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Baptista FM, Andias R, Rocha NP, Silva AG. A Practice Guide for Physical Therapists Prescribing Physical Exercise for Older Adults. J Aging Phys Act 2024:1-13. [PMID: 38862112 DOI: 10.1123/japa.2023-0283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 03/24/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Physical activity and exercise are protective factors for physical and cognitive decline in older adults, but recent studies reveal that a large percentage of this population do not practice exercise at the levels recommended by international guidelines. The frequency, intensity, type, time, volume, and progression (FITT-VP) principles are a widely used method for prescribing physical exercise, allowing the development of a personalized exercise program that meets the needs of each individual. OBJECTIVES This masterclass is intended to serve as a professional application tool for physical therapists who prescribe physical exercise for older adults. We present a section for each FITT-VP principle to facilitate handling these principles individually when prescribing exercise for this population. METHODS Review of the scientific literature and international guidelines on the prescription of physical exercises for older adults. RESULTS Aerobic, mobility, resistance, balance, and flexibility exercises, as well as functional training, should be included in an exercise program for older adults, which should be progressed using different methods for each of the exercise modalities. CONCLUSIONS An exercise program for older adults should integrate different exercise modalities. Exercise progression should be performed following the FITT-VP principles and some specific progression factors recommended for each exercise modality. SIGNIFICANCE Considering the challenge faced by clinicians in designing a viable exercise program for older adults that responds to international recommendations, with this masterclass we hope to help physical therapists to plan an exercise program that is feasible and at the same time, responds to the expected needs of this population.
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Affiliation(s)
- Frederico M Baptista
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- CINTESIS.UA@RISE, University of Aveiro, Aveiro, Portugal
| | - Rosa Andias
- CINTESIS.UA@RISE, University of Aveiro, Aveiro, Portugal
| | - Nelson P Rocha
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), Aveiro, Portugal
| | - Anabela G Silva
- CINTESIS.UA@RISE, University of Aveiro, Aveiro, Portugal
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Rodríguez-Almagro D, Achalandabaso-Ochoa A, Ibáñez-Vera AJ, Góngora-Rodríguez J, Rodríguez-Huguet M. Effectiveness of Virtual Reality Therapy on Balance and Gait in the Elderly: A Systematic Review. Healthcare (Basel) 2024; 12:158. [PMID: 38255047 PMCID: PMC10815791 DOI: 10.3390/healthcare12020158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/23/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Virtual reality (VR) therapies are presently utilized to treat physical and cognitive impairments among elderly people. This systematic review aims to collect the most recent evidence on the effectiveness of VR in improving balance and gait among healthy elderly individuals, in comparison with other therapies. A literature search was conducted using the PubMed, SCOPUS, PEDro, and WoS databases, by selecting randomized clinical trials that evaluated balance, both static and dynamic, as well as gait in a population of healthy older adults who underwent virtual reality therapy. The methodological quality of the studies was assessed using the PEDro scale. After eligibility criteria were applied and duplicates were removed, 20 studies were selected out of 1705 initially identified. The present systematic review concludes that virtual reality therapy is more effective than minimal intervention or usual care in enhancing static balance, dynamic balance, and gait in healthy elderly individuals. Moreover, virtual reality therapy yields better outcomes compared to traditional balance training and physical exercise in improving balance and gait in this demographic. However, both methods have shown effectiveness.
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Affiliation(s)
- Daniel Rodríguez-Almagro
- Department of Nursing, Physical Therapy and Medicine, University of Almería, 04120 Almería, Spain;
| | - Alexander Achalandabaso-Ochoa
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (A.A.-O.); (A.J.I.-V.)
| | - Alfonso Javier Ibáñez-Vera
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (A.A.-O.); (A.J.I.-V.)
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Poveda-López S, Lillo-Navarro C, Sánchez-Pérez A, Gacto-Sánchez M, Montilla-Herrador J. Older persons' expressed perceptions on exercise programs in long-term care institutions: Influence of professionals and institutions. PATIENT EDUCATION AND COUNSELING 2023; 117:107985. [PMID: 37734250 DOI: 10.1016/j.pec.2023.107985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/30/2023] [Accepted: 09/16/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To explore the perceptions of institutionalised older people about the professionals and institutions regarding exercise programs in long-term care institutions DESIGN, SETTING, AND PARTICIPANTS: A qualitative study was carried out using focus group discussions. Forty-seven institutionalised participants (≥ 65 years old) with a score of > 23 in the Mini-Mental State Examination (MMSE) were recruited. RESULTS Most participants believed that the frequency of the exercise sessions could be increased by enhancing the number of staff assisting them and by adapting the facilities to their needs. They also suggested using outdoor spaces and avoiding childish activities and treatment. Participants' beliefs were grouped into three major themes (i) Perceptions about the health professionals delivering the exercise programs (ii) Perceptions about the institution or centre regarding exercise programs; (iii) Perceptions about the exercise programs. CONCLUSION Participants proposed certain changes that could take place in the institutions to promote engagement with exercise programs: tailored exercise programs, avoiding puerile treatment, increasing the number of staff members, and the creation of well-equipped spaces to perform the exercise. PRACTICAL IMPLICATIONS Professionals should spend time designing tailored exercise programs and avoid puerile treatment. Institutions must review the need for spaces and the personnel assigned.
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Affiliation(s)
- Salud Poveda-López
- Faculty of Health Sciences, UCAM Catholic University of Murcia, Murcia, Spain
| | - Carmen Lillo-Navarro
- Center for Translational Research in Physiotherapy (CEIT). Department of Pathology and Surgery. Miguel Hernández University, Alicante, Spain.
| | - Alicia Sánchez-Pérez
- Department of Pathology and Surgery, Miguel Hernández University, Alicante, Spain. Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Mariano Gacto-Sánchez
- CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
| | - Joaquina Montilla-Herrador
- CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
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Malmir K, Ashrafganjooie M. Effects of HiBalance training program on physical function of individuals with idiopathic Parkinson disease: a systematic review and meta-analysis. Eur Geriatr Med 2023; 14:1273-1288. [PMID: 37698784 DOI: 10.1007/s41999-023-00860-4] [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: 05/23/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE The effectiveness of the HiBalance training program for individuals with Parkinson disease (PD) remains debated, prompting a systematic investigation. This study aims to assess whether the HiBalance training program yields favorable outcomes on physical function and self-reported function measures in PD individuals. METHODS A systematic search across PubMed, Cochrane Library, Ovid, Scopus, and PEDro databases identified studies exploring HiBalance training's impact on physical function in idiopathic PD. Publication date restrictions were not applied. Two independent reviewers evaluated bias risk using the Cochrane Risk of Bias tool and study quality using the PEDro scale. Effect size (standardized mean difference, SMD) and heterogeneity (Higgins I2) were determined. RESULTS Six studies underwent qualitative analysis, with two randomized-controlled trials and one multi-center clinical trial being included in the meta-analysis. HiBalance training exhibited a significant impact on physical function (SMD = 0.49; P = 0.0003). The Mini-BESTest score and gait velocity displayed improvements with moderate-effect sizes. However, solely gait velocity showed clinical enhancement. Yet, these benefits did not remain at the 6- and 12-month follow-ups post-intervention. Self-reported function measures showed no alteration post-HiBalance training. Publication bias was absent. CONCLUSION HiBalance training led to clinically significant improvements solely in gait velocity, though these gains waned over time. The findings suggest the necessity of refining the HiBalance program to sustain positive outcomes and ensure lasting enhancements. This underscores the importance of post-HiBalance training exercise programs to maintain benefits in the long term. PROSPERO REGISTRATION NUMBER The protocol of this review and meta-analysis was registered at PROSPERO (CRD42022325649). Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022325649 .
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Affiliation(s)
- Kazem Malmir
- School of Rehabilitation, Physical Therapy Department, Tehran University of Medical Sciences, P. O. Box: 113635-1683, Tehran, Iran.
| | - Majid Ashrafganjooie
- School of Paramedical Sciences, Physical Therapy Department, Kerman University of Medical Sciences, Kerman, Iran
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Søndergaard K, Curtis DJ, Caye-Thomasen P, Juhl CB. The reliability and agreement of scores in a novel balance measure for older adults: Specific Training According to BaLance Evaluation (STABLE). Disabil Rehabil 2023; 45:3582-3594. [PMID: 36205568 DOI: 10.1080/09638288.2022.2130446] [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: 02/24/2022] [Accepted: 09/25/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Falls are the leading cause of injury and premature death among community dwelling elderly but can be prevented through comprehensive balance rehabilitation which ideally targets the patient's specific needs. In this study, we evaluate the reliability and agreement of six novel clinical measures of different balance domains which applied in a patient-specific balance profile guides exercise prescription in balance rehabilitation. MATERIALS AND METHODS The intra-rater reliability and agreement of the six measures were evaluated on the same day in six different cohorts of elderly with balance disability (n = 65-100). Further, the inter-day intra-rater and inter-rater and test-retest reliability and agreement of the measures and the balance profile were evaluated (n = 100). RESULTS The intra-day intra-rater reliability and agreement was moderate to excellent (ICC2.1 = 0.525-0.968, with SDC% = 6.5-284.9%) but poor to good for the inter-day conditions (ICC2.1 = 0.123-0.832, with SDC% = 6.6-229.2%). The reliability of classifying the lower domain in the balance profile was fair, with kappa = 0.56 (95%CI 0.36-0.76). CONCLUSIONS Five of the six measures may reliably be applied to measure balance disability and to guide rehabilitation. Implications for rehabilitationBalance disability is the primary reason for accidental falls among elderly but can be prevented through comprehensive individualized balance rehabilitation.Specific Training According to BaLance Evaluation (STABLE) is a novel approach for designing effective balance exercises based on clinical measurements.Five of the six measures are reliable when applied in a patient-specific balance profile to guide rehabilitation following the STABLE approach.
