2022-0130] [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: 11/21/2022] Open
Abstract
Aim: To explore the effectiveness of home-based exercise programs with e-devices (HEPEs) on falls among community-dwelling older adults. Methods: Twelve randomized controlled trials were included in the meta-analysis considering four fall-related outcomes. Results: HEPEs significantly reduced the rate of falls (risk ratio: 0.82; 95% CI: 0.72-0.95; p = 0.006) and improved lower extremity strength (mean difference: -0.94; 95% CI: -1.71 to -0.47; p < 0.001). There was a significant improvement favoring HEPEs on balance if the participants were aged >75 years (mean difference: -0.55; 95% CI: -1.05 to -0.05; p = 0.03), or the intervention duration was at least 16 weeks (mean difference: -0.81; 95% CI: -1.58 to -0.05; p = 0.04). Conclusion: HEPEs demonstrated an overall positive effect on falls among community-dwelling older adults.
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Affiliation(s)
- Yu-Ting Cao
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Jian-Jie Wang
- Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Yi-Ting Yang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Shi-Jie Zhu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Liang-Dong Zheng
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Wei-Wei Lu
- Zhongshan Hospital, Fudan University, Shanghai, 200030, China
| | - Rui Zhu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Tao Wu
- Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
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22
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Liang H, Wang O, Cheng Z, Xia P, Wang L, Shen J, Kong X, Zeng Y, Chao A, Yan L, Lin H, Sun H, Cheng Q, Zhu M, Hu Z, Zhang Z, Tang H, Xia W. Jintiange combined with alfacalcidol improves muscle strength and balance in primary osteoporosis: A randomized, double-blind, double-dummy, positive-controlled, multicenter clinical trial. J Orthop Translat 2022; 35:53-61. [PMID: 36090002 PMCID: PMC9428785 DOI: 10.1016/j.jot.2022.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/11/2022] [Accepted: 05/04/2022] [Indexed: 10/28/2022] Open
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23
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Charles A, Mugisha A, Iconaru L, Baleanu F, Benoit F, Surquin M, Bergmann P, Body JJ. Distribution of Fracture Sites in Postmenopausal Overweight and Obese Women: The FRISBEE Study. Calcif Tissue Int 2022; 111:29-34. [PMID: 35316360 DOI: 10.1007/s00223-022-00968-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/05/2022] [Indexed: 12/01/2022]
Abstract
The association between obesity and fracture sites in postmenopausal women has been little studied. We examined the most common types of fractures in obese and overweight postmenopausal women compared to subjects with a normal BMI in the FRISBEE study, a cohort of postmenopausal women followed since 9.1 (7.2-10.6) years. Chi-squared tests and logistic regressions were used to compare the percentages of fracture sites in overweight/obese subjects to subjects with a normal BMI. Their mean (± SD) age was 76.7 ± 6.9 years and their mean BMI was 26.4 ± 4.4. Seven hundred seventy-seven subjects suffered at least one validated fragility fracture with a total of 964 fractures in the whole cohort. Subjects with a BMI higher than 25 had significantly more ankle fractures and less pelvic fractures than subjects with a normal BMI (OR 1.63, 95% CI 1.02-2.56, P = 0.04 and OR 0.55, 95% CI 0.34-0.89, P = 0.01, respectively). There were no significant differences between overweight and obese subjects. Among those older than 75, there were significantly fewer pelvic fractures in overweight/obese subjects (OR 0.49, 95% CI 0.27-0.87, P = 0.01), but before 75, ankle fractures were significantly more frequent in overweight/obese subjects than in subjects with a normal BMI (OR 1.89, 95% CI 1.01-3.57, P = 0.04). In conclusion, the proportion of ankle and pelvic fractures in obese and overweight subjects differs from that in subjects with a normal BMI, but these differences are age dependent. Fracture prevention strategies should take into account the differential effects of excess weight according to age and the site of fracture.
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Affiliation(s)
- A Charles
- Department of Endocrinology, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
| | - A Mugisha
- Department of Internal Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - L Iconaru
- Department of Endocrinology, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - F Baleanu
- Department of Endocrinology, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - F Benoit
- Department of Internal Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - M Surquin
- Department of Internal Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - P Bergmann
- Department of Nuclear Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
- Laboratory of Translational Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - J J Body
- Department of Endocrinology, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
- Laboratory of Translational Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
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24
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Zhang K, Qi J, Zuo P, Yin P, Liu Y, Liu J, Wang L, Li L. The mortality trends of falls among the elderly adults in the mainland of China, 2013-2020: A population-based study through the National Disease Surveillance Points system. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 19:100336. [PMID: 35257118 PMCID: PMC8897056 DOI: 10.1016/j.lanwpc.2021.100336] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Fall in elderly is a major public health problem. Characterizing trends in fall mortality in different subpopulations could help identifying the needs and developing preventive program for target groups. Here we evaluated the trends of fall-related deaths in Chinese mainland among adults aged ≥60 years specific in sex, age, and provinces, to measure the change in this mortality rate between 2013 and 2020, and to explore the underlying factors influencing this change. METHODS Mortality data were retrieved from the National Disease Surveillance Points system(DSPs) of China, a national-level and provincial-level representative data source, to estimate the impact of elderly falls on mortality in the mainland of China and the specific provinces from 2013 to 2020. The joinpoint regression model was used to estimate the temporal trend of mortality in elderly fallen by calculating the annual percentage change (APC). FINDINGS The age-standardized falls mortality was 10·438 per 100 000 in 2020. The age-standardized mortality of elderly falls in total and female showed a steady increasing trend (APC=1·96%, p = 0·023 total; APC=3·42%, p = 0·003 female), with it was stable in males (APC=1.26%, p>0·05). Fall mortality among the elderly was more common in people over 70 years of age and increased sharply. The death rates and APCs were highest among the oldest age groups(aged≥85 years). The higher fall mortality was mainly focused in the southeast and central regions, and lower rates were in the northeast provinces and Tibet. INTERPRETATION Since 2013, the overall fall-related mortality trend among individuals aged ≥60 years has been consistently increasing in China, making it most critical public health challenge. Adherence interventions and increased social support for those at most risk should be considered. FUNDING None.
