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Jiang X, Tan H, Ren H, Zhou H, Chen J, Wang Z, Guo Y, Zhou J. Clinical and physiological risk factors contributing to the restricted mobility in older adults: a longitudinal analysis. BMC Geriatr 2024; 24:630. [PMID: 39048949 PMCID: PMC11267748 DOI: 10.1186/s12877-024-05230-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Mobility limitations (e.g., using wheelchair) have been closely linked to diminished functional independence and quality of life in older adults. The regulation of mobility is pertaining to multiple neurophysiologic and sociodemographic factors. We here aimed to characterize the relationships of these factors to the risk of restricted mobility in older adults. METHODS In this longitudinal study, 668 older adults with intact mobility at baseline completed the baseline assessments of clinical characteristics, cognitive function, sleep quality, activities of daily living (ADL), walking performance, beat-to-beat blood pressure, and structural MRI of the brain. Then 506 of them (mean age = 70.7 ± 7.5 years) responded to the follow-up interview on the mobility limitation (as defined by if using wheelchair, cane, or walkers, or being disabled and lying on the bed) after 18 ± 3.5 months. Logistic regression analyses were performed to examine the relationships between the baseline characteristics and the follow-up mobility restriction. RESULTS At baseline, compared to intact-mobility group (n = 475), restricted-mobility group (n = 31) were older, with lower score of ADL and the Montreal Cognitive Assessment (MoCA), greater score of Pittsburgh Sleep Quality Index (PSQI), poorer cardio- and cerebral vascular function, and slower walking speeds (ps < 0.05). The logistic regression analysis demonstrated that participants who were with history of falls, uncontrolled-hypertension, and/or greater Fazekas scale (odds ratios (ORs):1.3 ~ 13.9, 95% confidence intervals (CIs) = 1.1 ~ 328.2), walked slower, and/or with lower ADL score (ORs: 0.0026 ~ 0.9; 95%CI: 0.0001 ~ 0.99) at baseline, would have significantly greater risk of restricted mobility (p < 0.05; VIFs = 1.2 ~ 1.9). CONCLUSIONS These findings provide novel profile of potential risk factors, including vascular characteristics, psycho-cognitive and motor performance, for the development of restricted mobility in near future in older adults, ultimately helping the design of appropriate clinical and rehabilitative programs for mobility in this population.
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Affiliation(s)
- Xin Jiang
- Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, China.
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China.
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China.
| | - Huiying Tan
- Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
| | - Huixia Ren
- Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Huiting Zhou
- Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Jingmei Chen
- Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Zhen Wang
- Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Yi Guo
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China.
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China.
- Department of Neurology, Shenzhen People's Hospital, Shenzhen, Guangdong, China.
- Shenzhen Bay Laboratory, Shenzhen, Guangdong, China.
| | - Junhong Zhou
- Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Roslindale, MA, USA
- Harvard Medical School, Boston, MA, USA
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Song C, Cao S, Luo H, Huang Y, Jiang S, Guo B, Li N, Li K, Zhang P, Zhu C, Fu E, Jiang M, Li X. Effects of simulated multi-sensory stimulation integration on physiological and psychological restoration in virtual urban green space environment. Front Psychol 2024; 15:1382143. [PMID: 38966742 PMCID: PMC11223631 DOI: 10.3389/fpsyg.2024.1382143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/30/2024] [Indexed: 07/06/2024] Open
Abstract
Virtual urban green environment images and audio stimuli had been proven to have restorative effects on subjects' physical and mental health. In this area, researchers predominantly focused on visual, auditory and olfactory aspects, while tactile and gustatory senses have been minimally explored. However, the optimal combination of sensory stimuli for promoting physical and mental recovery remains unclear. Therefore, a simulated sensory stimulation approach involving 240 participants was employed, with 30 individuals included in each of the eight experimental groups: the visual-auditory (VA), visual-auditory-olfactory (VAO), visual-auditory-tactile (VAT), visual-auditory-gustatory(VAG), visual-auditory-olfactory-tactile (VAOT), visual-auditory-olfactory-gustatory (VAOG), visual-auditory-tactile-gustatory (VATG), and visual-auditory-olfactory-tactile-gustatory (VAOTG) groups. This study aimed to explore the differences in participants' physiological and psychological health recovery after exposure to different combinations of simulated sensory stimuli in virtual UGSs. The results indicated that the following: (1) In terms of physiological recovery, the blood pressure of the 8 experimental groups decreased significantly after the experiment, indicating that the virtual urban green space environment has a certain recovery effect on physiological state. The combination of VAOTG stimuli in the multisensory group resulted in the best blood pressure recovery (p < 0.05). Tactile is an important sense to enhance the physiological recovery effect. Olfactory-tactile or tactile-gustatory stimuli interactions significantly enhance physiological recovery, emphasizing the importance of tactile stimulation in improving physiological recovery. (2) In terms of psychological recovery, the common trigger of olfactory-gustatory is the most key element to enhance psychological recovery through multi-sensory stimulation of virtual urban green space environment. VAOG stimulation had the best effect on psychological recovery (p < 0.05), followed by VAOTG stimulation (p < 0.05). Gustatory is an important sense to enhance the psychological recovery effect, and both the tactile-gustatory interaction and the olfactory-gustatory interaction significantly enhance the recovery effect. At the same time, the psychological recovery effect obtained by four or more sensory combinations was higher than that obtained by two or three sensory stimulation groups. This study confirms more possibilities for ways to restore physical and mental health through virtual natural environments. It expands the research on the benefits of virtual nature experience and provides theoretical support for the application of this method.
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Affiliation(s)
- Chen Song
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Saixin Cao
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Hao Luo
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou, China
| | - Yinghui Huang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Siwei Jiang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Baimeng Guo
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Nian Li
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Kai Li
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Ping Zhang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Chunyan Zhu
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Erkang Fu
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Mingyan Jiang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Xi Li
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
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Sahoo DP, Sahoo SS, Nirala SK, Rath RS, Agarwal N, Panda M, Kakkar R, Pandey S, Singh CM, Joshi HS, Nath B. Validation of the Indian (Hindi) version of the life-space assessment scale among community-dwelling older adults: a multicentric cross-sectional study. BMC Geriatr 2024; 24:500. [PMID: 38844833 PMCID: PMC11157764 DOI: 10.1186/s12877-024-05072-4] [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: 01/27/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The Life-Space Assessment (LSA) is an instrument that measures mobility in older adults as they reach different areas, defined as life-spaces extending from home to beyond towns or regions. The purpose of the study was to develop the Hindi version of the LSA (LSA- H) and to investigate the validity and reliability of the Hindi version as well as its cultural adaptation. METHODS A cross-sectional study of two hundred forty-five older adults participated in the study from four different study practice areas. Following forward backwards translation, the LSA-H was developed, and the scores were correlated with those of the Activities-Specific Balance Confidence Scale Hindi (ABC- H), the Physical Health Subscale of the WHO-BREF Questionnaire and the Geriatric Depression Scale: Short Form Hindi (GDS-SFH) to test the criterion and concurrent validity. RESULTS The mean score and standard deviation of the LSA-H questionnaire were 56.53 ± 35.99, those of the Physical Health Subscale of the WHO-BREF instrument were 18.54 ± 7.87, those of the GDS-SFH questionnaire were 6.95 ± 4.21 and those of the ABC- H questionnaire were 54.40 ± 28.96. The Pearson correlation coefficient (r) between the LSA-H score and ABC-H score was 0.707 (p value < 0.0001), that between the LSA-H score and the Physical Health Subscale of the WHO-BREF was 0.766 (p value < 0.0001), and that between the LSA-H score and GDS-SFG score was - 0.674 (p value < 0.0001). CONCLUSION This study demonstrated that the Hindi version of the LSA is a valid and reliable instrument for assessing living space among older adults in the Hindi language in an Indian population. Furthermore, the LSA-H was significantly correlated with other health assessment tools in terms of functional mobility, general health status and mental well-being.
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Affiliation(s)
- Durgesh Prasad Sahoo
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India.
| | - Soumya Swaroop Sahoo
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Santosh Kumar Nirala
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Rama Shankar Rath
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Neeraj Agarwal
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Meely Panda
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Rakesh Kakkar
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Sanjay Pandey
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - C M Singh
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Hari Shanker Joshi
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Bhola Nath
- Dept. of Community Medicine, All India Institute of Medical Sciences, Raebareli, India
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Park J, Zahabi M, Zheng X, Ory M, Benden M, McDonald AD, Li W. Automated vehicles for older adults with cognitive impairment: a survey study. ERGONOMICS 2024; 67:831-848. [PMID: 38226633 DOI: 10.1080/00140139.2024.2302020] [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: 07/27/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024]
Abstract
As the population is ageing, the number of older adults with cognitive impairment (CI) is increasing. Automated vehicles (AVs) can improve independence and enhance the mobility of these individuals. This study aimed to: (1) understand the perception of older adults (with and without CI) and stakeholders providing services and supports regarding care and transportation about AVs, and (2) suggest potential solutions to improve the perception of AVs for older adults with mild or moderate CI. A survey was conducted with 435 older adults with and without CI and 188 stakeholders (e.g. caregivers). The results were analysed using partial least square - structural equation modelling and multiple correspondence analysis. The findings suggested relationships between older adults' level of cognitive impairment, mobility, knowledge of AVs, and perception of AVs. The results provided recommendations to improve older adults' perception of AVs including education and adaptive driving simulation-based training.Practitioner summary: This study investigated the perception of older adults and other stakeholders regarding AVs. The findings suggested relationships between older adults' level of cognitive impairment, mobility, knowledge of AVs, and perception of AVs. The results provided guidelines to improve older adults' perception of AVs.
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Affiliation(s)
- Junho Park
- Department of General Engineering, Santa Clara University, Santa Clara, CA, USA
| | - Maryam Zahabi
- Wm Michael Barnes '64 Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, USA
| | | | - Marcia Ory
- School of Public Health, Texas A&M University, College Station, TX, USA
| | - Mark Benden
- School of Public Health, Texas A&M University, College Station, TX, USA
| | - Anthony D McDonald
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Wei Li
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
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Shakya I, Beck LF, Cordier L, Dugan S, Underwood Y, Bergen G. Special Report from the CDC: Evaluating the dissemination of CDC's MyMobility Plan: Findings and lessons learned. JOURNAL OF SAFETY RESEARCH 2024; 89:354-360. [PMID: 38858060 DOI: 10.1016/j.jsr.2024.03.001] [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: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Age-related changes (e.g., cognitive, physiologic) can affect an individual's mobility and increase risks for falls and motor-vehicle crashes, which are leading causes of injuries and injury deaths among older Americans. To address this issue, CDC developed MyMobility Plan (MMP) products to help older adults make plans to reduce injury risks and promote safe mobility. In 2019, MMP products were disseminated to older adults and partner organizations. Dissemination strategies consisted of digital and print distribution and partner outreach. METHODS To assess dissemination efforts, a process (or implementation) evaluation was conducted from January to June 2019. Data were collected for 17 indicators (e.g., counts of webpage visits, product downloads, social media posts). Key informant interviews were conducted with partners, and qualitative analyses of interview data were undertaken to identify key themes related to their dissemination experiences. RESULTS Findings showed the dissemination resulted in 13,425 product downloads and print copy orders and reached almost 155,000 individuals through email subscriber lists, websites, webinars, and presentations. It is unknown what proportion of these individuals were older adults. Social media metrics were higher than expected, and 58 partners promoted products within their networks. Partner interviews emphasized the need for guidance on dissemination, collaboration with local partners, and integration of the products within a program model to ensure broader reach to and use by older adults. CONCLUSIONS The evaluation of the dissemination campaign identified strategies that were successful in creating exposure to the MMP and others that could improve reach in the future. Those strategies include meaningful and early partner engagement for dissemination. PRACTICAL APPLICATIONS Building in evaluation from the start can facilitate development of appropriate data collection measures to assess project success. Engaging partners as active disseminators in the planning stages can help increase the reach of public health tools and resources.