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Affiliation(s)
- Kasper Søndergaard
- Department of Occupational and Physical Therapy, University Hospital Herlev and Gentofte, Hellerup, Denmark
- Department of ORL, H&N Surgery and Audiology, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense M, Denmark
| | - Derek John Curtis
- Child Centre Copenhagen, The Child and Youth Administration, Copenhagen Ø, Denmark
| | - Per Caye-Thomasen
- Department of ORL, H&N Surgery and Audiology, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Carsten Bogh Juhl
- Department of Occupational and Physical Therapy, University Hospital Herlev and Gentofte, Hellerup, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense M, Denmark
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Punnoose A, Claydon-Mueller LS, Weiss O, Zhang J, Rushton A, Khanduja V. Prehabilitation for Patients Undergoing Orthopedic Surgery: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e238050. [PMID: 37052919 PMCID: PMC10102876 DOI: 10.1001/jamanetworkopen.2023.8050] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Importance Prehabilitation programs for patients undergoing orthopedic surgery have been gaining popularity in recent years. However, the current literature has produced varying results. Objective To evaluate whether prehabilitation is associated with improved preoperative and postoperative outcomes compared with usual care for patients undergoing orthopedic surgery. Data Sources Bibliographic databases (MEDLINE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], AMED [Allied and Complementary Medicine], Embase, PEDRO [Physiotherapy Evidence Database], and Cochrane Central Register of Controlled Trials) were searched for published trials, and the Institute for Scientific Information Web of Science, System for Information on Grey Literature in Europe, and European clinical trials registry were searched for unpublished trials from January 1, 2000, to June 30, 2022. Study Selection Randomized clinical trials (RCTs) comparing prehabilitation with standard care for any orthopedic surgical procedure were included. Data Extraction and Synthesis Two independent reviewers screened trials. Data were pooled using a random-effects model. Recommendations were determined using the Grading of Recommendations Assessment, Development and Evaluation system and the study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Main Outcomes and Measures Pain, function, muscle strength, and health-related quality of life (HRQOL). Results Forty-eight unique trials involving 3570 unique participants (2196 women [61.5%]; mean [SD] age, 64.1 [9.1] years) were analyzed. Preoperatively, moderate-certainty evidence favoring prehabilitation was reported for patients undergoing total knee replacement (TKR) for function (standardized mean difference [SMD], -0.70 [95% CI, -1.08 to -0.32]) and muscle strength and flexion (SMD, 1.00 [95% CI, 0.23-1.77]) and for patients undergoing total hip replacement (THR) for HRQOL on the 36-item Short Form Health Survey (weighted mean difference [WMD], 7.35 [95% CI, 3.15-11.54]) and muscle strength and abduction (SMD, 1.03 [95% CI, 0.03-2.02]). High-certainty evidence was reported for patients undergoing lumbar surgery for back pain (WMD, -8.20 [95% CI, -8.85 to -7.55]) and moderate-certainty evidence for HRQOL (SMD, 0.46 [95% CI, 0.13-0.78]). Postoperatively, moderate-certainty evidence favoring prehabilitation was reported for function at 6 weeks in patients undergoing TKR (SMD, -0.51 [95% CI, -0.85 to -0.17]) and at 6 months in those undergoing lumbar surgery (SMD, -2.35 [95% CI, -3.92 to -0.79]). Other differences in outcomes favoring prehabilitation were of low to very low quality of evidence. Conclusions and Relevance In this systematic review and meta-analysis of RCTs, moderate-certainty evidence supported prehabilitation over usual care in improving preoperative function and strength in TKR and HRQOL and muscle strength in THR, high-certainty evidence in reducing back pain, and moderate-certainty evidence in improving HRQOL in lumbar surgery. Postoperatively, moderate-certainty evidence supported prehabilitation for function following TKR at 6 weeks and lumbar surgery at 6 months. Prehabilitation showed promising results for other outcomes, although high risk of bias and heterogeneity affected overall quality of evidence. Additional RCTs with a low risk of bias investigating preoperative and postoperative outcomes for all orthopedic surgical procedures are required.
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Affiliation(s)
- Anuj Punnoose
- Young Adult Hip Service, Physiotherapy Department, Addenbrooke's-Cambridge University Hospitals NHS (National Health Service) Trust, Cambridge, United Kingdom
- School of Allied Health, Anglia Ruskin University, Chelmsford and Cambridge, United Kingdom
| | | | - Ori Weiss
- Department of Orthopedics, Meir Medical Centre, Kfar-Saba, Israel
| | - Jufen Zhang
- School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Alison Rushton
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Vikas Khanduja
- Young Adult Hip Service, Department of Trauma and Orthopedics, Addenbrooke's-Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
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Lee HJ, Yang JM, Kim JH. Relationship between functional limitations due to subjective cognitive decline and falling focusing exercise intensity: Results from the Korean Community Health Survey. J Public Health Res 2023; 12:22799036231180991. [PMID: 37388710 PMCID: PMC10302546 DOI: 10.1177/22799036231180991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/07/2023] [Indexed: 07/01/2023] Open
Abstract
Background To explore the association between functional limitation due to subjective cognitive decline (SCD) and falling by focusing on exercise intensity in the Korean population aged 45 years and older. Study Design The 2019 Korean Community Health Survey (KCHS) was used to analyze 35,387 people by applying individual weights imposed from the raw data. Methods To analyze the association between functional limitation due to SCD and falling in the Korean population aged 45 years and older, weighted logistic regression analysis and weighted zero-inflated Poisson regression analysis were used. Results In both the middle-aged group and the older adult group, the functional limitation due to SCD had a higher fall experience rate and more falls than the non-functional limitation due to SCD group. Additionally, the middle-aged group and the moderate or vigorous physical exercise (MVPE) group had a higher fall experience rate and number of falls than the non-MVPE group; however, the older adult group walking regularly and performing MVPE had a lower fall experience rate and number of falls than the non-exercise group. Conclusions Active participation in exercise is encouraged and should lead to fewer falls in older adults. Furthermore, a group with functional limitations due to SCD should be provided with exercise guidelines and a community program and facilities that enable regular participation should be developed.
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Affiliation(s)
- Hyeon Ji Lee
- Institute for Digital Life Convergence, Dankook University, Cheonan, Chungnam, Republic of Korea
| | - Jeong Min Yang
- Institute for Digital Life Convergence, Dankook University, Cheonan, Chungnam, Republic of Korea
- Department of Public Health, General Graduate School of Dankook University, Cheonan, Chungnam, Republic of Korea
| | - Jae Hyun Kim
- Institute for Digital Life Convergence, Dankook University, Cheonan, Chungnam, Republic of Korea
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Chungnam, Republic of Korea
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Arguello D, Rogers E, Denmark GH, Lena J, Goodro T, Anderson-Song Q, Cloutier G, Hillman CH, Kramer AF, Castaneda-Sceppa C, John D. Companion: A Pilot Randomized Clinical Trial to Test an Integrated Two-Way Communication and Near-Real-Time Sensing System for Detecting and Modifying Daily Inactivity among Adults >60 Years-Design and Protocol. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23042221. [PMID: 36850822 PMCID: PMC9965440 DOI: 10.3390/s23042221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 05/14/2023]
Abstract
Supervised personal training is most effective in improving the health effects of exercise in older adults. Yet, low frequency (60 min, 1-3 sessions/week) of trainer contact limits influence on behavior change outside sessions. Strategies to extend the effect of trainer contact outside of supervision and that integrate meaningful and intelligent two-way communication to provide complex and interactive problem solving may motivate older adults to "move more and sit less" and sustain positive behaviors to further improve health. This paper describes the experimental protocol of a 16-week pilot RCT (N = 46) that tests the impact of supplementing supervised exercise (i.e., control) with a technology-based behavior-aware text-based virtual "Companion" that integrates a human-in-the-loop approach with wirelessly transmitted sensor-based activity measurement to deliver behavior change strategies using socially engaging, contextually salient, and tailored text message conversations in near-real-time. Primary outcomes are total-daily and patterns of habitual physical behaviors after 16 and 24 weeks. Exploratory analyses aim to understand Companion's longitudinal behavior effects, its user engagement and relationship to behavior, and changes in cardiometabolic and cognitive outcomes. Our findings may allow the development of a more scalable hybrid AI Companion to impact the ever-growing public health epidemic of sedentariness contributing to poor health outcomes, reduced quality of life, and early death.
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Affiliation(s)
- Diego Arguello
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
- Correspondence:
| | - Ethan Rogers
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Grant H. Denmark
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA
| | - James Lena
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Troy Goodro
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Quinn Anderson-Song
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Gregory Cloutier
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Charles H. Hillman
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Arthur F. Kramer
- College of Science, Northeastern University, Boston, MA 02115, USA
- Beckman Institute, University of Illinois, Urbana, IL 61801, USA
| | | | - Dinesh John
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
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Choma EA, Treat-Jacobson DJ, Keller-Ross ML, Wolfson J, Martin L, McMahon SK. Using the RE-AIM framework to evaluate physical activity-based fall prevention interventions in older adults with chronic conditions: A systematic review. Transl Behav Med 2023; 13:42-52. [PMID: 36394349 DOI: 10.1093/tbm/ibac072] [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: 11/19/2022] Open
Abstract
Falls are a serious public health problem, especially for older adults with chronic conditions. The purpose of this systematic review was to evaluate the translational potential of physical activity-based balance interventions for older adults with common chronic conditions guided by the Reach, Effectiveness/Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. Databases were searched (2011-2021) to identify studies with physical activity-based fall prevention interventions for older adults with chronic conditions. Data were collected using the RE-AIM coding guide and Mixed Methods Appraisal Tool for evidence quality. The search yielded 122 articles, of which 14 distinct studies were included. The most reported RE-AIM dimensions across the studies were Reach (46.2%) and Implementation (40.5%), with Effectiveness/Efficacy (29.4%), Adoption (2.0%), and Maintenance (5.4%) being the least reported. Studies were largely conducted in controlled research environments with minimal staff involvement and without long-term follow-up periods. While studies found that physical activity-based programs were effective in improving balance, information on representativeness and adoption/maintenance of programs was lacking. Studies included sufficient details about the intervention (content, dosage, progression). External validity RE-AIM indicators were reported less frequently than internal validity indicators. The studies were of moderate quality overall. Studies often lacked information on indicators critical for understanding how to implement these programs. This review signals the need to investigate the translation of these interventions from controlled research settings to clinical settings to improve the public impact of fall prevention for this population.