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Affiliation(s)
- Kaiting Zhang
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, Guangdong Province, China
- School of Public Health, Shantou University, Shantou 515041, Guangdong Province, China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Peijun Zuo
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, Guangdong Province, China
- School of Public Health, Shantou University, Shantou 515041, Guangdong Province, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yunning Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, Guangdong Province, China
- School of Public Health, Shantou University, Shantou 515041, Guangdong Province, China
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25
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Meyer C, Chapman A, Klattenhoff Reyes K, Joe A. Profiling the risk factors associated with falls in older people with diabetes receiving at-home nursing care: Retrospective analysis of an Australian aged care provider database. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:762-775. [PMID: 33084170 DOI: 10.1111/hsc.13194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/18/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Falls among older people with diabetes mellitus (DM) are a major health concern. Preventive measures can be implemented to reduce the likelihood of falls. The aim of this study was to determine the factors most strongly associated with falls in older people living with DM who receive at-home care support services. This will inform home-visiting nurses to prioritise falls prevention strategies in the care of clients who are at high risk of falls. A retrospective analysis of routinely collected data from a large not-for-profit community aged care service provider was undertaken. The sample comprised adults aged ≥65 years residing in Victoria, Australia, with a recorded diagnosis of DM, and who received at least one episode of care by the aged care provider during July 1, 2014 and June 30, 2015. Self-reported data on falls in previous 6 months was obtained via the Comprehensive Health Assessment Tool (CHAT). Selection of factors associated with falls was guided by the Falls Risk for Older People in the Community (FROP-Com) assessment tool. For the study population, data for these factors were obtained from clients' self-reported CHAT data, and from International Classification of Disease codes obtained from medical records. Descriptive statistics were used to identify the demographic and clinical profile; logistic regression was used to assess the strength of association between various factors and the occurrence of a fall. Data were obtained for 1,574 older adults; overall prevalence of falls was 30.6% (n = 482). Significant factors displaying the highest odds of falling were gait issues (OR: 2.11, p = 0.002); needing help to walk (OR: 1.91, p = <0.001); and cognitive dysfunction (OR: 1.55, p = 0.001). Interpreted with caution, several factors contribute to an increased odds of falling in older people with DM. Home-visiting nurses are uniquely placed to introduce preventive interventions to reduce the likelihood of debilitating falls in this population.
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Affiliation(s)
- Claudia Meyer
- Bolton Clarke Research Institute, Bentleigh, VIC, Australia
- Centre for Health Communication and Participation, La Trobe University, Bundoora, VIC, Australia
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Frankston, VIC, Australia
| | - Anna Chapman
- Faculty of Health, Centre for Quality & Patient Safety, Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, VIC, Australia
- Monash Health, Clayton, VIC, Australia
| | | | - Angela Joe
- Bolton Clarke Research Institute, Bentleigh, VIC, Australia
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26
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Abou L, Qin K, Alluri A, Du Y, Rice LA. The effectiveness of physical therapy interventions in reducing falls among people with multiple sclerosis: A systematic review and meta-analysis. J Bodyw Mov Ther 2022; 29:74-85. [DOI: 10.1016/j.jbmt.2021.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/16/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
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27
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Makino K, Lee S, Bae S, Chiba I, Harada K, Katayama O, Shinkai Y, Makizako H, Shimada H. Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study. Phys Ther 2021; 101:6131766. [PMID: 33561290 DOI: 10.1093/ptj/pzab059] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/06/2020] [Accepted: 01/03/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. METHODS A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48 ± 2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to "Are you afraid of falling?") at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. RESULTS Multivariable logistic regression showed that prefrailty or frailty increase the risk of not only future falls (odds ratio [OR]: 1.57; 95% CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95% CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95% CI = 1.04-1.68). CONCLUSIONS Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. IMPACT Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high risk not only for falls but also for FOF.
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Affiliation(s)
- Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Yohei Shinkai
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hyuma Makizako
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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28
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Feng F, Shi G, Chen H, Jia P, Bao L, Xu F, Sun QC, Tang H. Comprehensive Interventions Including Vitamin D Effectively Reduce the Risk of Falls in Elderly Osteoporotic Patients. Orthop Surg 2021; 13:1262-1268. [PMID: 33951328 PMCID: PMC8274142 DOI: 10.1111/os.13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/14/2021] [Accepted: 03/11/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate the effects of different intervention measures to prevent falls in elderly osteoporotic patients. Methods A randomized controlled trial was conducted in our outpatient ward from August 2014 to September 2015. A total of 420 patients over 60 years of age were assigned to four groups. NA VitD group took 800 mg calcium and 800 IU non‐active vitamin D. P‐NA VitD group took 800 mg calcium, 800 IU non‐active vitamin D, and received physical exercise. A VitD group took 800 mg calcium and 0.5 μg active vitamin D. P‐A VitD took 800 mg calcium, 0.5 μg active vitamin D, and received physical exercise. Physical exercise includes guidance in improving muscle strength and balance ability. Short physical performance battery (SPPB), grip strength, modified falls efficacy scale (MFES), blood calcium, and 25‐hydroxyl vitamin D were measured before interventions and at 3, 6, and 12 months after interventions. Bone mineral density (BMD) was detected before interventions and at 12 months after interventions. The incidence of falls and fractures, adverse events, and drug reactions were recorded for 12 months. Results A total of 420 patients were allocated in the four groups: 98 cases into the NA VitD group (11 males, 87 females), 97 cases into the P‐NA VitD group (13 males, 84 females), 99 cases in the A VitD group (15 males, 84 females), and 98 cases into the P‐A VitD group (11 males, 87 females). At 6 months after interventions, the SPPB of A VitD group significantly increased from 6.9 ± 1.9 to 8.0 ± 2.4 (P < 0.05), and the SPPB of A VitD group significantly increased from 7.2 ± 2.1 to 8.6 ± 1.7 (P < 0.05). At 6 months after interventions, MFES of P‐NA VitD group 7.0 ± 1.6 to 7.6 ± 1.6 (P < 0.05), and MFES of P‐A VitD group significantly increased from 6.7 ± 1.6 to 7.5 ± 1.6 (P < 0.05). At 12 months after interventions, SPPB of all groups, grip strength, and MFES of P‐NA VitD group, A VitD group, P‐A VitD group were significantly improved (P < 0.05). The BMD of lumbar vertebrae of A VitD group significantly increased from 0.742 ± 0.042 to 0.776 ± 0.039, and P‐A VitD group significantly increased from 0.743 ± 0.048 to 0.783 ± 0.042 (P < 0.05). No serious adverse events occurred during the 12 months of follow‐up. Conclusion Active vitamin D is better than non‐active vitamin D to improve physical ability and the BMD of lumbar vertebrae and reduce the risk of falls.