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Affiliation(s)
- Iju Shakya
- Oak Ridge Institute for Science and Education, ORISE Fellow, Oak Ridge, TN, United States; Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laurie F Beck
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - LeShaundra Cordier
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Susan Dugan
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Yamile Underwood
- 2M Research. Contractor, Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gwen Bergen
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
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Tuomola EM, Keskinen KE, Rantanen T, Portegijs E. Associations between walking limitations and reported activity destinations among older adults. Eur J Ageing 2024; 21:16. [PMID: 38775867 PMCID: PMC11111429 DOI: 10.1007/s10433-024-00813-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
In old age, walking difficulty may reduce opportunities to reach valued activity destinations. Walking modifications, e.g., slower pace or using a walking aid, may enable individuals to continue going where they wish, and hence postpone the consequences of the onset of walking difficulties. We studied visited activity destinations (type, distance) among older people with varying degrees of walking limitations. Community-dwelling 75-85-year-old people living in Jyväskylä (N = 901) were asked to state whether they had no difficulty walking 2 km, had modified their walking, or had difficulty walking. On a digital map, participants located physical exercise, attractive, and regular destinations they had visited during the past month. Destination counts and median distance to destinations from home were computed. Participants with intact walking reported higher counts of physical exercise (IRR = 1.45, 95% CI [1.31, 1.61]) and attractive destinations (IRR = 1.23, 95% CI [1.10, 1.40]) than those with walking difficulty and also visited these destinations further away from home than the others (b = 0.46, 95% CI [0.20, 0.71]). Those with walking modifications reported higher counts of physical exercise destinations than those with walking difficulty (IRR = 1.23, 95% CI [1.09, 1.40]). Counts of regular destinations and distance traveled were not associated with walking limitations. Walking modifications may help people with walking difficulty reach destinations further away from home, potentially contributing to their sense of autonomy. For those with walking difficulty, a low count of destinations other than regular destinations, e.g., shops or healthcare facilities, may signal their abandonment of recreational activities and a decrease in their life space, potentially leading to reduced well-being.
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Affiliation(s)
- Essi-Mari Tuomola
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, P.O. Box 35 (viv), 40014, Jyvaskyla, Finland.
| | - Kirsi E Keskinen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, P.O. Box 35 (viv), 40014, Jyvaskyla, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, P.O. Box 35 (viv), 40014, Jyvaskyla, Finland
| | - Erja Portegijs
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Souza GS, Furtado BKA, Almeida EB, Callegari B, Pinheiro MDCN. Enhancing public health in developing nations through smartphone-based motor assessment. Front Digit Health 2024; 6:1345562. [PMID: 38835672 PMCID: PMC11148357 DOI: 10.3389/fdgth.2024.1345562] [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: 11/28/2023] [Accepted: 05/10/2024] [Indexed: 06/06/2024] Open
Abstract
Several protocols for motor assessment have been validated for use on smartphones and could be employed by public healthcare systems to monitor motor functional losses in populations, particularly those with lower income levels. In addition to being cost-effective and widely distributed across populations of varying income levels, the use of smartphones in motor assessment offers a range of advantages that could be leveraged by governments, especially in developing and poorer countries. Some topics related to potential interventions should be considered by healthcare managers before initiating the implementation of such a digital intervention.
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Affiliation(s)
- Givago Silva Souza
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | | | | | - Bianca Callegari
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
- Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Brazil
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Lindeman K, Karavirta L, Koivunen K, Keskinen KE, Eronen J, Portegijs E, Rantanen T. Longitudinal changes in life-space mobility and autonomy in participation outdoors among Finnish community-dwelling older adults from pre-COVID-19 to through the pandemic. Aging Clin Exp Res 2024; 36:85. [PMID: 38558262 PMCID: PMC10984880 DOI: 10.1007/s40520-024-02734-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Among older people, community mobility was reduced at the beginning of the COVID-19 pandemic, but the longer-term changes are unclear. AIMS To study lower extremity performance and car driving as predictors of changes in older adults' life-space mobility, autonomy in participation outdoors, and the risk of developing restricted life-space mobility from 2017 to 2022. METHODS Life-space mobility (scoring range 0-120) and autonomy in participation outdoors (scoring range 0-20) were assessed in community-dwelling individuals (n = 657) in 2017-2018 (baseline age 75, 80, or 85 years), during the first wave of COVID-19 in 2020, and in 2021-2022. Lower extremity performance was assessed using the Short Physical Performance Battery, and car driving was self-reported at baseline. Data were analysed using generalized estimating equations and Cox regression. RESULTS During the first wave of COVID-19 in 2020, life-space mobility decreased on average by 10.3 (SD 21.6) points and partially recovered in 2021-2022 (+ 2.7, SD 21.8). The same pattern was observed for autonomy in participation outdoors. Non-drivers and those with impaired lower extremity performance had a 2.4-to-3.6-fold adjusted risk of developing restricted life-space mobility over the follow-up period compared to drivers with intact lower extremity performance. CONCLUSIONS For older people, the recovery of community mobility was incomplete after the restrictions stemming from the pandemic were lifted. Older adults with impaired lower extremity performance and who did not drive were particularly vulnerable to developing restricted life-space mobility, a situation that could lead to social isolation and reduced well-being.
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Affiliation(s)
- Katja Lindeman
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland.
| | - Laura Karavirta
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisa Koivunen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Kirsi E Keskinen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Johanna Eronen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Erja Portegijs
- Center of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
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Nie Q, Rice LA, Sosnoff JJ, Shen S, Rogers WA. Understanding Wheelchair Use in Older Adults From the National Health and Aging Trends Study. Arch Phys Med Rehabil 2024; 105:514-524. [PMID: 37734645 DOI: 10.1016/j.apmr.2023.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 07/07/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To identify the trends of wheelchair use and physical characteristics among older people who used wheelchairs relative to those who did not. DESIGN Cohort and survey. SETTING General community. PARTICIPANTS 7026 participants (N=7026) were selected from the 2011 cohort of the National Health and Aging Trends Study (NHATS), which is made up of Medicare beneficiaries over the age of 65. Repeated observations among participants in the 2011 cohort were analyzed in the 4 following rounds: 2013 (N=4454), 2015 (N=3327), 2017 (N=2623), and 2019 (N=2091). Participants were divided into 2 groups: those who used and did not use wheelchairs. INTERVENTIONS Not applicable. MAIN OUTCOMES MEASURES Physical characteristics, including pain, strength limitation, balance problems, mobility disability, as well as the frequency of going outside. RESULTS The number of older adults who use wheelchairs had increased significantly from 4.7 per 100 people in 2011 to 7.1 in 2019 (P<.001). The logistic regression analysis indicated that participants who reported less frequently going out were at least 4.27 times more likely to be wheelchair users than non-wheelchair users (P<.01). Participants who reported health and physical problems were at least 2.48 times more likely to be wheelchair users than non-wheelchair users from 2011 to 2017 (P<.0001). Balance or coordination problems increased (24%-38%) significantly among non-wheelchair users from 2011 to 2019 (all P<.05). CONCLUSIONS Current wheelchair users reported more physical difficulties and were much less likely to go outside. This lower outdoor mobility could be due to physical difficulties or potential barriers in physical and socio-cultural environments. In addition, older adults who do not use wheelchairs showed increasing physical problems over time (including balance or coordination problems). Clinicians should consider older wheelchair users' health and physical limitations when prescribing wheelchairs.
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Affiliation(s)
- Qiong Nie
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL
| | - Laura A Rice
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL
| | - Jacob J Sosnoff
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL
| | - Sa Shen
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL
| | - Wendy A Rogers
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL.
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Jahan AM, Guitard P, Jutai JW. Psychosocial predictors of mobility assistive devices non-adherence among older adults. Disabil Rehabil Assist Technol 2024:1-9. [PMID: 38393746 DOI: 10.1080/17483107.2024.2320723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Background: Mobility assistive devices (MADs) provide support to older adults to improve their quality of life; however, research shows that as many as 75% of older adults are non-adherent to prescribed MADs. This study investigated the psychosocial factors that predict non-adherence to MADs among older adults.Methods: A sample of Canadian older adult MADs users who resided in a long-term care facility was included. The data was collected using the Psychosocial Impact of Assistive Devices Scale (PIADS), and the Medical Outcomes Study Social Support Survey (mMOS-SS). Data analysis was performed using SPSS 28. Descriptive statistics were used to describe the sample and the study variables. Pearson correlation coefficients were used to evaluate the association between the study variables. Variables that were associated with non-adherence in a univariate analysis were subsequently entered into a multiple regression analysis.Results: The sample comprised 48 residents (26 females and 22 males), with a mean age of 86.8. In the univariate analysis, scores from the three PIADS subscales, namely, Competence, Adaptability, and Self-esteem, and the Social Support scale were significantly correlated with non-adherence (p < 0.05). In the multiple regression analyses, only Self-esteem significantly predicted non-adherence (p < 0.05), and this model explained between 43.5 and 54.3% of the variance in non-adherence.Conclusion: This study revealed that the Self-esteem construct, which includes several concepts related to psychological well-being, was the only significant predictor of non-adherence among the studied sample of older adults. The clinical implications of the findings are subsequently discussed.
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Affiliation(s)
- Alhadi M Jahan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Paulette Guitard
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Jeffrey W Jutai
- School of Interdisciplinary Health Sciences and Life Research Institute, University of Ottawa, Ottawa, Canada
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11
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Rosso AL, Baillargeon EM, Perera S, VanSwearingen J, Rosano C, Huppert TJ, Brach JS. Prefrontal cortex activation while walking did not change but gait speed improved after a randomized physical therapy intervention. Aging Clin Exp Res 2024; 36:43. [PMID: 38367207 PMCID: PMC10874329 DOI: 10.1007/s40520-023-02666-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/21/2023] [Indexed: 02/19/2024]
Abstract
BACKGROUND Higher prefrontal cortex (PFC) activation while walking may indicate reduced gait automaticity. AIM We examine whether PFC activation during walking improves after training in older adults at risk for mobility disability. METHODS Forty-two adults aged ≥ 65 participated in a randomized clinical trial (NCT026637780) of a 12-week timing and coordination physical therapy intervention to improve walking (n = 20 intervention, n = 22 active control). PFC activation was measured by functional near-infrared spectroscopy (fNIRS) during four walking tasks over 15 m, each repeated 4 times: even surface walking, uneven surface walking, even dual-task, uneven dual-task; dual-task was reciting every other letter of the alphabet while walking. Gait speed and rate of correct letter generation were recorded. Linear mixed models tested between arm differences in change of fNIRS, gait speed, and letter generation from baseline to follow-up (12-week, 24-week, and 36-week). RESULTS Intervention arms were similar in mean age (74.3 vs. 77.0) and baseline gait speed (0.96 vs. 0.93 m/s). Of 24 comparisons of between arm differences in the fNIRS signals, only two were significant which were not supported by differences at other follow-up times or on other tasks. Gait speed, particularly during dual-task conditions, and correct letter generation did improve post-intervention but improvements did not differ by arm. DISCUSSION AND CONCLUSIONS After training, PFC activation during walking generally did not improve and did not differ by intervention arm. Improvements in gait speed without increased PFC activation may point toward more efficient neural control of walking.
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Affiliation(s)
- Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Emma M Baillargeon
- Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Subashan Perera
- Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Theodore J Huppert
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Brach
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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12
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Missell-Gray R, Simning A. Driving Cessation and Late-Life Depressive and Anxiety Symptoms: Findings from the National Health and Aging Trends Study. Clin Gerontol 2024; 47:224-233. [PMID: 37313655 PMCID: PMC10719415 DOI: 10.1080/07317115.2023.2224795] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To describe the association between driving cessation and depressive and anxiety symptoms over time by assessing depression and anxiety at 1- and 4-years follow-up. METHODS The study examined community-dwelling adults aged 65 years and older from the National Health and Aging Trends Study who were driving at the 2015 interview and completed 1-year (N = 4,182) and 4-year (N = 3,102) follow-up interviews. Outcomes were positive screens for depressive and anxiety symptoms in 2016 or 2019, and the primary independent variable was driving cessation within one year of the baseline interview. RESULTS Adjusting for socio-demographic and clinical characteristics, driving cessation was associated with depressive symptoms at 1 year (OR = 2.25, 95% CI: 1.33-3.82) and 4-year follow-up (OR = 3.55, 95% CI: 1.72-7.29). Driving cessation was also associated with anxiety symptoms at 1 year (OR = 1.71, 95% CI: 1.05-2.79) and 4 year follow up (OR = 3.22, 95% CI: 1.04-9.99). CONCLUSIONS Driving cessation was associated with an increased risk of developing depressive and anxiety symptoms in later life. However, reasons for this association remain unclear. CLINICAL IMPLICATIONS Although the mechanism linking driving cessation with worse mental health symptoms is uncertain, driving facilitates many important activities. Clinicians should monitor the well-being of patients who stop or intend to stop driving.