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Affiliation(s)
- Elizabeth A Choma
- Department of Physical Therapy, College of Arts and Sciences, Whitworth University, Spokane, WA, USA
| | - Diane J Treat-Jacobson
- School of Nursing, Academic Health Center, University of Minnesota, Minneapolis, MN, USA
| | - Manda L Keller-Ross
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, MN, USA.,Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Julian Wolfson
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Lauren Martin
- School of Nursing, Academic Health Center, University of Minnesota, Minneapolis, MN, USA
| | - Siobhan K McMahon
- School of Nursing, Academic Health Center, University of Minnesota, Minneapolis, MN, USA
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Sousa CV, Lee K, Alon D, Sternad D, Lu AS. A Systematic Review and Meta-analysis of the Effect of Active Video Games on Postural Balance. Arch Phys Med Rehabil 2023; 104:631-644. [PMID: 36669637 PMCID: PMC10142571 DOI: 10.1016/j.apmr.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/28/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To conduct a comprehensive systematic review and meta-analysis of the effects of active video game (AVG) interventions on postural balance across all ages in populations with and without neurologic impairments, using all types of platforms. DATA SOURCE Six databases (PubMed, PsycINFO, Sport Discus, MEDLINE, Web of Science, and Google Scholar) were reviewed by December 31, 2020. STUDY SELECTION The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, a study must be original, published in English peer-reviewed venues and employed AVGs as the sole or primary intervention to enhance, maintain, or regain postural balance. At least 2 within- or between-subjects conditions must be included with ≥10 participants per condition. DATA EXTRACTION Three reviewers independently performed data extraction and assessed the risk of bias. DATA SYNTHESIS 129 studies were identified, with 102 eligible for meta-analysis. The total number of tested participants was 6407 (60.0% women, Mage=55.1 years, range=3-99 years, SD=22.6). The average intervention duration was 35.6 min/session with 3.1 sessions/week for 7.6 weeks. The overall effect favored AVG interventions (Hedges' g=0.469; 95% confidence interval [CI]=0.407-0.531). Although the overall study quality was relatively low, the analysis expectedly indicated significantly larger effects (P<.001) for AVG-interventions over passive controls (Hedges' g=0.627; 95% CI=0.466-0.788), but importantly also favored AVG-interventions over conventional treatment (Hedges' g=0.389; 95% CI=0.311-0.468). All clinical populations responded positively, although with different effect sizes (P=.023). Children experienced larger treatment effects (Hedges' g=0.550; 95% CI=0.336-0.764), closely followed by seniors (Hedges' g=0.529; 95% CI=0.402-0.656). The largest intervention effect on balance improvements was seen in healthy people without a medical condition (Hedges' g=0.609; 95% CI=0.465-0.753). CONCLUSIONS AVGs can produce postural balance improvements and better postural maintenance. All populations could benefit from AVG interventions.
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Affiliation(s)
- Caio Victor Sousa
- From the Health and Human Sciences, Frank R. Seaver College of Science and Engineering, Loyola Marymount University, Los Angeles, CA
| | - Kelly Lee
- Health Technology Lab, Departments of Communication Studies and Health Sciences, College of Arts, Media, and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA
| | - Dar Alon
- Health Technology Lab, Departments of Communication Studies and Health Sciences, College of Arts, Media, and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA
| | - Dagmar Sternad
- Departments of Biology, Electrical & Computer Engineering, and Physics, Northeastern University, Boston, MA
| | - Amy S Lu
- Health Technology Lab, Departments of Communication Studies and Health Sciences, College of Arts, Media, and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA.
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11
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Zhang J, Liang R, Lau N, Lei Q, Yip J. A Systematic Analysis of 3D Deformation of Aging Breasts Based on Artificial Neural Networks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:468. [PMID: 36612790 PMCID: PMC9819929 DOI: 10.3390/ijerph20010468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
The measurement and prediction of breast skin deformation are key research directions in health-related research areas, such as cosmetic and reconstructive surgery and sports biomechanics. However, few studies have provided a systematic analysis on the deformations of aging breasts. Thus, this study has developed a model order reduction approach to predict the real-time strain of the breast skin of seniors during movement. Twenty-two women who are on average 62 years old participated in motion capture experiments, in which eight body variables were first extracted by using the gray relational method. Then, backpropagation artificial neural networks were built to predict the strain of the breast skin. After optimization, the R-value for the neural network model reached 0.99, which is within acceptable accuracy. The computer-aided system of this study is validated as a robust simulation approach for conducting biomechanical analyses and predicting breast deformation.
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Affiliation(s)
- Jun Zhang
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Ruixin Liang
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong, China
| | - Newman Lau
- School of Design, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Qiwen Lei
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Joanne Yip
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong, China
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Chan DKY, Chan LKM, Kuang YM, Le MNV, Celler B. Digital care technologies in people with dementia living in long-term care facilities to prevent falls and manage behavioural and psychological symptoms of dementia: a systematic review. Eur J Ageing 2022; 19:309-323. [PMID: 36052197 PMCID: PMC9424434 DOI: 10.1007/s10433-021-00627-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 11/26/2022] Open
Abstract
Fall prevention and management of behavioural and psychological symptoms of dementia (BPSD) in long-term care (LTC) facility is a major challenge. The objective of this systematic review is to assess the evidence of digital technology in their management. All studies of English-language excluding case-reports were eligible for review. Databases chosen were MEDLINE, EMBASE, Scopus, Web of Science and PSYCINFO from January 2000 to June 2020. Downs and Black checklist was used to check for risk of bias. Papers with a focus in LTC setting, using digital technology as intervention for older adults with dementia, and with measurable outcomes (outcomes that are quantified, not descriptive) were included in the final review. Seventeen original papers (8 RCTs, 8 quasi-experimental and 1 mixed method) were included. Three articles examining position-sensor technology for fall prevention showed mixed results. Two showed no difference and 1 showed small reduction in fall after alarm removal but the positive effect might be due to bias. Overall, the sample sizes were too small to draw meaningful conclusion. Fourteen studies (9 pet robots of which 8 were robotic seal/PARO) were identified for BPSD and results were mixed. Overall, PARO might have modest benefit in BPSD compared to usual care but might be no better than plush toy with more hallucinations or delusions seen in advanced dementia. However, the significant heterogeneity in methodology (intervention intensity, lack of record in psychoactive drug use), clinical tools used (different BPSD scales, different digital technologies) and variability in outcomes made it difficult to draw clear-cut conclusion. Studies involving other digital technologies are scarce and in pilot phases; hence, conclusion is premature. One limitation of the review was that only 9 out of 17 studies were of good quality. The limited research work in position-sensors meant insufficient evidence to prove efficacy for their use in LTC setting. The possible modest benefit of PARO in BPSD (e.g. in agitation, apathy or reduction in psychoactive drugs) was off-set by possible adverse events such as delusions or hallucinations in advanced dementia. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-021-00627-5.
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Affiliation(s)
- Daniel Kam Yin Chan
- University of New South Wales, Sydney, NSW 2052 Australia
- Department of Aged Care and rehabilitation, Bankstown-Lidcombe Hospital, Bankstown, NSW 2200 Australia
| | | | - Ye Min Kuang
- Department of Aged Care and rehabilitation, Bankstown-Lidcombe Hospital, Bankstown, NSW 2200 Australia
| | - Mai Nhat Vi Le
- University of New South Wales, Sydney, NSW 2052 Australia
| | - Branko Celler
- University of New South Wales, Sydney, NSW 2052 Australia
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Criss MG, Wingood M, Staples WH, Southard V, Miller KL, Norris TL, Avers D, Ciolek CH, Lewis CB, Strunk ER. APTA Geriatrics' Guiding Principles for Best Practices in Geriatric Physical Therapy. J Geriatr Phys Ther 2022; 45:70-75. [DOI: 10.1519/jpt.0000000000000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Vonstad EK, Bach K, Vereijken B, Su X, Nilsen JH. Performance of machine learning models in estimation of ground reaction forces during balance exergaming. J Neuroeng Rehabil 2022; 19:18. [PMID: 35152877 PMCID: PMC8842746 DOI: 10.1186/s12984-022-00998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background Balance training exercise games (exergames) are a promising tool for reducing fall risk in elderly. Exergames can be used for in-home guided exercise, which greatly increases availability and facilitates independence. Providing biofeedback on weight-shifting during in-home balance exercise improves exercise efficiency, but suitable equipment for measuring weight-shifting is lacking. Exergames often use kinematic data as input for game control. Being able to useg such data to estimate weight-shifting would be a great advantage. Machine learning (ML) models have been shown to perform well in weight-shifting estimation in other settings. Therefore, the aim of this study was to investigate the performance of ML models in estimation of weight-shifting during exergaming using kinematic data. Methods Twelve healthy older adults (mean age 72 (± 4.2), 10 F) played a custom exergame that required repeated weight-shifts. Full-body 3D motion capture (3DMoCap) data and standard 2D digital video (2D-DV) was recorded. Weight shifting was directly measured by 3D ground reaction forces (GRF) from force plates, and estimated using a linear regression model, a long-short term memory (LSTM) model and a decision tree model (XGBoost). Performance was evaluated using coefficient of determination (\documentclass[12pt]{minimal}
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\begin{document}$$F_z$$\end{document}Fz) of 4.3 (2.5), 11.1 (4.5), and 11.0 (4.7) for LSTM, XGBoost and LinReg, respectively. Using 2D-DV data, LSTM and XGBoost achieve mean RMSE (± 1SD) in \documentclass[12pt]{minimal}
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\begin{document}$$F_z$$\end{document}Fz estimation of 10.7 (9.0) %BW and 19.8 (6.4) %BW, respectively. \documentclass[12pt]{minimal}
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\begin{document}$$>.97$$\end{document}>.97 for the LSTM in the \documentclass[12pt]{minimal}
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\begin{document}$$F_z$$\end{document}Fz component using 3DMoCap data, and \documentclass[12pt]{minimal}
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\begin{document}$$>.77$$\end{document}>.77 using 2D-DV data. For XGBoost, \documentclass[12pt]{minimal}
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\begin{document}$$F_z$$\end{document}Fz\documentclass[12pt]{minimal}
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\begin{document}$$R^2$$\end{document}R2 was \documentclass[12pt]{minimal}
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\begin{document}$$>.86$$\end{document}>.86 using 3DMoCap data, and \documentclass[12pt]{minimal}
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\begin{document}$$>.56$$\end{document}>.56 using 2D-DV data. Conclusion This study demonstrates that an LSTM model can estimate 3-dimensional GRF components using 2D kinematic data extracted from standard 2D digital video cameras. The \documentclass[12pt]{minimal}
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\begin{document}$$F_z$$\end{document}Fz component is estimated more accurately than \documentclass[12pt]{minimal}
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\begin{document}$$F_y$$\end{document}Fy and \documentclass[12pt]{minimal}
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\begin{document}$$F_x$$\end{document}Fx components, especially when using 2D-DV data. Weight-shifting performance during exergaming can thus be extracted using kinematic data only, which can enable effective independent in-home balance exergaming.