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Affiliation(s)
- Fei Feng
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guan Shi
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hao Chen
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pu Jia
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Li Bao
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Feng Xu
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qin-Chao Sun
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hai Tang
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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29
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Wen J, Bao M, Tang M, He X, Yao X, Li L. Low magnitude vibration alleviates age-related bone loss by inhibiting cell senescence of osteogenic cells in naturally senescent rats. Aging (Albany NY) 2021; 13:12031-12045. [PMID: 33888646 PMCID: PMC8109117 DOI: 10.18632/aging.202907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/18/2021] [Indexed: 04/14/2023]
Abstract
Dysfunction of bone marrow mesenchymal stem cells (BMSCs), osteoblasts and osteocytes may be one of the main causes of bone loss in the elderly. In the present study, we found osteogenic cells from aged rats all exhibited senescence changes, with the most pronounced senescence changes in osteocytes. Meanwhile, the proliferative capacity and functional activity of osteogenic cells from aged rats were suppressed. Osteogenic differentiation capacity of BMSCs from aged rats decreased while adipogenic capacity increased. The mineralization capacity, ALP activity and osteogenic proteins expression of osteoblasts from aged rats decreased. Additionally, osteocytes from aged rats up-expressed sclerosteosis protein, a negative regulator of bone formation. To inhibit osteogenic cell senescence, we use low magnitude vibration (LMV) to eliminate the senescent osteogenic cells. After LMV treatment, the number of osteogenic cells staining positively for senescence-associated-β-galactosidase (SA-β-Gal) decreased significantly. Besides, the expression of anti-aging protein SIRT1 was upregulated significantly, while p53 and p21 were downregulated significantly after LMV treatment. Thus, the LMV can inhibit the senescence of osteogenic cells partly through the Sirt1/p53/p21 axis. Furthermore, LMV was found to promote bone formation of aged rats. These results suggest that the inhibition of osteogenic cell senescence by LMV is a valuable treatment to prevent or delay osteoporosis.
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Affiliation(s)
- Jirui Wen
- Institute of Biomedical Engineering, West China School of Basic Medical Science and Forensic Medicine, Sichuan University, Chengdu 610041, Sichuan, China
| | - Mingyue Bao
- Institute of Biomedical Engineering, West China School of Basic Medical Science and Forensic Medicine, Sichuan University, Chengdu 610041, Sichuan, China
| | - Min Tang
- Institute of Biomedical Engineering, West China School of Basic Medical Science and Forensic Medicine, Sichuan University, Chengdu 610041, Sichuan, China
| | - Xueling He
- Laboratory Animal Center, Sichuan University, Chengdu 610041, Sichuan, China
| | - Xinghong Yao
- Institute of Biomedical Engineering, West China School of Basic Medical Science and Forensic Medicine, Sichuan University, Chengdu 610041, Sichuan, China
| | - Liang Li
- Institute of Biomedical Engineering, West China School of Basic Medical Science and Forensic Medicine, Sichuan University, Chengdu 610041, Sichuan, China
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30
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Livingstone I, Hefele J, Leland N. Physical and Occupational Therapy Staffing Patterns in Nursing Homes and Their Association with Long-stay Resident Outcomes and Quality of Care. J Aging Soc Policy 2020; 34:723-741. [DOI: 10.1080/08959420.2020.1824544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ian Livingstone
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
- Quality Measurement and Health Policy, RTI International, Waltham, MA, USA
| | - Jennifer Hefele
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
- Health Group, Booze Allen Hamilton, McLean, VA, USA
| | - Natalie Leland
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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31
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Kasović M, Štefan L, Zvonar M. Foot rotation and the risk of falls in older women: A cross-sectional study. PLoS One 2020; 15:e0239065. [PMID: 32925950 PMCID: PMC7489502 DOI: 10.1371/journal.pone.0239065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 08/30/2020] [Indexed: 11/20/2022] Open
Abstract
Although previous evidence has shown that deviated foot structure and function are associated with falls, little is known of the association between foot rotations and falls in apparently healthy older adults. Therefore, the main purpose of the study was to determine the associations between foot rotation and falls. In this cross-sectional study, we recruited 120 older women (mean±SD; age 71.01±6.77 years; height 158.92±21.41 cm; weight 70.29±12.97 kg; body-mass index 26.79±4.42 kg/m2). Foot rotations were assessed by using pressure platform (Zebris manufacturer, Munich, Germany), while the risk of falls was assessed by using Downtown Fall Risk Index questionnaire. Correlations and multiple regression models were applied to calculate the associations. In unadjusted model, higher foot rotation was associated with higher risk of falls (β = 0.14, p<0.001 for both feet). In a model adjusted for age, body-mass index, foot pain and fitness index, higher foot rotation remained associated with higher risk of falls (β = 0.10, p<0.001 for both feet). Our study shows that older adults with higher foot rotation are at higher risk of falls. Special interventions aiming to correct for deviated foot function in older women are warranted.