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Affiliation(s)
- Rachel Missell-Gray
- Department of Psychiatry, University of Rochester (U.R.), Rochester, NY, United States of America (USA)
- University of Rochester, Margaret Warner School of Education and Human Development, Rochester, NY, USA
| | - Adam Simning
- Department of Psychiatry, University of Rochester (U.R.), Rochester, NY, United States of America (USA)
- Department of Public Health Sciences, U.R., Rochester, NY, USA
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13
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Kim H, Kim G, Kim Y, Ha J. The Effects of ICT-Based Interventions on Physical Mobility of Older Adults: A Systematic Literature Review and Meta-Analysis. Int J Clin Pract 2023; 2023:5779711. [PMID: 38020536 PMCID: PMC10656205 DOI: 10.1155/2023/5779711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/06/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Systematic literature review and meta-analysis were conducted to integrate and analyze intervention studies dealing with the effects of information and communications technology- (ICT-) based interventions on the physical mobility of older adults in the community. The PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL databases were searched for studies published from January 2000 to December 2022. We used the Risk of Bias 2 (RoB 2) tool to evaluate the quality of the randomized controlled studies in the systematic review. The meta-analysis was performed using a random-effects model. The model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for both effect measures. I2 tests were used to measure the presence of heterogeneity. Thirty-seven randomized controlled trials were included (2,419 intervention participants), of which 23 were included in the meta-analysis. ICT interventions significantly improved Timed Up and Go (TUG) as a marker of physical mobility variable in older adults (SMD = -0.33, 95% CI: -0.57 to -0.10, p=0.005, I2 = 74.7%). A sensitivity analysis was performed on subgroups, and interventions were found to be effective in improving TUG in the exergame group (SMD = -0.40, 95% CI: -0.72 to -0.08, p < 0.001, I2 = 75.0%) and in the exergame with virtual reality (VR) group (SMD = -0.33, 95% CI: -1.01 to 0.35, p < 0.001, I2 = 91.0%) but both groups showed high heterogeneity. A meta-analysis was also performed on Short Physical Performance Battery (SPPB) but statistically significant results were not found (SMD = -0.19, 95% CI: -0.61 to 0.23, p=0.375, I2 = 87.7%). For the Berg Balance Scale (BBS), the post-intervention scores were significantly better than baseline (SMD = 1.52, 95% CI: 0.48 to 2.57, p=0.004, I2 = 93.5%). However, the number of studies included in the meta-analysis was small and heterogeneity was high, so follow-up studies are needed. This study confirmed that exergames, telecommunication, e-health, information applications, and robots were used as effective ICT-based interventions for improving the physical mobility of older adults. It is necessary to develop and apply more diverse ICT-based interventions that will prevent impairments of mobility and encourage older adults to live more independently, with a higher quality of life, based on extensive research on ICT-based interventions.
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Affiliation(s)
- Hyori Kim
- College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Gahye Kim
- College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Yeonghun Kim
- Robotics Lab, Hyundai Motor Company, Uiwang 16082, Republic of Korea
| | - Jiyeon Ha
- College of Nursing, Research Institute of Nursing Science, Ajou University, Suwon 16499, Republic of Korea
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14
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Hong J, Yang N, Kim K. Development and Validation of a Perceived Community Food Accessibility Measurement Questionnaire for Korean Older Adults. Nutrients 2023; 15:4301. [PMID: 37836585 PMCID: PMC10574782 DOI: 10.3390/nu15194301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
As the community food environment is known to be an important factor in healthy food choices, it needs to be measured, to increase awareness and improve healthy eating. The objective of this study was to develop a perceived community food accessibility measurement (P-CFAM) questionnaire applicable to older adults in Korea and evaluate its reliability and validity. The questionnaire was developed based on community food environment factors that were found to affect food choices in previous studies. We evaluated the internal consistency reliability, construct validity, and criterion-related validity. The subjects were 188 older adults for validity. The Cronbach's alpha value for the reliability measure was 0.9. The confirmatory factor analysis to evaluate the construct validity of the questionnaire showed values close to those of the optimal model (GFI = 0.983, AGFI = 0.948, RMR = 0.004, NFI = 0.987, CFI = 0.996). Regarding the criterion-related validity, the P-CFAM questionnaire results were significantly related to objective measurement indicators such as the number of grocery stores, the travel time to a grocery store, and the intake of vegetables and fruit. In conclusion, the developed P-CFAM questionnaire was shown to be reliable and valid, and useful for assessing older adults' perceptions of community food accessibility in Korea.
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Affiliation(s)
| | | | - Kirang Kim
- Department of Food Science and Nutrition, College of Science and Technology, Dankook University, Cheonan 31116, Republic of Korea
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15
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Kim H, Kim J, Ha J. Factors influencing mobility in community-dwelling older adults during the early COVID-19 pandemic: a cross-sectional study. BMC Public Health 2023; 23:1649. [PMID: 37641017 PMCID: PMC10464251 DOI: 10.1186/s12889-023-16553-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND In older adults, mobility is important for maintaining their independence and quality of life, and it influences their physical, cognitive, and social health. This study aimed to identify the physical and psychosocial factors that affected the mobility of community-dwelling older adults, aged 65 years or older, who were socially isolated during the coronavirus disease 2019 (COVID-19) pandemic due to stay-at-home policies. METHODS The participants in this study were 214 community-dwelling older adults in Korea, and a cross-sectional survey was conducted from December 2020 to January 2021. Variables included participants' general characteristics, mobility, sitting time, depression, social support, and cognitive function. RESULTS Multiple linear regression analysis showed that the factors influencing older adults' mobility during the COVID-19 pandemic were depression (β=-0.29, p < .001), age (65-74 years old) (β = 0.19, p = .002), a lower level of education (β=-0.17, p = .006), two or more comorbidities (β=-0.18, p = .001), sitting time (β=-0.17, p = .004), and the ability to drive a vehicle (β = 0.14, p = .017). CONCLUSIONS Home healthcare interventions are needed to limit psychosocial issues and improve mobility for older adults who had limited mobility during the COVID-19 pandemic.
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Affiliation(s)
- Hyori Kim
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Juah Kim
- Department of Nursing, Korean Bible University, Seoul, Republic of Korea
| | - Jiyeon Ha
- College of Nursing, Research Institute of Nursing Science, Ajou University, 164 World cup-ro, Yeongtong-gu, Suwon-si, 16499, Gyeonggi-do, Republic of Korea.
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16
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Licina S, Kjeken I, Førland O, Langeland E, Tuntland H. Exploring Goals and Functional Changes in Reablement for People with Fractures and People with Dizziness and Balance Problems. J Multidiscip Healthc 2023; 16:2323-2337. [PMID: 37601327 PMCID: PMC10439777 DOI: 10.2147/jmdh.s417883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/28/2023] [Indexed: 08/22/2023] Open
Abstract
Background Although older people often have challenges with fractures and dizziness/balance problems, knowledge concerning the impact of reablement of people with these conditions is limited. Aim To explore functional changes in reablement for older home-dwelling people with fractures and dizziness/balance problems regarding 1) occupational performance and satisfaction with performance, 2) physical function and 3) health-related quality of life, and 4) which occupations they prioritize as rehabilitation goals. Material and Methods The sample is derived from a nationwide clinically controlled trial in Norway consisting of 149 participants with fractures and 113 with dizziness/balance problems who participated in a four to 10-week reablement program. Data were collected at baseline and at 10-week, 6-month, and 12-month follow-up and were analyzed with paired t-tests and analysis of covariance. Occupational priorities were categorized into sub-areas of occupation. Results Both groups had significant short-, mid-, and long-term improvements in occupational performance and satisfaction with performance. Except for balance from baseline to 12-month follow-up, the fracture group showed significant improvements in physical function and health-related quality of life at all follow-ups. The results varied more in the group with dizziness/balance problems in physical function and health-related quality of life. Functional mobility was the highest prioritized occupational sub-area in both groups. Conclusion The findings of this study provide extended knowledge about goals and functional changes in people with fractures and dizziness/balance problems following a reablement program. Significance Tailoring and individual adjustments according to diagnosis may be important in person-centered care in reablement.
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Affiliation(s)
- Selma Licina
- Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ingvild Kjeken
- Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Oddvar Førland
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, Bergen, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Hanne Tuntland
- Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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17
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Müller C, Domokos B, Amersbach T, Hausmayer EM, Roßmann C, Wallmann-Sperlich B, Bucksch J. Development and reliability testing of an audit toolbox for the assessment of the physical activity friendliness of urban and rural environments in Germany. Front Public Health 2023; 11:1153088. [PMID: 37637797 PMCID: PMC10449332 DOI: 10.3389/fpubh.2023.1153088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Background According to socio-ecological theories, physical activity behaviors are linked to the physical and social neighborhood environment. Reliable and contextually adapted instruments are needed to assess environmental characteristics related to physical activity. This work aims to develop an audit toolbox adapted to the German context, to urban and rural settings, for different population groups, and different types of physical activity; and to evaluate its inter-rater reliability. Methods We conducted a systematic literature search to collect existing audit tools and to identify the latest evidence of environmental factors influencing physical activity in general, as well as in German populations. The results guided the construction of a category system for the toolbox. Items were assigned to the categories based on their relevance to physical activity and to the German context as well as their comprehensibility. We piloted the toolbox in different urban and rural areas (100 street segments, 15 parks, and 21 playgrounds) and calculated inter-rater reliability by Cohen's Kappa. Results The audit toolbox comprises a basic streetscape audit with seven categories (land use and destinations, traffic safety, pedestrian infrastructure, cycling infrastructure, attractiveness, social environment, and subjective assessment), as well as supplementary tools for children and adolescents, seniors and people with impaired mobility, parks and public open spaces, playgrounds, and rural areas. 76 % of all included items had moderate, substantial, or almost perfect inter-rater reliability (κ > 0.4). Conclusions The audit toolbox is an innovative and reliable instrument for the assessment of the physical activity friendliness of urban and rural environments in Germany.
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Affiliation(s)
- Christina Müller
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Bruno Domokos
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Tanja Amersbach
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Eva-Maria Hausmayer
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | | | | | - Jens Bucksch
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
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18
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Bianco NA, Collins SH, Liu K, Delp SL. Simulating the effect of ankle plantarflexion and inversion-eversion exoskeleton torques on center of mass kinematics during walking. PLoS Comput Biol 2023; 19:e1010712. [PMID: 37549183 PMCID: PMC10434928 DOI: 10.1371/journal.pcbi.1010712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 08/17/2023] [Accepted: 07/06/2023] [Indexed: 08/09/2023] Open
Abstract
Walking balance is central to independent mobility, and falls due to loss of balance are a leading cause of death for people 65 years of age and older. Bipedal gait is typically unstable, but healthy humans use corrective torques to counteract perturbations and stabilize gait. Exoskeleton assistance could benefit people with neuromuscular deficits by providing stabilizing torques at lower-limb joints to replace lost muscle strength and sensorimotor control. However, it is unclear how applied exoskeleton torques translate to changes in walking kinematics. This study used musculoskeletal simulation to investigate how exoskeleton torques applied to the ankle and subtalar joints alter center of mass kinematics during walking. We first created muscle-driven walking simulations using OpenSim Moco by tracking experimental kinematics and ground reaction forces recorded from five healthy adults. We then used forward integration to simulate the effect of exoskeleton torques applied to the ankle and subtalar joints while keeping muscle excitations fixed based on our previous tracking simulation results. Exoskeleton torque lasted for 15% of the gait cycle and was applied between foot-flat and toe-off during the stance phase, and changes in center of mass kinematics were recorded when the torque application ended. We found that changes in center of mass kinematics were dependent on both the type and timing of exoskeleton torques. Plantarflexion torques produced upward and backward changes in velocity of the center of mass in mid-stance and upward and smaller forward velocity changes near toe-off. Eversion and inversion torques primarily produced lateral and medial changes in velocity in mid-stance, respectively. Intrinsic muscle properties reduced kinematic changes from exoskeleton torques. Our results provide mappings between ankle plantarflexion and inversion-eversion torques and changes in center of mass kinematics which can inform designers building exoskeletons aimed at stabilizing balance during walking. Our simulations and software are freely available and allow researchers to explore the effects of applied torques on balance and gait.