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15
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The effects of low-impact moderate-intensity stepping exercise on fatigue and other functional outcomes in older adults with multimorbidity: A randomized controlled trial. Arch Gerontol Geriatr 2022; 98:104577. [DOI: 10.1016/j.archger.2021.104577] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 11/22/2022]
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Kwon IS, Park DS, Shin HC, Seok MG, Oh JK. Effects of marine oligomeric polyphenols on body composition and physical ability of elderly individuals with sarcopenia: a pilot study. Phys Act Nutr 2021; 25:1-7. [PMID: 34727682 PMCID: PMC8580584 DOI: 10.20463/pan.2021.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/03/2021] [Indexed: 11/22/2022] Open
Abstract
PURPOSE We aimed to identify the effects of marine oligomeric polyphenol (MOP) intake in elderly individuals with sarcopenia. METHODS Older adults (aged 65 years or older) were recruited based on the diagnostic criterion for sarcopenia and were randomly assigned to the MOP intake group (n=10) or the placebo (PBO) intake group (n=10). To determine the effect of MOP intake received for four weeks, the pre- and post-intake body composition (weight, skeletal muscle mass, and bone density) and senior fitness tests were assessed. RESULTS Our results showed there were significant differences in the skeletal muscle mass (p=0.039), bone density (p=0.020), fat-free mass index (p=0.026), and 2.4 m up and go test (p=0.001) between pretest and post-test. There was a significant difference between the pre-test and post-test and an interaction effect for the one-leg stand test (p=0.010 and p=0.049, respectively). However, there were no significant differences in body fat percentage, calf circumference, grip strength, or the chair rise test. CONCLUSION Some variables exhibited significant differences in the pre- and post-assessments, and there was an interaction effect for the one-leg stand. However, this was insufficient to prove the effectiveness of MOP intake in improving sarcopenia. Therefore, additional studies are essential to examine the effects of MOP intake and exercise intervention on the body composition and fitness of patients over a longer period.
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Affiliation(s)
- Il-Su Kwon
- Department of Health and Exercise Science, Korea National Sport University, Seoul, Republic of Korea
| | - Deuk-Su Park
- Department of Health and Exercise Science, Korea National Sport University, Seoul, Republic of Korea
| | | | - Myung-Gyu Seok
- Department of Physical Education, Kyung Hee University, Seoul, Republic of Korea
| | - Jae-Keun Oh
- Department of Health and Exercise Science, Korea National Sport University, Seoul, Republic of Korea
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Wang IL, Wang LI, Liu Y, Su Y, Yao S, Ho CS. Application of Real-Time Visual Feedback System in Balance Training of the Center of Pressure with Smart Wearable Devices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9637. [PMID: 34574560 PMCID: PMC8469963 DOI: 10.3390/ijerph18189637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 11/16/2022]
Abstract
Balance control with an upright posture is affected by many factors. This study was undertaken to investigate the effects of real-time visual feedback training, provided by smart wearable devices for COP changes for healthy females, on static stance. Thirty healthy female college students were randomly divided into three groups (visual feedback balance training group, non-visual feedback balance training group, and control group). Enhanced visual feedback on the screen appeared in different directions, in the form of fluctuations; the visual feedback balance training group received real-time visual feedback from the Podoon APP for training, while the non-visual feedback balance training group only performed an open-eye balance, without receiving real-time visual feedback. The control group did not do any balance training. The balance training lasted 4 weeks, three times a week for 30 min each time with 1-2 day intervals. After four weeks of balance training, the results showed that the stability of human posture control improved for the one leg static stance for the visual feedback balance training group with smart wearable devices. The parameters of COP max displacement, COP velocity, COP radius, and COP area in the visual feedback balance training group were significantly decreased in the one leg stance (p < 0.05). The results showed that the COP real-time visual feedback training provided by smart wearable devices can better reduce postural sway and improve body balance ability than general training, when standing quietly.
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Affiliation(s)
- I-Lin Wang
- College of Physical Education, Hubei Normal University, Huangshi 435002, China;
| | - Li-I Wang
- Department of Physical Education and Kinesiology, National Dong Hwa University, Hualien 97046, Taiwan;
| | - Yang Liu
- Graduate Institute, Jilin Sport University, No. 2476, Freedom Road, Nanguan District, Changchun 130022, China; (Y.L.); (Y.S.); (S.Y.)
| | - Yu Su
- Graduate Institute, Jilin Sport University, No. 2476, Freedom Road, Nanguan District, Changchun 130022, China; (Y.L.); (Y.S.); (S.Y.)
| | - Shun Yao
- Graduate Institute, Jilin Sport University, No. 2476, Freedom Road, Nanguan District, Changchun 130022, China; (Y.L.); (Y.S.); (S.Y.)
| | - Chun-Sheng Ho
- Division of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan City 26546, Taiwan
- Department of Physical Therapy, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
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Clinical-Community Connections: Incorporating Evidence-Based Programs for Improved Patient Outcomes. TOPICS IN GERIATRIC REHABILITATION 2021; 37:163-167. [PMID: 34366559 DOI: 10.1097/tgr.0000000000000322] [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: 10/20/2022]
Abstract
Incorporating evidence-based community programs into clinical care recommendations and goals may help bridge the clinic-to-community transition for older adults. Engagement in evidence-based programs can help older adults manage chronic conditions and reduce fall risk through behavior change and self-management following a clinical episode of care. This paper describes evidence-based fall prevention and physical activity programs, provides resources to locate programs, and strategies to match older adults to the right programs.
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19
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Quigley TP, Amdam GV. Social modulation of ageing: mechanisms, ecology, evolution. Philos Trans R Soc Lond B Biol Sci 2021; 376:20190738. [PMID: 33678020 PMCID: PMC7938163 DOI: 10.1098/rstb.2019.0738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2020] [Indexed: 12/11/2022] Open
Abstract
Human life expectancy increases, but the disease-free part of lifespan (healthspan) and the quality of life in old people may not show the same development. The situation poses considerable challenges to healthcare systems and economies, and calls for new strategies to increase healthspan and for sustainable future approaches to elder care. This call has motivated innovative research on the role of social relationships during ageing. Correlative data from clinical surveys indicate that social contact promotes healthy ageing, and it is time to reveal the causal mechanisms through experimental research. The fruit fly Drosophila melanogaster is a prolific model animal, but insects with more developed social behaviour can be equally instrumental for this research. Here, we discuss the role of social contact in ageing, and identify lines of study where diverse insect models can help uncover the mechanisms that are involved. This article is part of the theme issue 'Ageing and sociality: why, when and how does sociality change ageing patterns?'
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Affiliation(s)
- Tyler P. Quigley
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287, USA
| | - Gro V. Amdam
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287, USA
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, PO Box 5002, N-1432 Aas, Norway
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20
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Takahashi Y, Suzuki S, Hamada K, Nakada T, Oya Y, Sakakura N, Matsushita H, Kuroda H. Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:325. [PMID: 33708952 PMCID: PMC7944314 DOI: 10.21037/atm-20-4380] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Sarcopenia characterized by skeletal muscle loss may influence postoperative outcomes through physical decline and weakened immunity. We aimed to investigate clinical significance of sarcopenia in resected early-stage non-small cell lung cancer (NSCLC). Methods We retrospectively reviewed 315 consecutive patients with pathologic stage I NSCLC who had undergone lobectomy with systematic nodal dissection. Sarcopenia was defined as the lowest quartile of psoas muscle area on the 3rd vertebra on the high-resolution computed tomography (HRCT) image. Clinicopathological variables were used to investigate the correlation to postoperative complications as well as overall and recurrence-free survival. Results Upon multivariable analysis, male sex [odds ratio (OR) =5.780, 95% confidence interval (CI): 2.681–12.500, P<0.001], and sarcopenia (OR =21.00, 95% CI: 10.30–42.80, P<0.001) were independently associated with postoperative complications. The sarcopenia group showed significantly lower 5-over all survival (84.4% vs. 69.1%, P<0.001) and recurrence-free survival (77.2% vs. 62.0%, P<0.001) comparing with the non-sarcopenia group. In a multivariable analysis, sarcopenia was an independent prognostic factor [hazard ratio (HR) =1.978, 95% CI: 1.177–3.326, P=0.010] together with age ≥70 years (HR =1.956, 95% CI: 1.141–3.351, P=0.015) and non-adenocarcinoma histology (HR =1.958, 95% CI: 1.159–3.301, P=0.016). Conclusions This is the first study which demonstrates that preoperative sarcopenia is significantly associated with unfavorable postoperative complications as well as long-term survival in pathologic stage I NSCLC. This readily available factor on HRCT may provide valuable information to consider possible choice of surgical procedure and perioperative management.