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Affiliation(s)
- Mario Kasović
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- Department of Sports Motorics and Methodology in Kinanthropology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
| | - Lovro Štefan
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- * E-mail:
| | - Martin Zvonar
- Department of Sports Motorics and Methodology in Kinanthropology, Faculty of Sport Studies, Masaryk University, Brno, Czech Republic
- Department of Physical Activity and Fitness, Faculty of Science, Masaryk University, Brno, Czech Republic
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32
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Wang Q, Jiang X, Shen Y, Yao P, Chen J, Zhou Y, Gu Y, Qian Z, Cao X. Effectiveness of exercise intervention on fall-related fractures in older adults: a systematic review and meta-analysis of randomized controlled trials. BMC Geriatr 2020; 20:322. [PMID: 32887571 PMCID: PMC7650290 DOI: 10.1186/s12877-020-01721-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/19/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Exercise intervention can significantly improve physical function and bone strength; however, the effect of exercise on fall-related fractures in older adults remains controversial. This study aimed to assess the effectiveness of exercise intervention on fall-related fractures in older adults by conducting a meta-analysis of randomized controlled trials (RCTs). METHODS PubMed, EMBASE, and Cochrane databases were systematically searched for RCTs through November 24, 2019 to investigate the effectiveness of exercise intervention on fall-related fractures in older adults. Pooled relative risk (RR) with 95% confidence interval (CI) was calculated using the random-effects model. Sensitivity, subgroup, and publication bias analyses were also conducted. RESULTS A total of 7704 older adults and 428 fall-related fracture events from 20 RCTs were selected for the final meta-analysis. The follow-up duration across included trials ranged from 6.0 months to 7.0 years. The pooled RR suggested that exercise intervention was associated with a reduced fall-related fracture risk in older adults (RR: 0.74; 95% CI: 0.59-0.92; P = 0.007; I2 = 12.6%). The pooled conclusion was robust and not affected by any individual trial. Subgroup analysis revealed that the significant effect of exercise intervention on fall-related fractures was mainly detected when the study reported results from both male and female subjects, when it did not report the baseline body mass index, when individuals received both home- and center-based interventions, when the follow-up duration was > 1.0 year, and when it was a high-quality study. CONCLUSIONS Regular exercise intervention could prevent fall-related fractures in older adults. Further large-scale RCTs should be conducted to assess the effectiveness of different exercise programs on fall-related fractures at various sites.
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Affiliation(s)
- Qiang Wang
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China
| | - Xiaowei Jiang
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China.
| | - Yingchao Shen
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China
| | - Ping Yao
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China
| | - Jun Chen
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China
| | - Yuan Zhou
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China
| | - Yunfeng Gu
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China
| | - Zhiyuan Qian
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China
| | - Xi Cao
- Department of Orthopaedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6 Huanghe Road, Changshu, 215500, China
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Yu X, Zeng Y, Bao M, Wen J, Zhu G, Cao C, He X, Li L. Low‐magnitude vibration induces osteogenic differentiation of bone marrow mesenchymal stem cells via miR‐378a‐3p/Grb2 pathway to promote bone formation in a rat model of age‐related bone loss. FASEB J 2020; 34:11754-11771. [PMID: 32652777 DOI: 10.1096/fj.201902830rrr] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 06/15/2020] [Accepted: 06/19/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Xiaoqin Yu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences and Forensic Medicine Sichuan University Chengdu China
| | - Ye Zeng
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences and Forensic Medicine Sichuan University Chengdu China
| | - Mingyue Bao
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences and Forensic Medicine Sichuan University Chengdu China
| | - Jirui Wen
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences and Forensic Medicine Sichuan University Chengdu China
| | - Guangguang Zhu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences and Forensic Medicine Sichuan University Chengdu China
| | - Chengjian Cao
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences and Forensic Medicine Sichuan University Chengdu China
| | - Xueling He
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences and Forensic Medicine Sichuan University Chengdu China
- Laboratory Animal Center Sichuan University Chengdu China
| | - Liang Li
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences and Forensic Medicine Sichuan University Chengdu China
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Soleimani R, Jalali MM, Mirbolook AR. Predictors of Fear of Falling among Iranian Older Adults with Hip Fracture and Controls. Clin Gerontol 2020; 43:391-399. [PMID: 31842724 DOI: 10.1080/07317115.2019.1704958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To investigate predictors of fear of falling (FOF) among older people with or without hip fracture. METHODS The FOF was assessed by the Visual Analogue Scale (VAS-FOF), anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). The modified Berg Balance Scale (mBBS) to evaluate functional balance was used. All people were asked to complete the dizziness Handicap Inventory (DHI) and the 36-item Short Form Health Survey (SF-36) for evaluating quality of life. RESULTS Eighty-eight older adults (44 cases; 44 controls) took part in this study. The case group had received surgical intervention for femoral neck or trochanteric fracture resulting from a fall. The results showed significantly more intensity of FOF in hip fracture patients than controls (p < .001). The FOF was significantly correlated with anxiety, DHI, mBBS, and SF-36. The results of the multiple linear regression showed that four predictors explained about 44% of the variance of the FOF. It was found that mBBS and DHI significantly predicted FOF (p < .001 and < .001, respectively). CONCLUSIONS The hip fracture patients had a high degree of the fear of falling, low quality of life and low functional capacity. The mBBS and DHI were significant predictors of the FOF in older adults. CLINICAL IMPLICATIONS It may be useful to employ an inter-disciplinary approach to addressing fear of falling to best understand physiological and psychological contributions.
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Affiliation(s)
- Robabeh Soleimani
- Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences , Rasht, Iran
| | - Mir Mohammad Jalali
- Otorhinolaryngology Research Center, Department of Otolaryngology, School of Medicine, Guilan University of Medical Sciences , Rasht, Iran
| | - Ahmad-Reza Mirbolook
- Department of Orthopedics, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran
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Neal SR, Wood AD, Ablett AD, Gregory JS, Guillot J, Macdonald HM, Reid DM, Myint PK. Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen prospective osteoporosis screening study (APOSS). Ther Adv Drug Saf 2020; 11:2042098620929852. [PMID: 32547728 PMCID: PMC7273562 DOI: 10.1177/2042098620929852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/03/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Anticholinergic burden (ACB) is a recognised risk factor for falls in older
people; however, whether ACB in middle age predicts falls in later life is
unknown. Methods: We examined this association in the middle-aged women of the Aberdeen
Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the
second health visit (1997–1999, study baseline) using the Anticholinergic
Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent
falls (⩾2 falls) during the 12 months prior to follow up 2007–2011.
Multinomial logistic regression analyses adjusted for potential confounders
including demographics, comorbidities and falls history. Results: A total of 2125 women {mean age (standard deviation [SD]): 54.7 (2.2) years
at baseline and 66.0 (2.2) years at follow up} were included. Prevalence of
baseline ACB score of 0, 1 and ⩾2 was 87.1%, 7.3% and 5.6%, respectively.