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Affiliation(s)
- Nicholas A. Bianco
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Steven H. Collins
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Karen Liu
- Department of Computer Science, Stanford University, Stanford, California, United States of America
| | - Scott L. Delp
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, United States of America
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Sahni S, Dufour AB, Wang N, Kiel DP, Hannan MT, Jacques PF, Benjamin EJ, Vasan RS, Murabito JM, Newman AB, Fielding RA, Mitchell GF, Hamburg NM. Association of Vascular Health Measures and Physical Function: A Prospective Analysis in the Framingham Heart Study. J Gerontol A Biol Sci Med Sci 2023; 78:1189-1197. [PMID: 37183502 PMCID: PMC10329234 DOI: 10.1093/gerona/glad097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Dysfunction in blood vessel dynamics may contribute to changes in muscle measures. Therefore, we examined associations of vascular health measures with grip strength and gait speed in adults from the Framingham Heart Study. METHODS The cross-sectional study (1998-2001) included participants with 1 measure of grip strength (kg, dynamometer) or gait speed (4-m walk, m/s) and at least 1 measure of aortic stiffness (carotid-femoral pulse wave velocity, brachial pulse pressure, and brachial flow pulsatility index) or brachial artery structure and function (resting flow velocity, resting brachial artery diameter, flow-mediated dilation %, hyperemic brachial blood flow velocity, and mean arterial pressure [MAP]) assessed by tonometry and brachial artery ultrasound. The longitudinal study included participants with ≥1 follow-up measurement of gait speed or grip strength. Multivariable linear regression estimated the association of 1 standard deviation (SD) higher level of each vascular measure with annualized percent change in grip strength and gait speed, adjusting for covariates. RESULTS In cross-sectional analyses (n = 2 498, age 61 ± 10 years; 56% women), higher resting brachial artery diameter (β ± standard error [SE] per 1 SD: 0.59 ± 0.24, p = .01) and MAP (β ± SE: 0.39 ± 0.17, p = .02) were associated with higher grip strength. Higher brachial pulse pressure (β ± SE: -0.02 ± 0.01, p = .07) was marginally associated with slower gait speed. In longitudinal analyses (n = 2 157), higher brachial pulse pressure (β ± SE: -0.19 ± 0.07, p = .005), was associated with slowing of gait speed but not with grip strength. CONCLUSIONS Higher brachial artery pulse pressure (measure of aortic stiffness) was associated with loss of physical function over ~11 years, although we found no evidence that microvascular function contributed to the relation.
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Affiliation(s)
- Shivani Sahni
- Hinda and Arthur Marcus Institute of Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Alyssa B Dufour
- Hinda and Arthur Marcus Institute of Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Na Wang
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute of Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Marian T Hannan
- Hinda and Arthur Marcus Institute of Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Emelia J Benjamin
- Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine and Boston University School of Public Health, Boston, Massachusetts, USA
- Framingham Heart Study, Framingham, Massachusetts, USA
| | - Ramachandran S Vasan
- Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine and Boston University School of Public Health, Boston, Massachusetts, USA
- Framingham Heart Study, Framingham, Massachusetts, USA
| | | | - Anne B Newman
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Gary F Mitchell
- Cardiovascular Engineering, Inc., Norwood, Massachusetts, USA
| | - Naomi M Hamburg
- Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine and Boston University School of Public Health, Boston, Massachusetts, USA
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20
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Zhang B, Ma M, Wang Z. Promoting active aging through assistive product design innovation: a preference-based integrated design framework. Front Public Health 2023; 11:1203830. [PMID: 37404280 PMCID: PMC10315631 DOI: 10.3389/fpubh.2023.1203830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
Background With the accelerating trend of global aging, over one billion people need to use one or more types of assistive products. However, the high abandonment rate of current assistive products is affecting the quality of life of the older adults, posing challenges to public health. Accurately capturing the preference factors of the older adults in the design process is an important way to improve the acceptance of assistive products. In addition, a systematic approach is needed to translate these preference factors into innovative product solutions. These two issues are less addressed in existing research. Methods First, the evaluation grid method was used to conduct in-depth interviews with users and extract the structure of preference factors for assistive products. Quantification theory type I was used to calculate the weight of each factor. Secondly, universal design principles, TRIZ theory's contradiction analysis techniques, and invention principles were used to translate the preference factors into design guidelines. Then, finite structure method (FSM), morphological chart, and CAD techniques were used to visualize the design guidelines as alternatives. Finally, Analytic Hierarchy Process (AHP) was used to evaluate and rank the alternatives. Results A Preference-based Assistive Product Design Model (PAPDM) was proposed. The model includes three stages: definition, ideation, and evaluation. A case study on walking aid demonstrated the execution of PAPDM. The results show that 28 preference factors influence the four psychological needs of the older adults: sense of security, sense of independence, self-esteem, and sense of participation. These psychological needs were reflected in the shape, color, material, universality, user-friendly, reliability, and smart functions of assistive products. The preference factors were transformed into five design guidelines, and three alternatives were generated. Finally, the evaluation concludes that solution C was the optimal solution. Conclusion The PAPDM framework provides designers with a transparent, progressive approach to designing assistive products that meet unique needs and preferences of older adults. This enhances objectivity and scientific rigor in assistive product development, avoiding blind design and production. By considering the perspective of older adults from the outset, we can avoid high abandonment rates of assistive products and contribute to promoting active aging.
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Affiliation(s)
- Baoyi Zhang
- School of Design Art, Xiamen University of Technology, Xiamen, China
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Minyuan Ma
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Zongsheng Wang
- School of Design Art, Xiamen University of Technology, Xiamen, China
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21
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Smail E, Alpert J, Mardini M, Kaufmann C, Bai C, Gill T, Fillingim R, Cenko E, Zapata R, Karnati Y, Marsiske M, Ranka S, Manini T. Feasibility of a Smartwatch Platform to Assess Ecological Mobility: Real-Time Online Assessment and Mobility Monitor. J Gerontol A Biol Sci Med Sci 2023; 78:821-830. [PMID: 36744611 PMCID: PMC10172974 DOI: 10.1093/gerona/glad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Early detection of mobility decline is critical to prevent subsequent reductions in quality of life, disability, and mortality. However, traditional approaches to mobility assessment are limited in their ability to capture daily fluctuations that align with sporadic health events. We aim to describe findings from a pilot study of our Real-time Online Assessment and Mobility Monitor (ROAMM) smartwatch application, which uniquely captures multiple streams of data in real time in ecological settings. METHODS Data come from a sample of 31 participants (Mage = 74.7, 51.6% female) who used ROAMM for approximately 2 weeks. We describe the usability and feasibility of ROAMM, summarize prompt data using descriptive metrics, and compare prompt data with traditional survey-based questionnaires or other established measures. RESULTS Participants were satisfied with ROAMM's function (87.1%) and ranked the usability as "above average." Most were highly engaged (average adjusted compliance = 70.7%) and the majority reported being "likely" to enroll in a 2-year study (77.4%). Some smartwatch features were correlated with their respective traditional measurements (eg, certain GPS-derived life-space mobility features (r = 0.50-0.51, p < .05) and ecologically measured pain (r = 0.72, p = .01), but others were not (eg, ecologically measured fatigue). CONCLUSIONS ROAMM was usable, acceptable, and effective at measuring mobility and risk factors for mobility decline in our pilot sample. Additional work with a larger and more diverse sample is necessary to confirm associations between smartwatch-measured features and traditional measures. By monitoring multiple data streams simultaneously in ecological settings, this technology could uniquely contribute to the evolution of mobility measurement and risk factors for mobility loss.
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Affiliation(s)
- Emily J Smail
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,USA
| | - Jordan M Alpert
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, Florida,USA
| | - Mamoun T Mardini
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,USA
| | - Christopher N Kaufmann
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,USA
| | - Chen Bai
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,USA
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut,USA
| | - Roger B Fillingim
- Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida,USA
| | - Erta Cenko
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida,USA
| | - Ruben Zapata
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,USA
| | - Yashaswi Karnati
- Department of Computer & Information Science & Engineering, College of Liberal Arts and Sciences, University of Florida, Gainesville, Florida,USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida,USA
| | - Sanjay Ranka
- Department of Computer & Information Science & Engineering, College of Liberal Arts and Sciences, University of Florida, Gainesville, Florida,USA
| | - Todd M Manini
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,USA
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22
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Abou-Sharkh A, Mate KKV, Inceer M, Morais JA, Morin SN, Mayo NE. What Do Older Canadians Think They Need to Walk Well? Physiother Can 2023; 75:198-205. [PMID: 37736376 PMCID: PMC10510555 DOI: 10.3138/ptc-2021-0021] [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: 02/15/2021] [Revised: 07/01/2021] [Accepted: 10/08/2021] [Indexed: 09/23/2023]
Abstract
Purpose To identify older Canadians' perception of the importance of expert-generated elements of walking quality, and the contributors to and consequences of perceived walking quality. Method Cross-sectional survey of 649 adults was conducted through a commercial participant panel, Hosted in Canada Surveys. Results Of the 649 respondents, 75% were between 65 and 74 years old (25% ≥ 75) and 49% were women. The most important elements were foot, ankle, hip, and knee mobility with little difference in ranks across walking perception (Fr χ12 = 5.0, p > 0.05). People who were older by a decade were more likely to report poorer walking (POR: 1.4; 95% CI: 1.0, 1.7), as were women compared to men, and people who used a walking aid compared to none. Lung disease showed the highest association with a perception of not walking well (POR: 7.2; 95% CI: 3.7, 14.2). The odds of being willing to pay more for a technology to improve walking were always greater for those with a lower perception of their walking quality. Conclusions People who perceived their walking quality as poor were more likely to report poorer health and were willing to pay more for a technology to improve walking. This supports the opportunity of leveraging wearable technologies to improve walking.
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Affiliation(s)
- Ahmed Abou-Sharkh
- From the
Centre of Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Kedar K. V. Mate
- From the
Centre of Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Mehmet Inceer
- From the
Centre of Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - José A. Morais
- Division of Geriatric Medicine, McGill University, Montreal, Quebec, Canada
| | - Suzanne N. Morin
- Divisions of Endocrinology, General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nancy E. Mayo
- From the
Centre of Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Divisions of Clinical Epidemiology, Geriatrics, Experimental Medicine, McGill University Health Centre, Montreal, Quebec, Canada
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23
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Arcobelli VA, Zauli M, Galteri G, Cristofolini L, Chiari L, Cappello A, De Marchi L, Mellone S. mCrutch: A Novel m-Health Approach Supporting Continuity of Care. SENSORS (BASEL, SWITZERLAND) 2023; 23:4151. [PMID: 37112492 PMCID: PMC10146559 DOI: 10.3390/s23084151] [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: 03/14/2023] [Revised: 04/03/2023] [Accepted: 04/18/2023] [Indexed: 06/19/2023]
Abstract
This paper reports the architecture of a low-cost smart crutches system for mobile health applications. The prototype is based on a set of sensorized crutches connected to a custom Android application. Crutches were instrumented with a 6-axis inertial measurement unit, a uniaxial load cell, WiFi connectivity, and a microcontroller for data collection and processing. Crutch orientation and applied force were calibrated with a motion capture system and a force platform. Data are processed and visualized in real-time on the Android smartphone and are stored on the local memory for further offline analysis. The prototype's architecture is reported along with the post-calibration accuracy for estimating crutch orientation (5° RMSE in dynamic conditions) and applied force (10 N RMSE). The system is a mobile-health platform enabling the design and development of real-time biofeedback applications and continuity of care scenarios, such as telemonitoring and telerehabilitation.