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Affiliation(s)
- Yusuke Takahashi
- Department of General Thoracic Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan.,Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.,Division of Translational Oncoimmunology, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Shigeki Suzuki
- Department of General Thoracic Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan
| | - Kenichi Hamada
- Department of General Thoracic Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan
| | - Takeo Nakada
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Yuko Oya
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.,Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Noriaki Sakakura
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Hirokazu Matsushita
- Division of Translational Oncoimmunology, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
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21
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Zubatsky M. Editorial: Virtual Groups to Address the Health of Homebound Adults During COVID-19: A Biopsychosocial Framework. J Nutr Health Aging 2021; 25:281-283. [PMID: 33575716 PMCID: PMC7794637 DOI: 10.1007/s12603-021-1584-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/18/2022]
Affiliation(s)
- M Zubatsky
- Max Zubatsky, PhD, LMFT, Associate Professor, Program Director, Medical Family Therapy Program, School of Medicine, Saint Louis University, 3700 Lindell Boulevard, St. Louis, MO 63108, USA,
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Michalcova J, Vasut K, Airaksinen M, Bielakova K. Inclusion of medication-related fall risk in fall risk assessment tool in geriatric care units. BMC Geriatr 2020; 20:454. [PMID: 33158417 PMCID: PMC7648375 DOI: 10.1186/s12877-020-01845-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 10/22/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Falls are common undesirable events for older adults in institutions. Even though the patient's fall risk may be scored on admission, the medication-induced fall risk may be ignored. This study developed a preliminary categorization of fall-risk-increasing drugs (FRIDs) to be added as a risk factor to the existing fall risk assessment tool routinely used in geriatric care units. METHODS Medication use data of older adults who had experienced at least one fall during a hospital ward or a nursing home stay within a 2-year study period were retrospectively collected from patient records. Medicines used were classified into three risk categories (high, moderate and none) according to the fall risk information in statutory summaries of product characteristics (SmPCs). The fall risk categorization incorporated the relative frequency of such adverse drug effects (ADEs) in SmPCs that were known to be connected to fall risk (sedation, orthostatic hypotension, syncope, dizziness, drowsiness, changes in blood pressure or impaired balance). Also, distribution of fall risk scores assessed on admission without considering medications was counted. RESULTS The fall-experienced patients (n = 188, 128 from the hospital and 60 from nursing home records) used altogether 1748 medicaments, including 216 different active substances. Of the active substances, 102 (47%) were categorized as high risk (category A) for increasing fall risk. Fall-experienced patients (n = 188) received a mean of 3.8 category A medicines (n = 710), 53% (n = 375) of which affected the nervous and 40% (n = 281) the cardiovascular system. Without considering medication-related fall risk, 53% (n = 100) of the patients were scored having a high fall risk (3 or 4 risk scores). CONCLUSION It was possible to develop a preliminary categorization of FRIDs basing on their adverse drug effect profile in SmPCs and frequency of use in older patients who had experienced at least one documented fall in a geriatric care unit. Even though more than half of the fall-experienced study participants had high fall risk scores on admission, their fall risk might have been underestimated as use of high fall risk medicines was common, even concomitant use. Further studies are needed to develop the FRID categorization and assess its impact on fall risk.
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Affiliation(s)
- Jana Michalcova
- Faculty of Pharmacy, Department of Applied Pharmacy, Masaryk University, Palackeho 1946/1, 612 42, Brno, Czech Republic.
- Faculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Clinical Pharmacy Group, University of Helsinki, Viikinkaari 5E, 00014, Helsinki, Finland.
| | - Karel Vasut
- Faculty of Pharmacy, Department of Applied Pharmacy, Masaryk University, Palackeho 1946/1, 612 42, Brno, Czech Republic
| | - Marja Airaksinen
- Faculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Clinical Pharmacy Group, University of Helsinki, Viikinkaari 5E, 00014, Helsinki, Finland
| | - Katarina Bielakova
- Clinic of Internal Medicine, Geriatrics and Practical Medicine, University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic
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The Consequences of Glaucoma on Mobility and Balance Control in the Older Adults: A Cross-Sectional Study. J Aging Phys Act 2020; 29:372-381. [PMID: 32994380 DOI: 10.1123/japa.2020-0079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 11/18/2022]
Abstract
The aim of the study was to explore the functional impairments and related factors in older adults with moderate to advanced stages of glaucoma. Nineteen patients with glaucoma and 19 participants with no ocular disease performed step test and balance control tasks with analysis of overall stability index and fall risk index. Monocular and binocular Humphrey Visual Field tests were used to estimate visual field defect severity. The International Physical Activity Questionnaire was used to measure physical activity level. Patients with glaucoma showed poorer values for most of the mobility and balance control parameters with medium and large effect sizes (0.3-0.5). Mobility scores in patients were partly associated with their monocular visual field defect (rs = .507, p < .05). Low physical activity was identified as a risk factor for falls (rs = -.453, p < .05) and postural instability (rs = -.457, p < .05). Functional declines in dynamic tasks were not related to glaucoma severity. Older adults with glaucoma display impairment with mobility and balance control compared to controls, associated with the degree of monocular visual field loss and lower daily physical activity.
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Pérez-Ros P, Vila-Candel R, Martínez-Arnau FM. A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults. Geriatr Nurs 2020; 41:436-444. [DOI: 10.1016/j.gerinurse.2020.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/14/2020] [Accepted: 01/20/2020] [Indexed: 12/27/2022]
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Liew LK, Tan MP, Tan PJ, Mat S, Majid LA, Hill KD, Mazlan M. The Modified Otago Exercises Prevent Grip Strength Deterioration Among Older Fallers in the Malaysian Falls Assessment and Intervention Trial (MyFAIT). J Geriatr Phys Ther 2020; 42:123-129. [PMID: 29381526 DOI: 10.1519/jpt.0000000000000155] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Exercise-based interventions, such as the Otago Exercise Program (OEP), are effective in preventing falls in the older adult. Previous studies evaluating the OEP have determined falls, lower limb strength, or balance outcomes but with lack of assessment of hand grip strength. The objective of this study is to evaluate the effect of OEP on hand grip strength alongside mobility and balance outcomes. METHODS This was a single-center, prospective, and single-blind randomized controlled trial conducted at the University Malaya Medical Centre. Patients older than 65 years presenting to the hospital emergency department or geriatric clinic with 1 injurious fall or 2 falls in the past year and with impaired functional mobility were included in the study. The intervention group received a modified OEP intervention (n = 34) for 3 months, while the control group received conventional care (n = 33). All participants were assessed at baseline and 6 months. RESULTS Twenty-four participants in both OEP and control groups completed the 6-month follow-up assessments. Within-group analyses revealed no difference in grip strength in the OEP group (P = 1.00, right hand; P = .55, left hand), with significant deterioration in grip strength in the control group (P = .01, right hand; P = .005, left hand). Change in grip strength over 6 months significantly favored the OEP group (P = .047, right hand; P = .004, left hand). Significant improvements were also observed in mobility and balance in the OEP group. CONCLUSIONS In addition to benefits in mobility and balance, the OEP also prevents deterioration in upper limb strength. Additional benefits of exercise interventions for secondary prevention of falls in term of sarcopenia and frailty should also be evaluated in the future.
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Affiliation(s)
- Lin Kiat Liew
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur.,Department of Rehabilitation Medicine, Sarawak General Hospital, Kuching, Sarawak, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur
| | - Pey June Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur
| | - Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur
| | - Lokman A Majid
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Sydney, Australia
| | - Mazlina Mazlan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur
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Lu Y, Chen YSA, Kozak D, Cornelis H, Partyga P. Promoting Fall Prevention among Community Dwelling Older Adults through ActivLife: a Physical and Social Activation. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09261-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractFalls have been recognized as the second leading cause of injury or death for older adults. The related economic burden caused by fall related injuries is not negligible. Earlier research has demonstrated that regular participation in appropriate prescribed physical activity by improving upper and lower limb strength, balance, coordination, transfer skills, and reaction to environmental hazards can lower the risk for falls and fall-related fractures and other injuries. Conversely, physical inactivity can significantly double the risk of developing a disability, which will affect mobility as well as the ability to perform even the most basic activities of daily life, therefore, ultimately increases the older adults’ risk for falls.This paper first presents a technological solution ActivLife that aims at preventing older adults from falling through practicing physical training in a safe and playful manner, followed by a randomized controlled study with 43 older adults with an average age of 77 for a period of 16 weeks in a social activation center het Ontmoet en Groethuys in Eindhoven, the Netherlands to demonstrate to what extent ActivLife could help to prevent falling among older adults.
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Trapuzzano A, McCarthy L, Dawson N. Investigating the Effects of an Otago-Based Program among Individuals Living with Dementia. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1716131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ashleigh Trapuzzano
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida, USA
| | - Lise McCarthy
- Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California, USA
| | - Nicole Dawson
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, Florida, USA
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Mercuris K, Lowry K, Espey S. Does Instructor Experience Impact Balance and Health-Related Quality of Life in Healthy Older Adult Participants following a Tai Chi for Arthritis Program? J Community Health Nurs 2020; 37:26-34. [PMID: 31905305 DOI: 10.1080/07370016.2019.1693136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Tai chi improves balance in older adults; however, the level of instructor expertise on balance outcomes is not known. Older adults (mean age 72.6 ± 4.2 yrs.) were taught for 6 months by experienced (n = 15) or novice (n = 11) instructors. Both groups had large standardized response means (SRM) for the Four-Square-Step-Test. Only the experienced group had moderate to large SRMs (range 0.439-0.741) in all sway measures under challenge (standing with eyes closed on foam). Participants taught by experienced instructors had greater balance gains; the experience of instructors should be considered in future studies and community referrals.
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Affiliation(s)
- Kathy Mercuris
- Department of Physical Therapy, Des Moines University, Des Moines, Iowa, USA
| | - Kristin Lowry
- Department of Physical Therapy, Des Moines University, Des Moines, Iowa, USA
| | - Samuel Espey
- Department of Physical Therapy, Des Moines University, Des Moines, Iowa, USA
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Systematic Balance Exercises Influence Cortical Activation and Serum BDNF Levels in Older Adults. J Clin Med 2019; 8:jcm8111910. [PMID: 31703409 PMCID: PMC6912622 DOI: 10.3390/jcm8111910] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/23/2019] [Accepted: 11/05/2019] [Indexed: 11/17/2022] Open
Abstract
We sought to investigate whether systematic balance training modulates brain area activity responsible for postural control and influence brain-derived neurotrophic factor (BDNF) mRNA protein expression. Seventy-four older adults were randomly divided into three groups (mean age 65.34 ± 3.79 years, 30 females): Classic balance exercises (CBT), virtual reality balance exercises (VBT), and control (CON). Neuroimaging studies were performed at inclusion and after completion of the training or 12 weeks later (CON). Blood samples were obtained to measure BDNF expression. The study revealed significant interaction of sessions and groups: In the motor imagery (MI) condition for supplementary motor area (SMA) activity (Fat peak = 5.25, p < 0.05); in the action observation (AO) condition for left and right supramarginal gyrus/posterior insula (left: Fat peak = 6.48, p < 0.05; right: Fat peak = 6.92, p < 0.05); in the action observation together with motor imagery (AOMI) condition for the middle occipital gyrus (laterally)/area V5 (left: Fat peak = 6.26, p < 0.05; right: Fat peak = 8.37, p < 0.05), and in the cerebellum–inferior semilunar lobule/tonsil (Fat peak = 5.47, p < 0.05). After the training serum BDNF level has increased in CBT (p < 0.001) and in CBT compared to CON (p < 0.05). Systematic balance training may reverse the age-related cortical over-activations and appear to be a factor mediating neuroplasticity in older adults.