Compared with no ACB, ACB ⩾2 was associated with recurrent falls in the
previous 12 months [adjusted odds ratio (OR): 2.34, 95% confidence interval
(CI): 1.31, 4.19] at an average of 11 years after initial exposure. No such
association was found for an ACB score of 1. Conclusions: These findings highlight the potential negative effects of anticholinergic
medications in middle age. While cautious use of anticholinergic medications
is advisable, further longitudinal research should be conducted to confirm
these findings before any specific clinical recommendations can be made.
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Affiliation(s)
- Samuel R Neal
- Ageing Clinical and Experimental Research (ACER) Team, University of Aberdeen, UK
| | - Adrian D Wood
- Ageing Clinical and Experimental Research (ACER) Team, University of Aberdeen, UK
| | - Andrew D Ablett
- Ageing Clinical and Experimental Research (ACER) Team, University of Aberdeen, UK
| | - Jenny S Gregory
- Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK
| | - Jordan Guillot
- Ageing Clinical and Experimental Research (ACER) Team, University of Aberdeen, UK
| | - Helen M Macdonald
- Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK Arthritis and Musculoskeletal Medicine Research Programme, Institute of Medical Sciences, University of Aberdeen, UK
| | - David M Reid
- Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK Arthritis and Musculoskeletal Medicine Research Programme, Institute of Medical Sciences, University of Aberdeen, UK
| | - Phyo K Myint
- School of Medicine, Medical Sciences and Nutrition, Ageing Clinical and Experimental Research (ACER) Team, University of Aberdeen, Room 4:013, Polwarth Building, Foresterhill, Aberdeen, Scotland, AB25 2ZD, UK Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK Department of Medicine for the Elderly, NHS Grampian, Foresterhill Road, Aberdeen, UK
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Willaert J, De Vries AW, Tavernier J, Van Dieen JH, Jonkers I, Verschueren S. Does a novel exergame challenge balance and activate muscles more than existing off-the-shelf exergames? J Neuroeng Rehabil 2020; 17:6. [PMID: 31941518 PMCID: PMC6961365 DOI: 10.1186/s12984-019-0628-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Novel balance-targeting exergames controlled with off-the-shelf hardware, were developed based on current recommendations for balance training in healthy older adults and documented shortcomings of existing games. The aim of this study was to explore the feasibility of these novel exergames as training tool for elderly and, more specifically whether these games can elicit more challenging weight shifts and higher levels of muscle activity compared to existing off-the-shelf exergames. Furthermore, the motivational pull in these new games was studied. METHODS Sixteen healthy older adults were recruited to play the novel games and two reference games that were found to be the most challenging ones in terms of weight shifts or muscle activity in previous studies. Weight shifts were expressed relative to participants' Functional Limits of Stability (FLOS). Muscular challenge of the games was quantified by dividing the signal into 200 ms blocks and determining the average muscle activity within these blocks. The muscle activity was normalized to maximal voluntary contractions (MVC) to categorize the blocks in zones of < 40, 40-60, 60-80 and > 80% MVC. Subsequently, the number of blocks per intensity level and the number of consecutive blocks above 40% were determined. Motivation to play the games was assessed using the Intrinsic Motivation Inventory (IMI) and scores between the games were analyzed using Generalized Estimated Equations (GEE). RESULTS The novel exergames successfully elicited center of mass (COM) displacements with medians of around 80% of FLOS or higher for all directions. Furthermore, the COM displacements in the novel games were larger for each direction than in the reference games, although for one game the sideward left direction reached significance only at the third trial. Compared to the existing games, longer blocks of muscle activation above 40% MVC were found, but overall intensity remained low. IMI scores were high on all subscales, indicating that older adults experienced the games as motivating. CONCLUSION We conclude that affordable hardware can be used to create challenging and enjoyable balance training programs using exergames. The exergames that were successful in eliciting challenging weight shifts and muscle activity should now be further studied in longitudinal randomized controlled interventions, to assess effects on balance, muscle strength and eventually fall risk in healthy older adults.
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Affiliation(s)
- Jente Willaert
- KU Leuven (Faculteit bewegings- en revalidatiewetenschappen), Leuven, Belgium
| | | | - Julie Tavernier
- KU Leuven (Faculteit bewegings- en revalidatiewetenschappen), Leuven, Belgium
| | - Jaap H. Van Dieen
- Vrije Universiteit Amsterdam (Faculteit gedrags- en bewegingswetenschappen), Amsterdam, The Netherlands
| | - Ilse Jonkers
- KU Leuven (Faculteit bewegings- en revalidatiewetenschappen), Leuven, Belgium
| | - Sabine Verschueren
- KU Leuven (Faculteit bewegings- en revalidatiewetenschappen), Leuven, Belgium
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Impact of calcium, vitamin D, vitamin K, oestrogen, isoflavone and exercise on bone mineral density for osteoporosis prevention in postmenopausal women: a network meta-analysis. Br J Nutr 2020. [DOI: 10.1017/s0007114519002290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AbstractThe aim of this network meta-analysis is to compare bone mineral density (BMD) changes among different osteoporosis prevention interventions in postmenopausal women. We searched MEDLINE, Embase and Cochrane Library from inception to 24 February 2019. Included studies were randomised controlled trials (RCT) comparing the effects of different treatments on BMD in postmenopausal women. Studies were independently screened by six authors in three pairs. Data were extracted independently by two authors and synthesised using Bayesian random-effects network meta-analysis. The results were summarised as mean difference in BMD and surface under the cumulative ranking (SUCRA) of different interventions. A total of ninety RCT (10 777 participants) were included. Ca, vitamin D, vitamin K, oestrogen, exercise, Ca + vitamin D, vitamin D + vitamin K and vitamin D + oestrogen were associated with significantly beneficial effects relative to no treatment or placebo for lumbar spine (LS). For femoral neck (FN), Ca, exercise and vitamin D + oestrogen were associated with significantly beneficial intervention effects relative to no treatment. Ranking probabilities indicated that oestrogen + vitamin D is the best strategy in LS, with a SUCRA of 97·29 % (mean difference: +0·072 g/cm2 compared with no treatment, 95 % credible interval (CrI) 0·045, 0·100 g/cm2), and Ca + exercise is the best strategy in FN, with a SUCRA of 79·71 % (mean difference: +0·029 g/cm2 compared with placebo, 95 % CrI –0·00093, 0·060 g/cm2). In conclusion, in postmenopausal women, many interventions are valuable for improving BMD in LS and FN. Different intervention combinations can affect BMD at different sites diversely.