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Affiliation(s)
- Valerio Antonio Arcobelli
- Department of Electrical, Electronic and Information Engineering (DEI), Alma Mater Studiorum, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Matteo Zauli
- Department of Electrical, Electronic and Information Engineering (DEI), Alma Mater Studiorum, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Giulia Galteri
- Department of Industrial Engineering (DIN), Alma Mater Studiorum, University of Bologna, Via Umberto Terracini 24-28, 40131 Bologna, Italy
| | - Luca Cristofolini
- Department of Industrial Engineering (DIN), Alma Mater Studiorum, University of Bologna, Via Umberto Terracini 24-28, 40131 Bologna, Italy
- Health Sciences and Technologies-Interdepartmental Center for Industrial Research (CIRI-SDV), Alma Mater Studiorum, University of Bologna, 40136 Bologna, Italy
| | - Lorenzo Chiari
- Department of Electrical, Electronic and Information Engineering (DEI), Alma Mater Studiorum, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
- Health Sciences and Technologies-Interdepartmental Center for Industrial Research (CIRI-SDV), Alma Mater Studiorum, University of Bologna, 40136 Bologna, Italy
| | - Angelo Cappello
- Department of Electrical, Electronic and Information Engineering (DEI), Alma Mater Studiorum, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Luca De Marchi
- Department of Electrical, Electronic and Information Engineering (DEI), Alma Mater Studiorum, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Sabato Mellone
- Department of Electrical, Electronic and Information Engineering (DEI), Alma Mater Studiorum, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
- Health Sciences and Technologies-Interdepartmental Center for Industrial Research (CIRI-SDV), Alma Mater Studiorum, University of Bologna, 40136 Bologna, Italy
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24
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Reijnierse EM, Geelen SJG, van der Schaaf M, Visser B, Wüst RCI, Pijnappels M, Meskers CGM. Towards a core-set of mobility measures in ageing research: The need to define mobility and its constructs. BMC Geriatr 2023; 23:220. [PMID: 37024827 PMCID: PMC10080758 DOI: 10.1186/s12877-023-03859-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 02/28/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Mobility is a key determinant and outcome of healthy ageing but its definition, conceptual framework and underlying constructs within the physical domain may need clarification for data comparison and sharing in ageing research. This study aimed to (1) review definitions and conceptual frameworks of mobility, (2) explore agreement on the definition of mobility, conceptual frameworks, constructs and measures of mobility, and (3) define, classify and identify constructs. METHODS A three-step approach was adopted: a literature review and two rounds of expert questionnaires (n = 64, n = 31, respectively). Agreement on statements was assessed using a five-point Likert scale; the answer options 'strongly agree' or 'agree' were combined. The percentage of respondents was subsequently used to classify agreements for each statement as: strong (≥ 80%), moderate (≥ 70% and < 80%) and low (< 70%). RESULTS A variety of definitions of mobility, conceptual frameworks and constructs were found in the literature and among respondents. Strong agreement was found on defining mobility as the ability to move, including the use of assistive devices. Multiple constructs and measures were identified, but low agreements and variability were found on definitions, classifications and identification of constructs. Strong agreements were found on defining physical capacity (what a person is maximally capable of, 'can do') and performance (what a person actually does in their daily life, 'do') as key constructs of mobility. CONCLUSION Agreements on definitions of mobility, physical capacity and performance were found, but constructs of mobility need to be further identified, defined and classified appropriately. Clear terminology and definitions are essential to facilitate communication and interpretation in operationalising the physical domain of mobility as a prerequisite for standardisation of mobility measures.
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Affiliation(s)
- Esmee M Reijnierse
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dokter Meurerlaan 8, Amsterdam, 1067 SM, The Netherlands
| | - Sven J G Geelen
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Marike van der Schaaf
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam Movement Sciences, Amsterdam University of Applied Sciences, Tafelbergweg 51, Amsterdam, 1105 BD, The Netherlands
| | - Bart Visser
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam Movement Sciences, Amsterdam University of Applied Sciences, Tafelbergweg 51, Amsterdam, 1105 BD, The Netherlands
| | - Rob C I Wüst
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Mirjam Pijnappels
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands.
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25
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Hodges M, Butler D, Spaulding A, Litzelman DK. The Role of Community Health Workers in the Health and Well-Being of Vulnerable Older Adults during the COVID Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2766. [PMID: 36833462 PMCID: PMC9957090 DOI: 10.3390/ijerph20042766] [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: 01/07/2023] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic disrupted social support networks as well as resource access for participants. The purpose of this study was to: analyze the experiences of older adults enrolled in a geriatric-focused community health worker (CHW) support program, to gain a better understanding of how CHWs might enhance care delivery, and to further understand how COVID-19 affected the social and emotional needs and well-being of older adults during the first 18 months of the pandemic. Qualitative analysis was performed on notes entered by CHWs based on 793 telephone encounters with 358 participants between March 2020 and August 2021. Analysis was performed by two reviewers independently coding the data. Weighing the benefits of seeing family against the risks of COVID exposure was a source of emotional distress for participants. Our qualitative analysis suggests that CHWs were effective in providing emotional support and connecting participants to resources. CHWs are capable of bolstering the support networks of older adults and carrying out some of the responsibilities conventionally fulfilled by family supports. CHWs addressed participant needs that are frequently unmet by healthcare team members and provided emotional support to participants contributing to health and well-being. CHW assistance can fill gaps in support left by the healthcare system and family support structures.
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Affiliation(s)
- Matthew Hodges
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202, USA
| | - Dawn Butler
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | | | - Debra K. Litzelman
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202, USA
- Indiana University Health Physicians, Indianapolis, IN 46204, USA
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26
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Kekäläinen T, Terracciano A, Tirkkonen A, Savikangas T, Hänninen T, Neely AS, Sipilä S, Kokko K. Does Personality Moderate the Efficacy of Physical and Cognitive Training Interventions? A 12-month Randomized Controlled Trial in Older Adults. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023; 202:111957. [PMID: 36776733 PMCID: PMC9912828 DOI: 10.1016/j.paid.2022.111957] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study investigated whether personality traits moderate the effects of a 12-month physical or combined physical and cognitive training interventions on physical and cognitive functioning. Participants were community-dwelling 70-85-year-old adults (n=314). They were randomly assigned to physical training (weekly supervised walking/balance and strength/balance training, home exercises 2-3x/wk and moderate aerobic activity) or to a physical and cognitive training group (the same physical training and computer training on executive functions 3-4x/wk). The outcomes assessed at baseline and post-intervention were physical (maximum gait speed, six-minute walking distance, dual-task cost on gait speed) and cognitive functioning (Stroop, Trail-Making Test-B, verbal fluency, CERAD total score). Personality traits (NEO-PI-3, n=239) were assessed post-intervention. Personality traits did not moderate intervention effects on physical functioning. Higher openness was associated with greater improvement in CERAD scores, especially in the physical and cognitive training group (group×time×trait B=-.08, p=.038). Lower neuroticism (time×trait B=-.04, p=.021) and higher conscientiousness (time×trait B=.04, p=.027) were associated with greater improvement in CERAD scores in both groups. Personality traits had mostly null moderating effects across physical and cognitive outcomes, with the possible exception of CERAD score. Individuals with more adaptive personality traits gained more on global cognitive scores during a 12-month training intervention.
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Affiliation(s)
- Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Anna Tirkkonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Tiina Savikangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Tuomo Hänninen
- NeuroCenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Anna Stigsdotter Neely
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden,Engineering Psychology, Luleå University of Technology, Luleå, Sweden
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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27
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Li H, Ding Y, Zhao B, Xu Y, Wei W. Effects of immersion in a simulated natural environment on stress reduction and emotional arousal: A systematic review and meta-analysis. Front Psychol 2023; 13:1058177. [PMID: 36698558 PMCID: PMC9869155 DOI: 10.3389/fpsyg.2022.1058177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Background Although the mental health benefits of exposure to simulated natural environments are well established by researchers from environmental psychology, landscape architecture, and public health, it is unclear whether and to what extent technological immersion affects these benefits. Methods Systematical literature searches were conducted in May 2022 from six databases. The risk of bias was evaluated using the Cochrane's Risk of Bias tool 2.0 and the Risk of Bias in Non-randomized Studies of Interventions tool. We performed a random-effects meta-regression to investigate the heterogeneity. The immersion levels of included studies were classified by projection devices and motion capture, and then subgroup analysis was conducted. Results Twenty-six publications were included. Exposure to simulated nature was confirmed to be associated with increased positive affect 0.40 [95% confidence interval (CI): 0.22, 0.58], vigor 0.58 (95% CI: 0.30, 0.86), calmness 0.54 (95% CI: 0.17, 0.92) and decreased perceived stress -0.38 (95% CI: -0.71, -0.06), total mood disturbance -0.87 (95% CI: -1.17, -0.57), tension -0.70 (95% CI: -0.99, -0.41), fatigue -0.60 (95% CI: -0.91, -0.28), anxiety -0.72 (95% CI: -1.43, -0.02), depression -0.33 (95% CI: -0.52, -0.14), confusion -0.79 (95% CI: -1.19, -0.40), and anger -0.54 (95% CI: -0.76, -0.31). Gender, health status, study design, mean age, and single exposure duration were not significant when entered in a meta-regression. For positive affect, medium immersion was observed to produce a larger effect than low and high immersion. All included studies had a moderate to high risk of bias. Conclusion Audio-visual exposure to simulated nature contributes to stress relief and emotional arousal. The immersion level explains the heterogeneity of positive affect triggered by simulated nature. Focusing on the technical features will open up new possibilities for combining actual and simulated nature's mental health benefits.
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Affiliation(s)
- Hongyi Li
- The College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Yujun Ding
- The College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Bing Zhao
- The College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Yuhang Xu
- The College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Wei Wei
- The College of Environmental Science, Nanjing Xiaozhuang University, Nanjing, China,*Correspondence: Wei Wei, ✉
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Factors Influencing Mobility During the COVID-19 Pandemic in Community-Dwelling Older Adults. Arch Phys Med Rehabil 2023; 104:34-42. [PMID: 36055379 PMCID: PMC9424116 DOI: 10.1016/j.apmr.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/22/2022] [Accepted: 08/17/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To describe and identify factors influencing mobility among older adults during the first 5 months of the COVID-19 pandemic. DESIGN A cross-sectional telesurvey. SETTING Community dwelling older adults, situated within the first 5 months of the COVID-19 pandemic, in Hamilton, Canada. PARTICIPANTS A random sample of 2343 older adults were approached to be in the study, of which 247 completed the survey (N=247). Eligible participants were aged ≥65 years. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Mobility was measured using global rating of change items and the Late Life Function Instrument (LLFI). Multivariate linear regression models were used to examine the association between mobility and related factors based on Webber's model. RESULTS 247 older adults (29% male, mean age 78±7.3 years) completed surveys between May and August 2020. Respectively, 26%, 10%, and 9%, rated their ability to engage in physical activity, housework, and move around their home as worse compared with the start of the pandemic. The mean LLFI score was 60.9±13.4. In the model, walking volume (β=0.03 95% confidence interval 0.013, 0.047), fall history (β=-0.04, 95% confidence interval -0.08, -0.04), male sex (β=0.06, 95% confidence interval 0.02, 0.09), unpleasant neighborhood (β=-0.06, 95% confidence interval -0.11, -0.02), musculoskeletal pain (β=-0.07, 95% confidence interval -0.11, -0.03), and self-reported health (β=0.08, 95% confidence interval 0.03, 0.13) had the strongest associations with LLFI scores and explained 64% of the variance in the LLFI score. CONCLUSIONS Physical and environmental factors may help explain poorer mobility during lockdowns. Future research should examine these associations longitudinally to see if factors remain consistent over time and could be targeted for rehabilitation.
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29
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Choi NG, Choi BY, Marti CN. Changes in Older Adults' Frequency of Going Outside between 2020 and 2021: Associations with Health Status and Environmental Factors. Clin Gerontol 2023; 46:745-758. [PMID: 36760067 PMCID: PMC10409875 DOI: 10.1080/07317115.2023.2177573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVES To examine the changes in the frequency of going outside among U.S. older adults between 2020 and 2021 (post-COVID vaccine) and correlates of those changes. METHODS We used the 2019-2021 National Health and Aging Trend Study (NHATS) (N = 3,063, age 70+) and multinomial logistic regression to analyze associations of increased and decreased frequencies in going outside with physical, psychosocial, and cognitive health, environmental (COVID concerns and transportation) factors, and social media use as the independent variables. RESULTS In 2021 compared to 2020, 13% and 16% of those age 70+ reported increased and decreased frequencies, respectively. Increased frequency was associated with social media use. Decreased frequency was associated with poor physical health, depression/anxiety, and perceived memory decline. COVID concerns and transportation problems, as well as female gender, age 90+, and being non-Hispanic Black, were also significant correlates of decreased frequency. CONCLUSIONS Most U.S. adults age 70+ appear to have resumed their 2019 level of frequency of going outside in 2021 after the COVID vaccines became available; however, 16% reported decreased frequency of going outside in 2021 compared to 2020. CLINICAL IMPLICATIONS Older adults with physical, mental, and cognitive health challenges need help to increase their frequency of going outside.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin
| | - Bryan Y. Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and Bayhealth Medical Center
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin
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30
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DiGuiseppi CG, Hyde HA, Betz ME, Scott KA, Eby DW, Hill LL, Jones VC, Mielenz TJ, Molnar LJ, Strogatz D, Li G. Association of falls and fear of falling with objectively-measured driving habits among older drivers: LongROAD study. JOURNAL OF SAFETY RESEARCH 2022; 83:96-104. [PMID: 36481041 PMCID: PMC10115437 DOI: 10.1016/j.jsr.2022.08.007] [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: 08/10/2021] [Revised: 02/28/2022] [Accepted: 08/09/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Falls in older adults are associated with increased motor vehicle crash risk, possibly mediated by driving behavior. We examined the relationship of falls and fear of falling (FOF) with subsequent objectively measured driving habits. METHODS This multi-site, prospective cohort study enrolled 2990 active drivers aged 65-79 (53% female). At enrollment, we assessed falls in the past year and FOF (Short Falls Efficacy Scale-International). Driving outcomes included exposure, avoidance of difficult conditions, and unsafe driving during one-year follow-up, using in-vehicle Global Positioning System devices. RESULTS Past-year falls were associated with more hard braking events (HBE). High FOF was associated with driving fewer days, miles, and trips, driving nearer home and more HBE. Differences were attenuated and not significant after accounting for health, function, medications and sociodemographics. DISCUSSION Differences in objectively measured driving habits according to past-year fall history and FOF were largely accounted for by differences in health and medications. Rather than directly affecting driving, falls and FOF may serve as markers for crash risk and reduced community mobility due to age-related changes and poor health.