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Effect of Single-Leg Squat Speed and Depth on Dynamic Postural Control Under Single-Task and Dual-Task Paradigms. J Appl Biomech 2019; 35:272-279. [PMID: 31034324 DOI: 10.1123/jab.2018-0327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although single-leg squats are a common dynamic balance clinical assessment, little is known about the relationship between parameters that influence squat movement and postural control performance. The objective of this study was to determine the relationships between squat parameters (speed and depth) and postural control under single task and dual task. A total of 30 healthy college students performed single-leg squats under single task and dual task with Stroop. Random-intercepts generalized linear mixed models determined the effect of squat parameters on center of pressure (CoP) parameters. For each 1-cm·s-1 increase in squat speed, sway range (mediolateral: β = -0.03; anteroposterior: β = -0.05) and area (β = -0.25) decreased, whereas sway speed (mediolateral: β = 0.05; anteroposterior: β = 0.29; total: β = 0.29) increased. For each 1-cm increase in squat depth, sway range (mediolateral: β = 0.05; anteroposterior: β = 0.20) and area (β = 0.72) increased, whereas sway speed (anteroposterior: β = -0.14; total: β = -0.14) decreased. Compared with single task, the association between total and anteroposterior sway speed and squat speed was stronger under dual task. Clinicians and researchers should consider monitoring squat speed and depth when assessing dynamic balance during single-leg squats, as these parameters influence postural control, especially under dual task.
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Fall Risk Reduction Program Paired with a Transportation Program in an Underserved, Urban Minority Community: A Qualitative Evaluation. J Aging Res 2019; 2019:2719290. [PMID: 31354996 PMCID: PMC6636562 DOI: 10.1155/2019/2719290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/04/2019] [Indexed: 11/20/2022] Open
Abstract
This study sought to evaluate A Matter of Balance/Volunteer Lay Leaders (AMOB/VLL) fall prevention curriculum in combination with a “door-through-door” program: Coordinated Older-Adult Senior Transportation Services (COASTS) for older adults living in an urban, underserved community. AMOB/VLL participants were offered eight 2-hour classes as part of the training program. Focus groups were conducted with older adult participants, COASTS mobility facilitators, and AMOB/VLL master trainers. A thematic analysis was conducted, and primary themes relating to curriculum content, cultural relevancy, and outcomes were examined. Older adults and facilitators felt the course was rewarding and led to improvements in mobility and confidence. Master trainers were more critical and recommended simplifying content, with tailored guidance for specific populations. They also recommended increased emphasis on balance and physical activity. Although participants and MoFas felt combining AMOB/VLL and COASTS was rewarding and improved participant mobility, master trainers and participants suggested minor modifications to increase program benefits for urban, underserved communities.
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Sibley KM, Touchette AJ, Singer JC, Dubberley KMA, Oates AR. To what extent do older adult community exercise programs in Winnipeg, Canada address balance and include effective fall prevention exercise? A descriptive self-report study. BMC Geriatr 2019; 19:201. [PMID: 31357940 PMCID: PMC6664743 DOI: 10.1186/s12877-019-1224-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/22/2019] [Indexed: 01/08/2023] Open
Abstract
Background Effective fall prevention exercise for community-dwelling older adults requires (i) challenging balance exercise, (ii) offered at least 3 hrs/ week, and (iii) on an ongoing basis, to reduce falls. Community exercise programs are a potential implementation strategy for fall prevention exercise; however, the extent to which they address balance and include effective fall prevention exercise is unknown. Study objectives were to describe program delivery, exercise design, and assessment characteristics of older adult community exercise programs in Winnipeg, Canada; determine if they included effective fall prevention exercise; determine the balance challenge and components of postural control addressed in the most- and least-frequently reported exercises. Methods A public inventory of older adult community exercise programs served as the sampling frame for cross-sectional telephone questionnaires exploring program, exercise, and assessment characteristics. Exercises were coded independently by two investigators for balance challenge level and components of postural control. Programs were categorized by number of effective fall prevention exercise components established by evidence-based recommendations. Descriptive statistics were calculated. Results Thirty-three eligible programs were identified and nine individuals participated. Most programs (n = 5, 56%) identified as general exercise, and two (22%) as fall prevention exercise. Most programs (n = 5, 56%) were offered two or more times/ week and reported exercise intensity as somewhat challenging. Exercise time offered ranged between 1 and 3 h/ week. Assessments were conducted in two programs (22%). Only one program (general exercise) included all components of effective fall prevention exercise. Two programs (22%) included the component of being offered at least 3 hrs/ week. Three programs (33%) included the component of being offered on an ongoing basis. Seven programs (78%) prescribed mostly moderate challenge balance exercise, and one program (11%) prescribed mostly high challenge exercise. Most of the 19 most-frequently prescribed exercises (n = 17, 89%) targeted static stability and none targeted reactive postural control. Conclusions Most of the older adult community exercise programs participating in this study did not focus on fall prevention, and did not include all components of effective fall prevention exercise. Future studies should focus on fall prevention programs and explore factors influencing implementation of effective fall prevention exercise components to facilitate planning. Electronic supplementary material The online version of this article (10.1186/s12877-019-1224-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kathryn M Sibley
- Department of Community Health Sciences Rady Faculty of Health Sciences, University of Manitoba, 379- 753 McDermot Avenue, Winnipeg, MB, R3E 0W3, Canada. .,George and Fay Yee Centre for Healthcare Innovation, 379- 753 McDermot Avenue, Winnipeg, MB, R3E 0W3, Canada.
| | - Alexie J Touchette
- Department of Community Health Sciences Rady Faculty of Health Sciences, University of Manitoba, 379- 753 McDermot Avenue, Winnipeg, MB, R3E 0W3, Canada
| | - Jonathan C Singer
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | | | - Alison R Oates
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, Canada
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Oates AR, Kumar A, Cowell W, Awdhan A, Santoro R, Lanovaz JL. Comparing the effect of haptic modalities on walking balance control: Is using one or two arms better? Hum Mov Sci 2019; 67:102495. [PMID: 31326741 DOI: 10.1016/j.humov.2019.102495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 06/19/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Adding haptic input by lightly touching a railing or using haptic anchors may improve walking balance control. Typical use of the railing(s) and haptic anchors requires the use of one and two arms in an extended position, respectively. It is unclear whether it is arm configuration and/or the number of arms used or the addition of sensory input that affects walking balance control. RESEARCH QUESTION This study examined whether using one arm or two arms to add haptic input through light touch on a railing or using the haptic anchors affects walking balance control. METHODS In this study, young adults (n = 24) walked while using (actual use) or pretending to use (pretend use) the railing(s) and haptic anchors with one or two arms. Inertial-based sensors (Mobility Lab, APDM) were used to measure stride velocity, relative time spent in double support (%DS), and peak normalized medio-lateral trunk velocity (pnMLTV). RESULTS Using two arms lead to a decrease in pnMLTV compared to using one arm and pnMLTV was lower in the actual use trials compared to the pretend use trials for the anchors only. Stride velocity and %DS did not change between trials when one or two arms were used or when participants actually or pretended to use the haptic tools. Participants walked slower when using the railing compared to the anchors. SIGNIFICANCE The importance of considering the number of arms is highlighted in the improved balance control when using two arms with either tool. The augmented sensory input adds to the stabilizing effect of arm configuration for the anchors but not the railings. These results have implications for future research and rehabilitation efforts emphasizing sensorimotor integration to improve walking balance control.
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Affiliation(s)
- Alison R Oates
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Abhishek Kumar
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Wyatt Cowell
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Aaron Awdhan
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Regan Santoro
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joel L Lanovaz
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Gallo E, Stelmach M, Frigeri F, Ahn DH. Determining Whether a Dosage-Specific and Individualized Home Exercise Program With Consults Reduces Fall Risk and Falls in Community-Dwelling Older Adults With Difficulty Walking: A Randomized Control Trial. J Geriatr Phys Ther 2019; 41:161-172. [PMID: 27893567 DOI: 10.1519/jpt.0000000000000114] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the efficacy of a new practice model, incorporating Shubert's evidence-based fall prevention recommendations, with the usual ambulatory physical therapy (PT) at Rusk Rehabilitation, to decrease fall risk among older adults living in the community. The hypotheses were (1) the proposed program would decrease participants' fall risk, (2) it would be more effective than our usual PT, and (3) the addition of 4 consults after discharge would improve compliance with a home exercise program. METHODS This was a randomized controlled trial. Sixty-nine participants who were independent community dwellers, were 65 years or older, had difficulty walking or complaints of instability, and had 1 or more risk of falls were randomly assigned into a usual care group (UCG, n = 43) or an experimental group (EG, n = 26). Both groups received PT 2 times per week for 30 minutes for 10 to 32 visits. The UCG received the usual PT delivered at Rusk. The EG was instructed in a moderate- to high-intensity home exercise program designed after completing the mini-Balance Evaluation Systems Test to assist with exercise prescription. The EG was educated on performing a recommended dosage of exercise over 6 months using a diary. The EG received 4 additional 30-minute consults every 2 to 4 weeks postdischarge to reinforce compliance. Self-report of number of falls, number of minutes of exercise per week, and performance on outcome measures (Timed Up and Go, 5-times sit-to-stand, Berg Balance Scale, and Activity Balance Confidence Scale) were monitored at evaluation, 2, 4, and 6 months. RESULTS AND DISCUSSION Thirty-five participants completed the study (UCG n = 22; EG n = 13). Both groups were similar at baseline on outcome measures and number of visits. Random effect model analyses demonstrated that both groups made significant reductions in fall risk over 6 months as identified by performance on outcome measures. However, the EG improved significantly more compared with the UCG over time (P < .05). Linear regression analyses showed that the EG exercised significantly more compared with the UCG at all times (P < .05). The EG exceeded the target of 115 min/wk of exercise (154 minutes, standard deviation [SD] 68.5; 170 minutes, SD 96.8; and 143 minutes, SD 68.5) at 2, 4, and 6 months, respectively. This study demonstrated that the experimental program is effective in decreasing fall risk in community-dwelling older adults and is more effective than our usual care. Moreover, it suggests that the overall experimental protocol may offer an effective strategy to foster adherence to an exercise program without the increasing number of visits. CONCLUSION This study supports the efficacy of the experimental program in decreasing fall risk and being more effective than our usual care, as well as fostering greater compliance with an exercise regimen. It provides some preliminary evidence to support Shubert's recommendation on exercise prescription for fall prevention.