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A Pilot Study on Falling-Risk Detection Method Based on Postural Perturbation Evoked Potential Features. SENSORS 2019; 19:s19245554. [PMID: 31888176 PMCID: PMC6960671 DOI: 10.3390/s19245554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 12/02/2022]
Abstract
In the human-robot hybrid system, due to the error recognition of the pattern recognition system, the robot may perform erroneous motor execution, which may lead to falling-risk. While, the human can clearly detect the existence of errors, which is manifested in the central nervous activity characteristics. To date, the majority of studies on falling-risk detection have focused primarily on computer vision and physical signals. There are no reports of falling-risk detection methods based on neural activity. In this study, we propose a novel method to monitor multi erroneous motion events using electroencephalogram (EEG) features. There were 15 subjects who participated in this study, who kept standing with an upper limb supported posture and received an unpredictable postural perturbation. EEG signal analysis revealed a high negative peak with a maximum averaged amplitude of −14.75 ± 5.99 μV, occurring at 62 ms after postural perturbation. The xDAWN algorithm was used to reduce the high-dimension of EEG signal features. And, Bayesian linear discriminant analysis (BLDA) was used to train a classifier. The detection rate of the falling-risk onset is 98.67%. And the detection latency is 334ms, when we set detection rate beyond 90% as the standard of dangerous event onset. Further analysis showed that the falling-risk detection method based on postural perturbation evoked potential features has a good generalization ability. The model based on typical event data achieved 94.2% detection rate for unlearned atypical perturbation events. This study demonstrated the feasibility of using neural response to detect dangerous fall events.
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Zhao R, Bu W, Chen X. The efficacy and safety of exercise for prevention of fall-related injuries in older people with different health conditions, and differing intervention protocols: a meta-analysis of randomized controlled trials. BMC Geriatr 2019; 19:341. [PMID: 31795944 PMCID: PMC6892137 DOI: 10.1186/s12877-019-1359-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022] Open
Abstract
Background Whether exercise prevents fall-related injuries in different health conditions and with different training protocols is still unclear. This study aimed to determine the effect of exercise on fall-related injuries by participant characteristics and divergent exercise protocols. The safety and compliance of exercise were also examined. Methods Electronic database searches were conducted in PubMed, Web of Science, and EMBASE for randomised controlled trials that evaluated the influence of exercise on fall-induced injuries in older people. Results Twenty-five trials met the inclusion criteria. Exercise significantly reduced the risk of fall-related injuries in older adults, risk ratio (RR) 0.879 [95% confidence interval (CI) 0.832–0.928]. Among the injuries, events needing medical care or resulting fractures were also decreased by exercise intervention, with RR 0.681 (0.562–0.825) and 0.561 (0.366–0.860), respectively. When analysis was stratified by participant characteristics and exercise protocols, we found that participants at high risk of falling, or with osteoporosis, were sensitive to exercise intervention. Combined exercise protocols and balance training were the most effective exercise types in reducing fall-related injuries. Exercise-associated beneficial effects were even significant in very old people (≥80 years) and across the duration of interventions (< 6 months, 6 to 12 months and ≥ 12 months). Exercise only generated a very low injury rate per participant year (0.002, 95% CI 0–0.05) and showed relatively good compliance of exercise (as reported in the included papers) (78.5, 95% CI 72.8–84.2%). Conclusions Exercise is effective in preventing fall-induced injuries across a variety of baseline participant characteristics and exercise protocols. Exercise was associated with a low injury rate and had a good compliance, suggesting it is a feasible approach to managing fall-related injuries.
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Affiliation(s)
- Renqing Zhao
- College of Physical Education, Yangzhou University, 88 Daxue South Rd, Yangzhou, 225009, Jiangsu Province, China.
| | - Wenqian Bu
- College of Physical Education, Yangzhou University, 88 Daxue South Rd, Yangzhou, 225009, Jiangsu Province, China
| | - Xianghe Chen
- College of Physical Education, Yangzhou University, 88 Daxue South Rd, Yangzhou, 225009, Jiangsu Province, China
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Bone Mass and Strength and Fall-Related Fractures in Older Age. J Osteoporos 2019; 2019:5134690. [PMID: 31583071 PMCID: PMC6754934 DOI: 10.1155/2019/5134690] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/14/2019] [Accepted: 08/22/2019] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Low bone mineral density is a risk factor for fractures. The aim of this follow-up study was to assess the association of various bone properties with fall-related fractures. MATERIALS AND METHODS 187 healthy women aged 55 to 83 years at baseline who were either physically active or inactive were followed for 20 years. They were divided into two groups by whether or not they sustained fall-related fractures: fracture group (F) and nonfracture group (NF). At baseline, several bone properties were measured with DXA and pQCT, and their physical performance was also assessed. RESULTS During the follow-up, 120 women had no fall-related fractures, while 67 (38%) sustained at least one fall with fracture. NF group had about 4 to 11% greater BMD at the femoral neck and distal radius; the mean differences (95% CI) were 4.5 (0.3 to 8.6) % and 11.1 (6.3 to 16.1) %, respectively. NF group also had stronger bone structure at the tibia, the mean difference in BMC at the distal tibia was 6.0 (2.2 to 9.7) %, and at the tibial shaft 3.6 (0.4 to 6.8) %. However, there was no mean difference in physical performance. CONCLUSIONS Low bone properties contribute to the risk of fracture if a person falls. Therefore, in the prevention of fragility fractures, it is essential to focus on improving bone mass, density, and strength during the lifetime. Reduction of falls by improving physical performance, balance, mobility, and muscle power is equally important.