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Affiliation(s)
- Carolyn G DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Hailey A Hyde
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marian E Betz
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kenneth A Scott
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David W Eby
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA; Center for Advancing Transportation Leadership and Safety (ATLAS Center), University of Michigan, Ann Arbor, MI, USA
| | - Linda L Hill
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Vanya C Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thelma J Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia's Injury Control Research Center, Columbia University, New York, NY, USA
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA; Center for Advancing Transportation Leadership and Safety (ATLAS Center), University of Michigan, Ann Arbor, MI, USA
| | - David Strogatz
- Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY, USA
| | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia's Injury Control Research Center, Columbia University, New York, NY, USA; Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Patil DS, Bailey A, Yadav UN, George S, Helbich M, Ettema D, Ashok L. Contextual factors influencing the urban mobility infrastructure interventions and policies for older adults in low- and middle-income countries: a realist review. BMC Public Health 2022; 22:1489. [PMID: 35927657 PMCID: PMC9354419 DOI: 10.1186/s12889-022-13875-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 07/25/2022] [Indexed: 12/03/2022] Open
Abstract
Transportation is among the key aspects that influence active ageing. This realist review intends to understand the mechanisms of urban mobility infrastructure interventions and policies in low- and middle-income countries for older adults and to identify factors, which influenced the success or failure of interventions. We followed the steps suggested by Pawson and colleagues for a realist review. Electronic databases were searched from inception until August 2020. Studies were screened based on titles, abstracts and full text. The quality of included studies was assessed based on rigour and relevance. The evidence was obtained from 36 articles with diverse study designs conducted in 36 low- and middle-income countries. Findings were validated through stakeholder consultations from three low- and middle-income countries. Of the various individual factors identified, behaviour change communication interventions were low-cost, had a long-term impact and were efficient in increasing awareness among users to improve safety, social inclusion and about transport schemes for older adults. Improved transport infrastructure resulted in a shift from private to public transportation. For a sustainable urban transport infrastructure, good governance and involvement of stakeholders for planning and implementing transport interventions were considered necessary. Lack of evaluation, experience of transport planners, and inter-sectoral coordination were key challenges to successful interventions. The review highlighted a lack of older adult-specific transportation policies, and gender-targeted interventions for older women, suggesting a need for interventions and policies based on the contextual factors existing in a region.
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Affiliation(s)
- Divya Sussana Patil
- Transdisciplinary Centre for Qualitative Methods, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.
| | - Ajay Bailey
- Transdisciplinary Centre for Qualitative Methods, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.,Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Sobin George
- Centre for Study of Social Change and Development, Institute for Social and Economic Change, Bengaluru, Karnataka, India
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - Dick Ettema
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - Lena Ashok
- MSW Program, Department of Global Health, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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The potential of assessment based on the WHO framework of intrinsic capacity in fragility fracture prevention. Aging Clin Exp Res 2022; 34:2635-2643. [PMID: 35829991 DOI: 10.1007/s40520-022-02186-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/14/2022] [Indexed: 11/01/2022]
Abstract
The risk of falls associated with population ageing and the burden of chronic diseases increase the risk of fragility fractures. Globally, a large increase in the numbers of people sustaining fragility fractures is predicted. The management of highly vulnerable older persons who present and/or are at risk of fragility fractures is challenging given their clinical complexity and the fragmentation of the healthcare services. Fragility fractures frequently result in reduced functional ability and quality of life. Therefore, it is essential to implement person-centered models of care to address the individual's priorities and needs. In this context, the multidimensional construct of intrinsic capacity, composed of the critical functions on which the individual's functional ability rely, becomes of particular interest.In this article, the potential of current models to meet the global challenge is considered, particularly where healthcare systems are less integrated and poorly structured. It then describes how assessment of intrinsic capacity might provide the clinician with a holistic picture of an older individual's reserves before and after a fragility fracture and the implications of implementing this approach based on the construct of intrinsic capacity in healthcare systems, in both well-developed and low-resourced settings. It suggests that optimization of intrinsic capacity and functional ability is a credible conceptual model and might support a generally feasible approach to primary and secondary fracture prevention in older people.
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Twardzik E, Colabianchi N, Duncan L, Lisabeth LD, Brown SH, Clarke PJ. "Well in in this neighborhood I have walked, not at all": Stroke survivors lived experience in the outdoor environment. Soc Sci Med 2022; 305:115107. [PMID: 35690031 PMCID: PMC9310555 DOI: 10.1016/j.socscimed.2022.115107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 04/05/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
Stroke survivors face unique challenges in the outdoor environment when returning to their home community following a stroke. Challenges include navigating uneven terrain, social stigma, and adapting to changes in functioning. Outdoor environments may serve as potential points of intervention to promote independence and participation post stroke. This study aimed to understand lived post-stroke experience in the outdoor environment as it pertains to independent mobility. METHODS Qualitative semi-structured interviews were conducted with 20 stroke survivors (8 males, 12 females; mean age 64.2 years: range 45 years-90 years). Participants were eligible if they were over the age of 45, could communicate in English, lived outside a nursing home, able to walk safely outdoors, were a minimum of six-months post stroke, and had no severe cognitive impairment. Interviews with participants were tape recorded, audio files were transcribed verbatim, codes were created and applied to transcripts, and themes were generated using interpretative phenomenological analysis. RESULTS Post-stroke experiences in the outdoor environment were multidimensional. Three themes emerged from the stroke survivors' description of personal experiences in the outdoor environment. These themes included feelings of vigilance, employing adaptation strategies, and management of dynamic relations between the self and context. DISCUSSION The findings highlight the post-stroke experience traversing the outdoor environment. Investing in the public outdoor environment to remove barriers and install facilitators could reduce feelings of apprehension and hypervigilance while walking in the outdoor environment. Future research is needed to evaluate the role of environmental interventions on hypervigilance in the outdoor environment post stroke.
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Affiliation(s)
- Erica Twardzik
- School of Kinesiology, University of Michigan, 830 N University Ave, Ann Arbor, MI, 48109, USA; Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, Ann Arbor, MI, USA.
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, 830 N University Ave, Ann Arbor, MI, 48109, USA; Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104-1248, USA
| | - Lilia Duncan
- School of Kinesiology, University of Michigan, 830 N University Ave, Ann Arbor, MI, 48109, USA
| | - Lynda D Lisabeth
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, Ann Arbor, MI, USA
| | - Susan H Brown
- School of Kinesiology, University of Michigan, 830 N University Ave, Ann Arbor, MI, 48109, USA
| | - Philippa J Clarke
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104-1248, USA
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Rodrigues P, Trajano GS, Stewart IB, Minett GM. Potential role of passively increased muscle temperature on contractile function. Eur J Appl Physiol 2022; 122:2153-2162. [PMID: 35771296 PMCID: PMC9463203 DOI: 10.1007/s00421-022-04991-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Declines in muscle force, power, and contractile function can be observed in older adults, clinical populations, inactive individuals, and injured athletes. Passive heating exposure (e.g., hot baths, sauna, or heated garments) has been used for health purposes, including skeletal muscle treatment. An acute increase in muscle temperature by passive heating can increase the voluntary rate of force development and electrically evoked contraction properties (i.e., time to peak twitch torque, half-relation time, and electromechanical delay). The improvements in the rate of force development and evoked contraction assessments with increased muscle temperature after passive heating reveal peripheral mechanisms’ potential role in enhancing muscle contraction. This review aimed to summarise, discuss, and highlight the potential role of an acute passive heating stimulus on skeletal muscle cells to improve contractile function. These mechanisms include increased calcium kinetics (release/reuptake), calcium sensitivity, and increased intramuscular fluid.
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Affiliation(s)
- Patrick Rodrigues
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, A Wing O Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia.
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, A Wing O Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Ian B Stewart
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, A Wing O Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Geoffrey M Minett
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, A Wing O Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
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Wermelinger Ávila MP, Corrêa JC, Zaidem MCDCF, Passos MV, Sena Lomba Vasconcelos AP, Lucchetti ALG, Lucchetti G. Resilience and Mental Health Among Regularly and Intermittently Active Older Adults: Results From a Four-Year Longitudinal Study. J Appl Gerontol 2022; 41:1924-1933. [PMID: 35543168 DOI: 10.1177/07334648221095075] [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: 11/16/2022] Open
Abstract
BACKGROUND This study aims to investigate whether regularly active individuals have different levels of mental health and resilience compared to intermittently active individuals. METHODS In this 4-year longitudinal study, 180 older people were included. General linear models were used to assess the level of physical activity, psychological resilience, and mental health among regularly and intermittently active older adults. RESULTS Those who maintained regular physical activity were more resilient than those who did not. However, no differences were observed for mental health outcomes. Although those with higher levels of resilience had fewer mental health problems, there were no significant differences between the groups based on their level of physical activity. CONCLUSION Differences in resilience levels favoring regularly active individuals were found. In both groups, resilience was inversely associated with mental health problems. These findings may help elucidate the underlying mechanisms in the relationship between physical activity and health outcomes.
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Affiliation(s)
| | - Jimilly Caputo Corrêa
- Division of Geriatric Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
| | | | - Matheus Venancio Passos
- Division of Geriatric Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
| | | | | | - Giancarlo Lucchetti
- Division of Geriatric Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
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Liu CK. Mobility and What Matters: Moving Kidney Care Toward the 4Ms of an Age-Friendly Health System. Kidney Med 2022; 4:100481. [PMID: 35620084 PMCID: PMC9127682 DOI: 10.1016/j.xkme.2022.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Christine Kee Liu
- Section of Geriatrics, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA
- Geriatric Research and Education Clinical Center, Veteran Affairs Palo Alto Health Care System, Palo Alto, California
- Address for Correspondence: Christine Kee Liu, MD, MS, Geriatric Research and Education Clinical Center, Veteran Affairs Palo Alto Health Care System, 3801 Miranda Ave, Building 4, Mail Code 182-B, Palo Alto, CA 94304.
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Dose-Response Relationship Between Life-Space Mobility and Mortality in Older Japanese Adults: A Prospective Cohort Study. J Am Med Dir Assoc 2022; 23:1869.e7-1869.e18. [DOI: 10.1016/j.jamda.2022.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/04/2022] [Accepted: 04/25/2022] [Indexed: 12/11/2022]
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Kontto J, Paalanen L, Sund R, Sainio P, Koskinen S, Demakakos P, Tolonen H, Härkänen T. Using multiple imputation and intervention-based scenarios to project the mobility of older adults. BMC Geriatr 2022; 22:311. [PMID: 35397525 PMCID: PMC8994920 DOI: 10.1186/s12877-022-03008-4] [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: 09/21/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Projections of the development of mobility limitations of older adults are needed for evidence-based policy making. The aim of this study was to generate projections of mobility limitations among older people in the United States, England, and Finland.
Methods
We applied multiple imputation modelling with bootstrapping to generate projections of stair climbing and walking limitations until 2026. A physical activity intervention producing a beneficial effect on self-reported activities of daily living measures was identified in a comprehensive literature search and incorporated in the scenarios used in the projections. We utilised the harmonised longitudinal survey data from the Ageing Trajectories of Health – Longitudinal Opportunities and Synergies (ATHLOS) project (N = 24,982).