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Affiliation(s)
- Estelle Gallo
- NYU Langone Medical Center Rusk Rehabilitation, New York
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Liddle J, Clemson L, Mackenzie L, Lovarini M, Tan A, Pit SW, Roberts C, Tiedemann A, Sherrington C, Willis K. Influences on general practitioner referral to allied health professionals for fall prevention in primary care. Australas J Ageing 2019; 39:e32-e39. [DOI: 10.1111/ajag.12680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/02/2019] [Accepted: 05/08/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Jeannine Liddle
- Faculty of Health Sciences The University of Sydney Lidcombe New South Wales Australia
| | - Lindy Clemson
- Faculty of Health Sciences The University of Sydney Lidcombe New South Wales Australia
- CEPAR—ARC Centre of Excellence in Population Ageing Research Sydney New South Wales Australia
| | - Lynette Mackenzie
- Faculty of Health Sciences The University of Sydney Lidcombe New South Wales Australia
| | - Meryl Lovarini
- Faculty of Health Sciences The University of Sydney Lidcombe New South Wales Australia
| | - Amy Tan
- Faculty of Health Sciences The University of Sydney Lidcombe New South Wales Australia
| | - Sabrina W. Pit
- University Centre for Rural Health, Sydney Medical School The University of Sydney Sydney New South Wales Australia
- School of Medicine, Medical School Western Sydney University Sydney New South Wales Australia
| | - Chris Roberts
- Sydney Medical School—Northern The University of Sydney Sydney New South Wales Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, School of Public Health The University of Sydney Sydney New South Wales Australia
| | - Cathie Sherrington
- Institute for Musculoskeletal Health, School of Public Health The University of Sydney Sydney New South Wales Australia
| | - Karen Willis
- School of Allied Health La Trobe University Melbourne Victoria Australia
- Allied Health Melbourne Health Melbourne Victoria Australia
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Arkkukangas M, Hultgren S. Implementation of motivational interviewing in a fall prevention exercise program: experiences from a randomized controlled trial. BMC Res Notes 2019; 12:270. [PMID: 31088557 PMCID: PMC6518683 DOI: 10.1186/s13104-019-4309-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 05/08/2019] [Indexed: 11/27/2022] Open
Abstract
Objective The elderly population over 65 is increasing globally, and interventions promoting health and preventive work, especially fall prevention, will constitute a large part of physiotherapists’ duties in the near future. To address the challenges of promoting effective and sustainable health behavior changes among older persons, physiotherapists need support when it comes to how to apply behavior change strategies, especially in fall prevention. Therefore, the aim of this study was to describe implementation of motivational interviewing in a fall prevention exercise program. This study is a side product of another project. Results Data from a recently performed three-armed randomized controlled trial were used to describe the implementation of motivational interviewing in the exercise group (n = 58). Level of motivation (priorities) and self-efficacy for both the physiotherapist and the participant in treatment, and to use a guide targeted towards the planned treatment are recommended actions. Regular meetings and follow ups as well as updates of motivational interviewing skills during a treatment period, should also be considered to achieve treatment fidelity. Trial registration NCT01778972, Retrospectively registered January 29, 2013
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Affiliation(s)
- Marina Arkkukangas
- Department of Neuroscience, Physiotherapy, Uppsala University, Box 593, 751 24, Uppsala, Sweden. .,Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
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Major MJ. Fall Prevalence and Contributors to the Likelihood of Falling in Persons With Upper Limb Loss. Phys Ther 2019; 99:377-387. [PMID: 30561742 PMCID: PMC6684228 DOI: 10.1093/ptj/pzy156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 10/20/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Arms are important for locomotor stability and preventing falls by controlling whole-body angular momentum, redirecting the body's center of mass, and providing support to arrest descent. Hence, upper limb loss (ULL) can increase fall risk. However, the prevalence of falls and factors that influence fall risk have not previously been reported for people with ULL. OBJECTIVE This study quantified fall prevalence in persons with ULL at or proximal to the wrist and identified clinical factors that contributed to the likelihood of falling. DESIGN This was a cross-sectional study. METHODS Factors including body and health characteristics, activity level, fall history, prosthesis use, and balance confidence were determined for persons with ULL proximal to the wrist using an online survey. Logistic regression analyses assessed the contribution of these factors to the classification of fallers (≥2 falls in previous year) and nonfallers. RESULTS A percentage (28.6%) of participants (n = 105) reported experiencing 2 or more falls in the past year. The regression model (R2 = 0.473) correctly classified 84.5% of cases and indicated that increased likelihood of falling was significantly influenced by reduced balance confidence, use of upper limb prostheses, and reduced physical capabilities. LIMITATIONS Data were collected online from a convenience sample, and fall classification was based on retrospective data. CONCLUSIONS Falls in persons with ULL are prevalent, suggesting that clinicians should use screening methods to identify at-risk individuals. Balance confidence, use of upper limb prostheses, and perceived physical capabilities could be useful screening metrics. Research is warranted to better understand the factors that underlie fall risk in persons with ULL and the efficacy of therapeutic interventions capable of mitigating fall risk.
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Affiliation(s)
- Matthew J Major
- Department of Physical Medicine and Rehabilitation, Northwestern University, 680 N Lake Shore Dr, Suite 1100, Chicago, IL 60611 (USA); and Jesse Brown VA Medical Center, Chicago, Illinois
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Follador L, Alves RC, Ferreira SDS, Silva AC, Silva SGD. Perceived Exertion and Affect From Tai Chi, Yoga, and Stretching Classes for Elderly Women. Percept Mot Skills 2019; 126:223-240. [PMID: 30638426 DOI: 10.1177/0031512518823661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Tai Chi, yoga, and stretching regimens are gaining popularity as alternatives to more traditional exercise, but there is scant research regarding participants' perceived exertion and affective responses to these practices. We compared experienced states of perceived exertion, feelings of pleasure/displeasure, and arousal in 70 elderly women enrolled in groups of Tai Chi ( n = 26), yoga ( n = 25), or stretching ( n = 19) classes. Mean rates of perceived exertion, feelings of pleasure, and arousal responses were significantly higher over the time course of all three groups, while the overall mean perceived exertion ( Somewhat Hard on the Borg CR-10 scale) and pleasure responses (∼ Very Good on the Feeling Scale) were similar between them. The circumplex model of affect showed that changes occurred in the high-activation pleasure quadrant (energy on the Felt Arousal Scale). From a practical perspective, the exercise intensity and affective responses elicited during these classes made participants feel good and infused with energy, likely creating a positive memory and reinforcing continued physical activity participation.
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Affiliation(s)
- Lucio Follador
- 1 Department of Physical Education, Federal University of Parana, Brazil
| | - Ragami C Alves
- 1 Department of Physical Education, Federal University of Parana, Brazil
| | | | - Aldo C Silva
- 1 Department of Physical Education, Federal University of Parana, Brazil
| | - Sergio G da Silva
- 1 Department of Physical Education, Federal University of Parana, Brazil
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Thompson CJ, Holskey TH, Wallenrod S, Simunovich S, Corn R. Effectiveness of a Fall Prevention Exercise Program on Falls Risk in Community-Dwelling Older Adults. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2019. [DOI: 10.1249/tjx.0000000000000078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Falls are common among older adults. One in 3 adults aged 65 years or older and 1 in 2 adults aged 80 years or older fall each year. Interventions for prevention have been identified; however, they are often not addressed in primary care practice. Screening all older adults annually for falls can identify who will benefit from further clinical evaluation and management. Falls and the need for care from subsequent injury increase with age. They adversely affect quality of life and are a financial burden on the health care industry. As a result, risk reduction is a key focus of prevention efforts, even among very elderly persons.
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Affiliation(s)
- Elizabeth A Phelan
- From the Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington. (E.A.P., K.R.)
| | - Katherine Ritchey
- From the Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington. (E.A.P., K.R.)
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Eagen TJ, Teshale SM, Herrera-Venson AP, Ordway A, Caldwell J. Participation in Two Evidence-Based Falls Prevention Programs by Adults Aging With a Long-Term Disability: Case-Control Study of Reach and Effectiveness. J Aging Health 2018; 31:39S-67S. [PMID: 30442042 DOI: 10.1177/0898264318808918] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Adults aging with a long-term disability (LTD) are at an increased risk for falls. The Older Americans Act Title III-D and Prevention and Public Health Fund (PPHF) support several organizations to deliver falls prevention evidence-based programs designed to reduce risk factors; however, little is understood about the reach and effectiveness of these fall prevention programs for those with LTD compared to those without LTD. This study compared the reach and effectiveness of two evidence-based falls prevention programs between older adults with and without LTD. Method: Using a matched case-control design, 105 LTD older adults enrolled in A Matter of Balance (AMOB) or Stepping On were matched to 315 non-LTD older adults on age, sex, race, and education. Results: On average, LTD older adults attended a higher number of class sessions and were significantly more likely to complete the program compared with the matched-sample of non-LTD older adults. LTD older adults were equally likely as non-LTD older adults to report significant reductions in self-reported fear of falling, falls-related activity restriction, and improvement in falls self-efficacy following completion of the programs. Discussion: These findings provide preliminary evidence for the effectiveness of these evidence-based falls prevention programs for LTD older adults; however, more research is needed to extend these findings.