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The Role of Recovery Lower Limb Segments in Post-Slip Determination of Falls Due to Instability or Limb Collapse. Ann Biomed Eng 2019; 48:192-202. [PMID: 31338626 DOI: 10.1007/s10439-019-02327-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
Slip-related falls can be induced by instability or limb collapse, but the key factors that determine these two fall causations remain unknown. The purpose of this study was to investigate the factors that contribute towards instability-induced and limb-collapse-induced slip-related falls by investigating 114 novel slip trials. The segment angles and moments of the recovery limb after slip-onset from pre-left-touchdown (pre-LTD) to post-left-touchdown (post-LTD) were calculated, and logistic regression was used to detect which variable contributed most to instability-induced and limb-collapse-induced falls. The results showed that recovery from instability was determined by the angle of the thigh at LTD (87.7%), while recovery from limb collapse was determined by the angle of the shank at post-LTD (90.4%). Correspondingly, instability-induced falls were successfully predicted (81.5%) based on the initial thigh angle at pre-LTD and the following peak thigh moment, while limb-collapse-induced falls were successfully predicted (85.5%) based on the initial shank angle at LTD and the following peak shank moment. According to our findings, taking a shorter recovery step and/or increasing the counterclockwise moment of the thigh after pre-LTD would help individuals resist instability-induced falls, while taking a larger recovery step and/or increasing the clockwise moment of the shank post-LTD would help resist limb-collapse-induced falls. The findings of this study are crucial for future clinical applications, because individually tailored reactive balance training could be provided to reduce vulnerability to specific types of falls and improve recovery rates post-slip exposure.
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The Relationship Between Quality of Care, Physical Therapy, and Occupational Therapy Staffing Levels in Nursing Homes in 4 Years' Follow-up. J Am Med Dir Assoc 2019; 20:462-469. [DOI: 10.1016/j.jamda.2019.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/01/2019] [Accepted: 02/03/2019] [Indexed: 11/15/2022]
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Abstract
PURPOSE OF REVIEW With the incidence of distal radius fractures increasing in the elderly population, we sought to summarize the current orthopedic and medical management of these fractures in the elderly osteoporotic population. RECENT FINDINGS The number of osteoporotic patients undergoing surgical fixation for distal radius fractures has increased in recent years. This is likely due to the improved outcomes seen with volar locking plates, as well as an increase in the number of fellowship-trained hand surgeons. Despite this potential improvement in acute fracture management, a majority of these patients are underdiagnosed and undertreated for their underlying osteoporosis or endocrinopathies. The implementation of fracture liaison services and the ability of the treating orthopedist to recognize this gap in patient care result in a higher number of patients initiating appropriate treatment. It is vital that when discussing acute fracture management, a thorough discussion is had with patients regarding functional outcome and the benefits of both surgical and non-operative management. As these fractures become more prevalent and a greater percentage undergo surgical intervention, the economic burden of distal radius fractures will continue to rise. It is imperative that the treating surgeon view these fractures as sentinel events that are predictive of future hip and vertebral fractures. While relatively new, the use of fracture liaison services to help aide in proper screening and treatment of osteoporotic patients is of great value. Non-pharmacologic therapy such as physical therapy, smoking and alcohol cessation programs, and dietary modifications are crucial in treating patients with osteoporosis. While bisphosphonates remain the first-line treatment in patients with osteoporosis, novel therapies show promise for future use.
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Uusi-Rasi K, Patil R, Karinkanta S, Tokola K, Kannus P, Lamberg-Allardt C, Sievänen H. Serum 25-hydroxyvitamin D levels and incident falls in older women. Osteoporos Int 2019; 30:93-101. [PMID: 30255229 DOI: 10.1007/s00198-018-4705-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 01/06/2023]
Abstract
UNLABELLED Three hundred eighty-seven home-dwelling older women were divided into quartiles based on mean serum 25-hydroxyvitamin D (S-25(OH)D) levels. The rates of falls and fallers were about 40% lower in the highest S-25(OH)D quartile compared to the lowest despite no differences in physical functioning, suggesting that S-25(OH)D levels may modulate individual fall risk. INTRODUCTION Vitamin D supplementation of 800 IU did not reduce falls in our previous 2-year vitamin D and exercise RCT in 70-80 year old women. Given large individual variation in individual responses, we assessed here effects of S-25(OH)D levels on fall incidence. METHODS Irrespective of original group allocation, data from 387 women were explored in quartiles by mean S-25(OH)D levels over 6-24 months; means (SD) were 59.3 (7.2), 74.5 (3.3), 85.7 (3.5), and 105.3 (10.9) nmol/L. Falls were recorded monthly with diaries. Physical functioning and bone density were assessed annually. Negative binomial regression was used to assess incidence rate ratios (IRRs) for falls and Cox-regression to assess hazard ratios (HR) for fallers. Generalized linear models were used to test between-quartile differences in physical functioning and bone density with the lowest quartile as reference. RESULTS There were 37% fewer falls in the highest quartile, while the two middle quartiles did not differ from reference. The respective IRRs (95% CI) for falls were 0.63 (0.44 to 0.90), 0.78 (0.55 to 1.10), and 0.87 (0.62 to 1.22), indicating lower falls incidence with increasing mean S-25(OH)D levels. There were 42% fewer fallers (HR 0.58; 040 to 0.83) in the highest quartile compared to reference. Physical functioning did not differ between quartiles. CONCLUSIONS Falls and faller rates were about 40% lower in the highest S-25(OH)D quartile despite similar physical functioning in all quartiles. Prevalent S-25(OH)D levels may influence individual fall risk. Individual responses to vitamin D treatment should be considered in falls prevention.
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Affiliation(s)
- K Uusi-Rasi
- The UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland.