Results
Based on the scenarios from 2012 to 2026, the prevalence of walking limitations will decrease from 9.4 to 6.4%. A physical activity intervention would decrease the prevalence of stair climbing limitations compared with no intervention from 28.9 to 18.9% between 2012 and 2026.
Conclusions
A physical activity intervention implemented on older population seems to have a positive effect on maintaining mobility in the future. Our method provides an interesting option for generating projections by incorporating intervention-based scenarios.
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Liu CK, Seo J, Lee D, Wright K, Kurella Tamura M, Moye J, Weiner DE, Bean JF. The Impact of Care Partners on the Mobility of Older Adults Receiving Hemodialysis. Kidney Med 2022; 4:100473. [PMID: 35663231 PMCID: PMC9157255 DOI: 10.1016/j.xkme.2022.100473] [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] [Indexed: 11/05/2022] Open
Abstract
Rationale & Objective Many older adults receiving hemodialysis have mobility limitations and rely on care partners, yet data are sparse regarding the support provided by care partners. Our aim was to examine how care partners support the mobility of an older adult receiving hemodialysis. Study Design Qualitative study. Setting & Participants Using purposive sampling, we recruited persons aged 60 years or more receiving maintenance hemodialysis and care partners aged 18 years or more who were providing support to an older adult receiving hemodialysis. We conducted in-person semi-structured interviews about mobility with each individual. Analytical Approach We conducted descriptive and focused coding of interview transcripts and employed thematic analysis. Our outcome was to describe perceived mobility supports provided by care partners using qualitative themes. Results We enrolled 31 older adults receiving hemodialysis (42% women, 68% Black) with a mean age of 73 ± 8 years and a mean dialysis duration of 4.6 ± 3.5 years. Of these, 87% of patients used assistive devices and 90% had care partners. We enrolled 12 care partners (75% women, 33% Black) with a mean age of 54 ± 16 years. From our patient and care partner interviews, we found three themes: (1) what care partners see, (2) what care partners do, and (3) what care partners feel. Regarding what they see, care partners witness a decline in patient mobility. Regarding what they do, care partners guide and facilitate activities and manage others who also assist. Regarding what they feel, care partners respect the patient’s autonomy but experience frustration and worry about the patient’s future mobility. Limitations Modest sample size; single geographic area. Conclusions In older adults receiving hemodialysis, care partners observe a decline in mobility and provide support for mobility. They respect the patient’s autonomy but worry about future mobility losses. Future research should incorporate care partners in interventions that address mobility in older adults receiving hemodialysis.
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Esfandiari E, Miller WC, Berardi A, King S, Ashe MC. Telehealth interventions for mobility after lower limb loss: A systematic review and meta-analysis of randomized controlled trials. Prosthet Orthot Int 2022; 46:108-120. [PMID: 35412520 DOI: 10.1097/pxr.0000000000000075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/15/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mobility is a crucial component for healthy aging after lower limb loss (LLL). Telehealth technologies, for example, smart devices, are novel approaches for health programs delivery regardless of geographical boundaries. OBJECTIVES To assess the effect of telehealth interventions on mobility, quality of life, and antecedents of health behavior compared with a control condition (usual care or simpler telehealth interventions with fewer number of behavior change techniques [BCTs]) for community-dwelling adults (>50 years) with an LLL and the effect of mode of delivery and BCTs used in telehealth interventions on health outcomes. STUDY DESIGN Systematic review and meta-analysis. METHODS We systematically searched MEDLINE, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane, PsycINFO, and SPORTDiscus on January 28, 2021, to identify relevant randomized controlled trials. Two authors independently screened records and assessed risk of bias. We conducted a narrative synthesis of evidence and, when appropriate, used the standardized mean difference (SMD) and mean difference for meta-analyses and the Grading Recommendations Assessment, Development, and Evaluation approach for practice recommendations. RESULTS We identified six randomized controlled trials. Telephone was the most common delivery mode (n = 3), and "instructions for performing behaviors" was the most common BCT (n = 5). Very low certainty evidence showed no changes in mobility (six studies: SMD = 0.33 [95% confidence interval [CI] = -0.08, 0.75]), quality of life (two studies: mean difference = -0.08 [95% CI = -0.30, 0.15]), and antecedents of behavior (five studies: SMD = 0.04 [95% CI = -0.28, 0.36]). CONCLUSIONS Our review highlights a knowledge gap for the effect of telehealth interventions for people with LLL. Although no promising effect was shown for telehealth interventions, very low certainty evidence precludes making a definitive clinical recommendation.
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Affiliation(s)
- Elham Esfandiari
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
| | - William C Miller
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Anna Berardi
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Sheena King
- GF Strong Rehabilitation Centre, Physiotherapist, Clinical Specialist-Amputee, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Maureen C Ashe
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada Vancouver, BC, Canada
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
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Martinez-Amezcua P, Dooley EE, Reed NS, Powell D, Hornikel B, Golub JS, Pettee Gabriel K, Palta P. Association of Hearing Impairment and 24-Hour Total Movement Activity in a Representative Sample of US Adults. JAMA Netw Open 2022; 5:e222983. [PMID: 35302630 PMCID: PMC8933734 DOI: 10.1001/jamanetworkopen.2022.2983] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Lower physical activity (PA) levels have been proposed as a mechanism to explain the association between hearing loss and various adverse outcomes of aging. But whether hearing loss is associated with lower PA is poorly understood. OBJECTIVE To evaluate whether hearing loss is associated with lower levels of PA. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis was conducted in a representative sample of US adults (aged 30-69 years) who participated in the 2011-2012 cycle of the National Health and Nutrition Examination Survey (NHANES). Data analysis was conducted from July to September 2021. EXPOSURES Hearing was assessed, in dB, by pure-tone audiometry and summarized as the better hearing ear's pure-tone average (BPTA) of 4 speech frequencies (500, 1000, 2000, and 4000 kHz); a higher BTPA indicates worse hearing. Hearing was also categorized into normal (BPTA ≤25 dB), mild hearing impairment (>25 to 40 dB), and moderate or greater hearing impairment (>40 dB). MAIN OUTCOMES AND MEASURES Total 24-hour movement activity was measured using wrist accelerometers worn at all times for 7 consecutive days and summarized in monitor-independent movement summary units (MIMS) units (higher MIMS units indicate more movement). The association between BPTA and MIMS units was evaluated using a multivariable-adjusted (demographic characteristics and chronic conditions) piecewise spline regression (knot at 15 dB). Mean differences in MIMS units across hearing categories compared with normal hearing were estimated. RESULTS The study included 2490 participants (mean [SE] age, 48.9 [0.3] years; 900 [weighted percentage, 69.3%] White individuals, 1248 [weighted percentage, 50.8%] female participants). Before the knot at 15 dB, we found that each 10-dB higher BPTA was associated with 860.4 (95% CI, 444.8-1276.1) higher MIMS units. Conversely, after the knot, each 10-dB higher BPTA was associated with 458.6 (95% CI, 27.7-889.4) lower MIMS units. The difference in MIMS units across hearing categories was not statistically significant. CONCLUSIONS AND RELEVANCE In this cross-sectional study, in the range of hearing sensitivity of BPTA of 15 dB or greater, worse hearing was associated with lower MIMS units. Lower PA may be a mechanism contributing to the association between hearing impairment and adverse health.
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Affiliation(s)
- Pablo Martinez-Amezcua
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Erin E. Dooley
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Nicholas S. Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
| | - Danielle Powell
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Bjoern Hornikel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Justin S. Golub
- Department of Otolaryngology–Head & Neck Surgery, Columbia University Irving Medical Center, New York, New York
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
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Jayasinghe N, Backus S, Gibbons M, Sobel J, Spielman L, Ganz SB, Moallem BI, Ojie MJ, Kakoullis M, Hillstrom H. Brief training of gait and posture using a wearable sensory feedback device with older adults who have fears of falling: A feasibility study. HEALTH AND TECHNOLOGY 2022. [DOI: 10.1007/s12553-021-00623-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chen B, Zhao X, Ding Z, Li Y, Wan M, He Q, Liu X. Why do older drivers self-regulate: Psychological factors influencing self-regulation in a Chinese sample. JOURNAL OF SAFETY RESEARCH 2022; 80:330-340. [PMID: 35249613 DOI: 10.1016/j.jsr.2021.12.008] [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: 02/05/2021] [Revised: 06/28/2021] [Accepted: 12/11/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION As China has recently lifted the age limit for getting access to driving licenses, older drivers' safety issues have received wide attention. Driving self-regulation can be regarded as an adjustment strategy for older adults to reduce risks and extend driving lives. Studies abroad mainly stress the three levels and influencing factors of driving self-regulation. China has a long history with a unique cultural background and social reality and relevant research are still in the initial stage. METHOD This study applied the extended Theory of Planned Behavior (TPB) to explore the psychological factors that affected self-regulation of older drivers. 317 participants mainly from Beijing urban area completed the questionnaires including demographic information and extend TPB items. RESULTS Bivariate correlation analysis showed that self-regulation was negatively correlated with the amount of driving experience (days per week and mileages per month) in a significant way. And so was the number of family-owned motor vehicles. Exploratory factor analysis indicated that the extended TPB questionnaire was reliable and effective for measuring self-regulation. The proposed Structural Equation Model (SEM) explained 73.673% of the variance in self-regulation intention. Attitude (0.50) had the strongest influence among all variables on intention. Subjective norms (0.28), perceived behavior control (0.27), and alternative traffic quality (0.20) significantly influenced intention. Intention (0.34) and physical condition (0.22) imposed significant effect on self-regulation behavior. Practical applications: Feasible suggestions were put forward that contribute to self-regulate reasonably. This study helps to better understand the nature of self-regulation behaviors and provides a theoretical basis for formulating scientific intervention measures. On the transportation side, people from all communities of society should care for and support older drivers.
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Affiliation(s)
- Bingshuo Chen
- Beijing Key Laboratory of Traffic Engineering, College of Metropolitan Transportation, Beijing University of Technology, PR China.
| | - Xiaohua Zhao
- Beijing Key Laboratory of Traffic Engineering, College of Metropolitan Transportation, Beijing University of Technology, PR China.
| | - Zhen Ding
- Beijing Traffic Management Bureau, PR China.
| | - Yang Li
- Department of Road Traffic Management, Beijing Police College, PR China.
| | - Meina Wan
- Department of Road Traffic Management, Beijing Police College, PR China.
| | - Qing He
- Department of Road Traffic Management, Beijing Police College, PR China.
| | - Xiaoming Liu
- Beijing Key Laboratory of Traffic Engineering, College of Metropolitan Transportation, Beijing University of Technology, PR China.
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Narsakka N, Suhonen R, Stolt M. Environment in institutional care settings as a promoting factor for older individuals' mobility: A systematic review. Scand J Caring Sci 2021; 36:382-392. [PMID: 34893995 PMCID: PMC9300114 DOI: 10.1111/scs.13053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
Background Mobility is important for health and well‐being; however, older individuals in institutional care settings are relatively sedentary. The environment has an increased influence on mobility in older age due to changes in individual functioning; thus, environmental mobility support solutions for this population are needed. Objectives The aim of this systematic review was to identify elements of the environment that have been used in the content and delivery of interventions to promote mobility and to assess the effects of these interventions on mobility outcomes. Design A systematic literature search was conducted using CINAHL and MEDLINE from the earliest date through 30 September 2020 for randomised controlled trials, quasi‐experimental and pre‐post design studies. Inclusion and critical appraisal of articles were conducted by two independent researchers. Data were extracted and synthesised. Setting and participants Studies were included if they had employed some element of the environment in the content and/or delivery of the intervention and had assessed mobility‐related outcomes of older individuals in institutional long‐term care settings providing full‐time care. Measures Studies were included if they reported data on mobility‐related outcomes including aspects of physical activity, physical function, life space and functional autonomy. Results Eight studies were included. Physical, social and symbolic elements of the environment were utilised in the interventions. Positive effects on mobility outcomes were reported in exercise interventions utilising environmental elements mostly as supportive components. Conclusions and implications Empirical evidence about effective mobility interventions employing elements of the environment as main intervention components is lacking. A serious dilemma exists about the need for older individuals’ independence and mobile/active late life and the lack of support for such initiatives in long‐term care. Given the emphasised relationship of the environment and mobility with age due to changes in functioning, environmental solutions require further examination.