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Affiliation(s)
- Thomas J Eagen
- University of Washington, Seattle, USA.,National Council on Aging, Arlington, VA, USA
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Tisher K, Mann K, VanDyke S, Johansson C, Vallabhajosula S. Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk. Physiother Theory Pract 2018; 35:305-317. [DOI: 10.1080/09593985.2018.1444116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Kristen Tisher
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - Kimberly Mann
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - Sarah VanDyke
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - Charity Johansson
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - Srikant Vallabhajosula
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
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43
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Kusuma Wati DN, Sahar J, Rekawati E. Effectiveness of Lafiska exercise on risk of fall, balance, and health status in the elderly. ENFERMERIA CLINICA 2018. [DOI: 10.1016/s1130-8621(18)30181-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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44
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Jiménez-Martín PJ, Liu H, Meléndez Ortega A. The importance of differentiating the three modalities of Tai Chi Chuan practice in clinical trials – A critical review. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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45
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Flaherty LM, Schoeppe J, Kruse‐Jarres R, Konkle BA. Balance, falls, and exercise: Beliefs and experiences in people with hemophilia: A qualitative study. Res Pract Thromb Haemost 2018; 2:147-154. [PMID: 30046715 PMCID: PMC6055559 DOI: 10.1002/rth2.12060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/12/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Prior research has established that falls are commonplace in adults with hemophilia, and advises that physical therapy and exercise are successful in fall prevention. Recognizing obstacles and catalysts to physical therapy and exercise in people with hemophilia may augment the efficacy of efforts to prevent falls in this population. OBJECTIVES To learn about the experiences and ideas of patients with hemophilia, especially associated with balance, falls, and exercise. METHODS Semi-structured interviews with 14 adult patients with hemophilia were performed. The interviews were coded for themes founded on the study aims. RESULTS Most subjects described difficulty with balance, often ascribed to joint problems. They believed that staying strong and fit could positively influence balance, but expressed concerns and fear related to falling. Those who exercised regularly did not view exercise as hazardous, while those who did not dependably exercise articulated worry that dangers of exercise may offset the benefits. The most common obstacle to exercise was pain and having someone to exercise with was often described as an enabler. Barriers to partaking in physical therapy included weak proof of its success and distrust in the therapist. Positive physical therapy experiences in the past and the connection with the therapist were reported as facilitators. CONCLUSIONS People with hemophilia describe some attitudes and experiences that are unique to hemophilia while others are found in the general population. Attending to fear, pain, and support for interventions, while encouraging a robust therapeutic alliance and a plan for routine exercise may aid fall prevention behaviors.
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Affiliation(s)
| | - Jennie Schoeppe
- Health Research InstituteKaiser Permanente Washington Health Research InstituteSeattleWAUSA
| | - Rebecca Kruse‐Jarres
- Washington Center for Bleeding DisordersBloodworks NorthwestSeattleWAUSA
- Division of HematologyUniversity of WashingtonSeattleWAUSA
| | - Barbara A. Konkle
- Washington Center for Bleeding DisordersBloodworks NorthwestSeattleWAUSA
- Division of HematologyUniversity of WashingtonSeattleWAUSA
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Oates AR, Unger J, Arnold CM, Fung J, Lanovaz JL. The effect of light touch on balance control during overground walking in healthy young adults. Heliyon 2017; 3:e00484. [PMID: 29322107 PMCID: PMC5753755 DOI: 10.1016/j.heliyon.2017.e00484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 11/25/2022] Open
Abstract
Balance control is essential for safe walking. Adding haptic input through light touch may improve walking balance; however, evidence is limited. This research investigated the effect of added haptic input through light touch in healthy young adults during challenging walking conditions. Sixteen individuals walked normally, in tandem, and on a compliant, low-lying balance beam with and without light touch on a railing. Three-dimensional kinematic data were captured to compute stride velocity (m/s), relative time spent in double support (%DS), a medial-lateral margin of stability (MOSML) and its variance (MOSMLCV), as well as a symmetry index (SI) for the MOSML. Muscle activity was evaluated by integrating electromyography signals for the soleus, tibialis anterior, and gluteus medius muscles bilaterally. Adding haptic input decreased stride velocity, increased the %DS, had no effect on the MOSML magnitude, decreased the MOSMLCV, had no effect on the SI, and increased activity of most muscles examined during normal walking. During tandem walking, stride velocity and the MOSMLCV decreased, while %DS, MOSML magnitude, SI, and muscle activity did not change with light touch. When walking on a low-lying, compliant balance beam, light touch had no effect on walking velocity, MOSML magnitude, or muscle activity; however, the %DS increased and the MOSMLCV and SI decreased when lightly touching a railing while walking on the balance beam. The decreases in the MOSMLCV with light touch across all walking conditions suggest that adding haptic input through light touch on a railing may improve balance control during walking through reduced variability.
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Affiliation(s)
- A R Oates
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7 N 5B2, Canada
| | - J Unger
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7 N 5B2, Canada
| | - C M Arnold
- School of Physical Therapy, College of Medicine, University of Saskatchewan, Canada
| | - J Fung
- Feil/Oberfeld/CRIR Research Centre of the Jewish Rehabilitation Hospital of CISSS-Laval and School of Physical and Occupational Therapy, McGill University, Canada
| | - J L Lanovaz
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7 N 5B2, Canada
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47
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Park SJ, Shim SJ, Choi BR. Comparison of quadriceps, hamstring, and gastrocnemius muscle co-activation in balance exercises. ISOKINET EXERC SCI 2017. [DOI: 10.3233/ies-173154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sun-Ju Park
- Department of Physical Therapy, Metro Hospital, Busan, Korea
| | - Su-Jin Shim
- Department of Physical Therapy, Busan Orthopedics Hospital, Busan, Korea
| | - Bo-Ram Choi
- Department of Physical Therapy, College of Health and Welfare, Silla University, Busan, Korea
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Viladrosa M, Lavedán A, Jürschik P, Mas-Alòs S, Planas-Anzano A, Masot O. Differences in fitness level between women aged 60 and over participating in three different supervised exercise programs and a sedentary group. J Women Aging 2017; 30:326-343. [PMID: 28783470 DOI: 10.1080/08952841.2017.1358976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to compare fitness levels in women aged 60 and over participating in a supervised exercise program (involving tai chi, recreational gymnastics, and/or aquatic fitness) with those in a sedentary group. An observational, descriptive, cross-sectional study was performed on a total of 171 women aged from 60 to 92 who attended public community clubs for older adults. The instruments used included the Senior Fitness Test, the Tinetti Balance Assessment Tool, the Katz Index, and the Lawton & Brody Activities of Daily Living Scale. Significant differences in fitness levels were observed when we compared the exercise groups with the sedentary group. Women with better fitness levels had a lower risk of suffering falls and greater autonomy in performing activities of daily living and instrumental activities of daily living. Agility and gait control were found to be independently associated with exercise groups.
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Affiliation(s)
- Maria Viladrosa
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain.,b Arnau de Vilanova University Hospital of Lleida , Lleida , Spain
| | - Ana Lavedán
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain
| | - Pilar Jürschik
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain
| | - Sebastià Mas-Alòs
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain.,c National Institute of Physical Education of Catalonia , University of Lleida , Lleida , Spain
| | - Antoni Planas-Anzano
- c National Institute of Physical Education of Catalonia , University of Lleida , Lleida , Spain
| | - Olga Masot
- a Department of Nursing and Physiotherapy , University of Lleida , Lleida , Spain
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49
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Wilson D, Jackson T, Sapey E, Lord JM. Frailty and sarcopenia: The potential role of an aged immune system. Ageing Res Rev 2017; 36:1-10. [PMID: 28223244 DOI: 10.1016/j.arr.2017.01.006] [Citation(s) in RCA: 331] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/26/2017] [Accepted: 01/31/2017] [Indexed: 12/19/2022]
Abstract
Frailty is a common negative consequence of ageing. Sarcopenia, the syndrome of loss of muscle mass, quality and strength, is more common in older adults and has been considered a precursor syndrome or the physical manifestation of frailty. The pathophysiology of both syndromes is incompletely described with multiple causes, inter-relationships and complex pathways proposed. Age-associated changes to the immune system (both immunesenescence, the decline in immune function with ageing, and inflammageing, a state of chronic inflammation) have been suggested as contributors to sarcopenia and frailty but a direct causative role remains to be established. Frailty, sarcopenia and immunesenescence are commonly described in older adults but are not ubiquitous to ageing. There is evidence that all three conditions are reversible and all three appear to share common inflammatory drivers. It is unclear whether frailty, sarcopenia and immunesenescence are separate entities that co-occur due to coincidental or potentially confounding factors, or whether they are more intimately linked by the same underlying cellular mechanisms. This review explores these possibilities focusing on innate immunity, and in particular associations with neutrophil dysfunction, inflammation and known mechanisms described to date. Furthermore, we consider whether the age-related decline in immune cell function (such as neutrophil migration), increased inflammation and the dysregulation of the phosphoinositide 3-kinase (PI3K)-Akt pathway in neutrophils could contribute pathogenically to sarcopenia and frailty.
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50
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Mielenz TJ, Durbin LL, Hertzberg F, Nobile-Hernandez D, Jia H. Predictors of and health- and fall-related program outcomes resulting from complete and adequate doses of a fall risk reduction program. Transl Behav Med 2017; 7:330-340. [PMID: 27718062 PMCID: PMC5526800 DOI: 10.1007/s13142-016-0444-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Falls are dangerous and costly for older adults. The A Matter of Balance/Volunteer Lay Leader (AMOB/VLL) program is an evidence-based fall risk reduction program that could help reduce this burden. This study introduced a door-through-door transportation program to improve program delivery (N = 126). Characteristics predicting completion of all eight AMOB/VLL sessions were identified using logistic regression. Individual growth models were employed to determine the immediate, intermediate, and long-term goal outcomes resulting from receiving an adequate dose of the program (five to eight sessions). Self-restriction of activities due to fear of falling (OR 5.04, 95 % CI 1.86-13.69) and a lower frequency of moderate and vigorous physical activity (OR 1.14, 95 % CI 1.04-1.27) were significantly predictive of receiving a complete dose. Three outcome goals were significant, including (1) immediate-improved self-efficacy of managing medications and treatments, (2) intermediate-reduced activity limitations, and (3) intermediate-reduced physical disability. Self-restriction of activities due to a fear of falling and physical activity levels may be simple and effective screening questions to prevent AMOB/VLL attrition. In our study, those who did receive the program improved on a specific type of self-efficacy and on self-reported physical functioning.
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Affiliation(s)
- Thelma J Mielenz
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., Room 512, New York, NY, 10032, USA.
| | - Laura L Durbin
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., Room 512, New York, NY, 10032, USA
| | | | | | - Haomiao Jia
- Department of Biostatistics (in Nursing), Columbia University Medical Center, New York, NY, USA
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