| | - R Patil
- The UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland
- Department of Physiotherapy, Jehangir Hospital, Pune, Maharashtra, 411001, India
| | - S Karinkanta
- The UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland
| | - K Tokola
- The UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland
| | - P Kannus
- The UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland
- Medical School, University of Tampere, Tampere, Finland
- Department of Orthopedics and Trauma Surgery, Tampere University Central Hospital, Tampere, Finland
| | - C Lamberg-Allardt
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - H Sievänen
- The UKK Institute for Health Promotion Research, P.O. Box 30, 33501, Tampere, Finland
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Xu L, Liu B, Li P, Li J, Wang J, Han J, Yang N. Correlations of Serum Hormones and Bone Mineral Density with Fracture and Balance Ability of Postmenopausal Patients and Effects of Calcitriol. Med Sci Monit 2018; 24:7309-7315. [PMID: 30315646 PMCID: PMC6196597 DOI: 10.12659/msm.910792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The aim of this study was to analyze the correlations of serum hormones and bone mineral density (BMD) with fracture and balance ability of postmenopausal patients and effects of calcitriol on them. Material/Methods The clinical data of 164 postmenopausal female patients with osteoporosis (OP) treated in our hospital were retrospectively analyzed. Results The incidence rates of OVCF, balance index score (BIS), front-back ratio (FBR), and right-left ratio (RLR) in the normal BMD group, reduced BMD group, and OP group showed increasing trends, and there were statistically significant differences in comparisons among groups (p<0.05). The levels of serum estradiol (E2) and progesterone (P) in the OVCF group were lower than those in the non-OVCF group, and there were statistically significant differences in comparisons between the 2 groups (p<0.05). However, there was no statistically significant difference in the comparison of serum luteinizing hormone (LH) level between the 2 groups (p>0.05). BIS, FBR, and RLR were negatively correlated with E2 and testosterone (T) (p<0.05). With the prolongation of calcitriol treatment time, BIS, FBR, and RLR gradually decreased, but T value gradually increased. At 6 months and 12 months after intervention, BIS, FBR, and RLR had significant differences compared to those before the experiment (p<0.05). (5) Total hip BMD, height, age, and body mass index (BMI) were the independent factors affecting SDI. Conclusions Hip BMD, age, height, and BMI are significantly correlated with OVCF. Calcitriol treatment can increase lumbar BMD and improve balance ability, and these effects become more obvious with prolongation of intervention time.
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Affiliation(s)
- Lili Xu
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Bing Liu
- Department of Vascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Peng Li
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Juanjuan Li
- Department of Endocrinology, Qilu Hospital of Shandong University, Qingdao, Shandong, China (mainland)
| | - Jun Wang
- Department of Endocrinology, The 401 Hospital of PLA, Qingdao, Shandong, China (mainland)
| | - Jialin Han
- Department of Endocrinology, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China (mainland)
| | - Nailong Yang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
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Feng JE, Novikov D, Anoushiravani AA, Wasterlain AS, Lofton HF, Oswald W, Nazemzadeh M, Weiser S, Berger JS, Iorio R. Team Approach: Perioperative Optimization for Total Joint Arthroplasty. JBJS Rev 2018; 6:e4. [DOI: 10.2106/jbjs.rvw.17.00147] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Sahib MN. Validation and Assessment of Osteoporosis Self-Efficacy Among Iraqi General Population. Open Nurs J 2018; 12:76-85. [PMID: 29997710 PMCID: PMC5997860 DOI: 10.2174/1874434601812010076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/18/2018] [Accepted: 04/27/2018] [Indexed: 11/22/2022] Open
Abstract
Background Poor quality of life, fractures and disability are the consequences of preventable osteoporosis. Objectives The aims of this study were to validate and assess Osteoporosis Self-efficacy Scale (OSES-A) Arabic version among Iraqi general population. Methods A cross-sectional study with a random cluster sampling method from the community was used. Forward-backward-forward translation method was used to translate the questionnaire from English to Arabic. Beside OSES-A, Osteoporosis Knowledge Tool (OKT) and Osteoporosis Health Belief Scale (OHBS) Arabic versions were used to assess osteoporosis preventive behaviours. Results The results showed good face validity and reliability. The construct validity showed two factors which explain 80.86% of the variance. In addition, the result showed low self-efficacy score (658.43±222.014) with 83.33% were found to have low OSES-A level. There were significant associations between age, gender, and self-reported osteoporosis with OSES-A levels. In addition, there were significant differences between age, gender, marital status, family history of osteoporosis, self-reported osteoporosis and osteoporosis diagnosis or screening in relation to total OSES-A scores. Moreover, there were positive correlations between the OSES-A total score with total knowledge and health belief. Multivariate analysis revealed that OKT levels, OHBS levels, age and gender were predictors for OSES-A levels. Conclusion This study showed good cultural adaptation and psychometric properties of OSES-A tool and could be used in any osteoprotective educational program.
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Affiliation(s)
- Mohanad Naji Sahib
- Faculty of Pharmacy, Al-Rafidain University College, Palestine street, 10052, Baghdad, Iraq
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Continuously declining incidence of fall injuries in older adults: nationwide statistics from Finland between 1970 and 2016. Eur Geriatr Med 2018; 9:371-375. [DOI: 10.1007/s41999-018-0053-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/24/2018] [Indexed: 01/31/2023]
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Kannus P, Niemi S, Parkkari J, Sievänen H. Continuously declining incidence of hip fracture in Finland: Analysis of nationwide database in 1970-2016. Arch Gerontol Geriatr 2018; 77:64-67. [PMID: 29684740 DOI: 10.1016/j.archger.2018.04.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/07/2018] [Accepted: 04/09/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Hip fractures of older adults are a major public health issue. METHODS We determined the current trend in the number and incidence (per 100,000 persons) of hip fracture among older adults in Finland by taking into account all persons 50 years of age or older who were admitted to hospitals for primary treatment of such fracture between 1970 and 2016. RESULTS The number of hip fractures rose sharply till the end of 1990s (from 1857 in 1970 to 7122 in 1997), but since then, the rise has slowed down (7716 fractures in 2016). Similarly, the age-adjusted incidence of hip fracture increased until 1997 but declined thereafter. The decline was especially clear in women whose age-adjusted incidence was 537.9 (per 100,000 persons) in 1997 but only 344.1 in 2016. In men, the corresponding incidence was 256.5 in 1997 and 194.7 in 2016. With the current 2016 incidence rates, the number of hip fractures in Finland will increase by 44% by the year 2030 due to the sharp growth of the population at risk. The only way to limit the rise is to have a further decline in fracture incidence in 2016-2030. CONCLUSIONS The decline in the incidence of hip fracture in Finland has continued through the entire new millennium. Despite this we have to effectively continue implementation of the fracture prevention efforts, because our elderly population will grow rapidly in the near future.
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Affiliation(s)
- Pekka Kannus
- Injury & Osteoporosis Research Center, UKK Institute for Health Promotion Research, Tampere, Finland; Medical School, University of Tampere, Department of Orthopedics and Trauma Surgery, Tampere University Hospital, Tampere, Finland.
| | - Seppo Niemi
- Injury & Osteoporosis Research Center, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Harri Sievänen
- Injury & Osteoporosis Research Center, UKK Institute for Health Promotion Research, Tampere, Finland
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