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Affiliation(s)
- Noora Narsakka
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital and City of Turku Welfare Division, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
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Moving around a Large City in Latin America: The Mobility Challenges Faced by Older Adults with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412984. [PMID: 34948594 PMCID: PMC8700889 DOI: 10.3390/ijerph182412984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022]
Abstract
A growing body of research has shown that barriers in the urban environment can be disabling by reducing the ability of older people to manage independently in the community, but also because they can negatively affect health by limiting the possibilities to move outside the home. In this study, we ask how obstacles in the urban environment are associated with the need for help to go to places in the community. To respond to this question, we used the Annual Household Survey of the City of Buenos Aires, Argentina 2018, which had a specific questionnaire for people with disabilities. From this sample, we selected adults aged 65 years or older with difficulties in at least one of six domains: vision; hearing; upper and lower body mobility; cognition; self-care; and communication. The final sample consisted of 513 persons (weighted = 109,316). First, we conducted a principal component analysis identifying three factors from variables of obstacles to access and use the urban environment: transportation; outdoor spaces; and information. Second, through a logistic regression model, we observed a direct relationship between these factors and the need for help to move in the community, controlling for sociodemographic characteristics, health status, and number of disabilities. This paper provides evidence on the significance of improving urban spaces to reduce dependent mobility. In Latin America, cities still face many challenges in becoming more age-friendly.
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Chan SHM, Qiu L, Esposito G, Mai KP, Tam KP, Cui J. Nature in virtual reality improves mood and reduces stress: evidence from young adults and senior citizens. VIRTUAL REALITY 2021; 27:1-16. [PMID: 34849087 PMCID: PMC8617374 DOI: 10.1007/s10055-021-00604-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
Large populations worldwide have been deprived from nature experiences due to mass quarantines and lockdowns during the COVID-19 pandemic, and face a looming mental health crisis. Virtual reality offers a safe and practical solution to increase nature exposure. This research examined the effects of virtual nature using a within-subject design with young adults (Study 1) and senior citizens (Study 2). Results from the young adult sample showed that walking in a virtual forest reduced negative affect due to enhanced nature connectedness, and reduced stress measured by heart rate. Consistently, the senior citizen sample reported improved positive affect due to enhanced nature connectedness after the virtual nature walk. Our findings unveil the underlying mechanism of how virtual nature may improve psychological well-being and demonstrated how virtual nature can be used as an intervention to promote mental health. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10055-021-00604-4.
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Affiliation(s)
- Sarah Hian May Chan
- Division of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
- Global Asia, Interdisciplinary Graduate School, Nanyang Technological University, Singapore, Singapore
| | - Lin Qiu
- Division of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Division of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Ky Phong Mai
- Division of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Kim-Pong Tam
- Division of Social Science, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Jian Cui
- Nanyang Technological University, Singapore, Singapore
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47
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Kyrönlahti SM, Nygård CH, K C P, Neupane S. Trajectories of low back pain from midlife to retirement and functional ability at old age. Eur J Public Health 2021; 32:497-503. [PMID: 34792114 PMCID: PMC9159306 DOI: 10.1093/eurpub/ckab191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study aimed to identify trajectories of low back pain (LBP) over a 16-year follow-up from midlife to retirement and investigate their association with mobility limitations and disability in activities of daily living (ADL-disability) in later life. METHODS The study population consisted of 6257 baseline (1981) respondents aged 44-58 years from Finnish Longitudinal study on Aging Municipal Employees. Repeated measurements of LBP were collected in 1985, 1992 and 1997. We studied persons who had data on LBP at baseline and in at least one of the follow-ups and had information on mobility limitations (n = 2305) and ADL-disability (n = 2359) at a 28-year follow-up in 2009. Latent class growth analysis was used to identify LBP trajectories. Odds ratios (ORs) with 95% confidence intervals (CIs) for the associations of LBP trajectory and later life mobility limitations and ADL-disability were estimated and adjusted for confounders. RESULTS Three LBP trajectories with parallel shapes were identified: high-decreasing (19%), intermediate-stable (60%) and low (21%). After adjustment for confounders, high-decreasing trajectory had 3.2 times the odds (95% CI 2.1-4.9) of mobility limitations and 2.9 times the odds (95% CI 2.0-4.2) of ADL-disability as compared to low trajectory. The respective ORs for intermediate-stable trajectory were 1.6 (95% CI 1.2-2.1) and 1.7 (95% CI 1.3-2.3). CONCLUSIONS Among majority of respondents, LBP remained stable over the follow-up. The respondents belonging to intermediate-stable and high-decreasing trajectories of LBP had higher odds of mobility limitations and ADL-disability at old age. This highlights that LBP during midlife to retirement has far-reached consequences on functional ability at old age.
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Affiliation(s)
- Saila M Kyrönlahti
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere University, Tampere, Finland
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere University, Tampere, Finland
| | - Prakash K C
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere University, Tampere, Finland.,Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Department of Psychology, Stress Research Institute, Stockholm University, Sweden
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere University, Tampere, Finland.,Tampere University Hospital, Tampere, Finland
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48
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Pinel S, Kelp NY, Bugeja JM, Bolsterlee B, Hug F, Dick TJM. Quantity versus quality: Age-related differences in muscle volume, intramuscular fat, and mechanical properties in the triceps surae. Exp Gerontol 2021; 156:111594. [PMID: 34673171 DOI: 10.1016/j.exger.2021.111594] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022]
Abstract
With aging comes reductions in the quality and size of skeletal muscle. These changes influence the force-generating capacity of skeletal muscle and contribute to movement deficits that accompany aging. Although declines in strength remain a significant barrier to mobility in older adults, the association between age-related changes in muscle structure and function remain unresolved. In this study, we compared age-related differences in (i) muscle volume and architecture, (ii) the quantity and distribution of intramuscular fat, and (iii) muscle shear modulus (an index of stiffness) in the triceps surae in 21 younger (24.6 ± 4.3 years) and 15 older (70.4 ± 2.4 years) healthy adults. Additionally, we explored the relationship between muscle volume, architecture, intramuscular fat and ankle plantar flexion strength in young and older adults. Magnetic resonance imaging was used to determine muscle volume and intramuscular fat content. B-mode ultrasound was used to quantify muscle architecture, shear-wave elastography was used to measure shear modulus, and ankle strength was measured during maximal isometric plantar flexion contractions. We found that older adults displayed higher levels of intramuscular fat yet similar muscle volumes in the medial (MG) and lateral gastrocnemius (LG) and soleus, compared to younger adults. These age-related higher levels of intramuscular fat were associated with lower muscle shear modulus in the LG and MG. We also found that muscle physiological cross-sectional area (PCSA) that accounted for age-associated differences in intramuscular fat showed a modest increase in its association with ankle strength compared to PCSA that did not account for fat content. This highlights that skeletal muscle fat infiltration plays a role in age-related strength deficits, but does not fully explain the age-related loss in muscle strength, suggesting that other factors play a more significant role.
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Affiliation(s)
- Sabrina Pinel
- The University of Queensland, School of Biomedical Sciences, Brisbane, Queensland, Australia; The University of Groningen, Faculty of Medicine, Groningen, The Netherlands
| | - Nicole Y Kelp
- The University of Queensland, School of Biomedical Sciences, Brisbane, Queensland, Australia
| | - Jessica M Bugeja
- The University of Queensland, School of Information Technology and Electrical Engineering, Brisbane, Queensland, Australia; Australian e-Health Research Centre, CSIRO Health and Biosecurity, Brisbane, Queensland, Australia
| | - Bart Bolsterlee
- Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia; University of New South Wales, Randwick, New South Wales, Australia; Queensland University of Technology, School of Mechanical, Medical and Process Engineering, Brisbane, Queensland, Australia
| | - François Hug
- The University of Queensland, School of Biomedical Sciences, Brisbane, Queensland, Australia; University of New South Wales, Graduate School of Biomedical Engineering, Randwick, New South Wales, Australia; Institut Universitaire de France (IUF), Paris, France; Université Côte d'Azur, LAMHESS, Nice, France
| | - Taylor J M Dick
- The University of Queensland, School of Biomedical Sciences, Brisbane, Queensland, Australia.
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Unsworth CA, Baker A, Morton-Kehle D, Darzins S. Survey of Occupational Therapy Driver Assessors' Rehabilitation Interventions With Older Drivers. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2021; 42:115-126. [PMID: 34643144 DOI: 10.1177/15394492211050634] [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: 11/16/2022]
Abstract
The rehabilitation strategies used by occupational therapy driver assessors with older drivers with age-related decline or health conditions are not well understood. The objective of the study was to describe driver rehabilitation interventions used by Australian driver assessors, identify factors that guide rehabilitation choices, and identify barriers and facilitators encountered. An online survey was emailed to 300 driver assessors. Descriptive statistics were used to summarize and to rank order participant responses. A total of 148 respondents selected from a combined total of 655 interventions. The four most common rehabilitation methods were (a) graded driving (18%, n = 118), (b) practicing specific maneuvers (17.7%, n = 116), (c) using a modified vehicle (16.9%, n = 111), and (d) graded driving in local areas only (15.1%, n = 99). The most common barrier limiting driver rehabilitation was cost (M = 2.92, SD = 1.24). The most frequently used driver rehabilitation method was on-road training. Practice can be enhanced by collating and evaluating resources, and ensuring effective interventions are more accessible.
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Affiliation(s)
- Carolyn Anne Unsworth
- Federation University Australia, Churchill, VIC, Australia.,Monash University, Clayton, VIC, Australia.,James Cook University, Townsville, QLD, Australia.,Jönköping University, Jönköping, Sweden
| | - Anne Baker
- Federation University Australia, Churchill, VIC, Australia
| | | | - Susan Darzins
- Australian Catholic University, Fitzroy, VIC, Australia
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Zajac JA, Cavanaugh JT, Baker T, Colón-Semenza C, DeAngelis TR, Duncan RP, Fulford D, LaValley M, Nordahl T, Rawson KS, Saint-Hilaire M, Thomas CA, Earhart GM, Ellis TD. Are Mobile Persons With Parkinson Disease Necessarily More Active? J Neurol Phys Ther 2021; 45:259-265. [PMID: 34091569 PMCID: PMC8460597 DOI: 10.1097/npt.0000000000000362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Walking activity in persons with Parkinson disease (PD) is important for preventing functional decline. The contribution of walking activity to home and community mobility in PD is poorly understood. METHODS Cross-sectional baseline data (N = 69) were analyzed from a randomized controlled PD trial. The Life-Space Assessment (LSA) quantified the extent, frequency, and independence across 5 expanding levels of home and community mobility, producing individual subscores and a total score. Two additional summed scores were used to represent mobility within (Levels 1-3) and beyond (Levels 4-5) neighborhood limits. An accelerometer measured walking activity for 7 days. Regression and correlation analyses evaluated relationships between daily steps and mobility scores. Mann-Whitney U tests secondarily compared differences in mobility scores between the active and sedentary groups. RESULTS Walking activity contributed significantly to the summed Level 1-3 score (β = 0.001, P = 0.004) but not to the summed Level 4-5 (β = 0.001, P = 0.33) or total (β = 0.002, P = 0.07) scores. Walking activity was significantly related to Level 1 (ρ = 0.336, P = 0.005), Level 2 (ρ = 0.307, P = 0.010), and Level 3 (ρ = 0.314, P = 0.009) subscores. Only the summed Level 1-3 score (P = 0.030) was significantly different between the active and sedentary groups. DISCUSSION AND CONCLUSIONS Persons with PD who demonstrated greater mobility beyond the neighborhood were not necessarily more active; walking activity contributed more so to home and neighborhood mobility. Compared with LSA total score, the Level 1-3 summed score may be a more useful participation-level measure for assessing the impact of changes in walking activity.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A349).
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Affiliation(s)
- Jenna A Zajac
- Departments of Physical Therapy and Athletic Training (J.A.Z., T.B., T.R.D., T.N., T.D.E) and Occupational Therapy (D.F.), Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts; Department of Physical Therapy (J.T.C.), University of New England, Portland, Maine; Department of Kinesiology (C.C.-S.), College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, Connecticut; Program in Physical Therapy (R.P.D., K.S.R., G.M.E), Department of Neuroscience (G.M.E), and Department of Neurology (R.P.D., G.M.E), Washington University in St Louis School of Medicine, St Louis, Missouri; School of Public Health (M.L.), Boston University, Boston, Massachusetts; and Department of Neurology (M.S.-H., C.A.T.), Parkinson's Disease and Movement Disorders Center, Boston University, Boston, Massachusetts
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