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Honda H, Ashizawa R, Take K, Hirase T, Arizono S, Yoshimoto Y. Effect of chronic pain on the occurrence of falls in older adults with disabilities: a prospective cohort study. Physiother Theory Pract 2024; 40:1206-1214. [PMID: 36335438 DOI: 10.1080/09593985.2022.2141597] [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: 07/31/2021] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The relationship between chronic pain and the occurrence of falls in healthy older adults has been clarified in previous studies, but its relationship in older adults with disabilities has not. OBJECTIVE This study aimed to determine whether chronic pain is related to the occurrence of falls in older adults with disabilities. METHODS The participants were 101 older adults above 65 years old who used long-term care insurance services in Japan. Of these, 30 were fallers and 71 were non-fallers. Chronic pain, defined as pain lasting more than three months, was assessed using questionnaires, and the falls' occurrence was followed up for six months using a fall calendar. Logistic regression analysis was used to analyze the data, with falls as the dependent variable, chronic pain as the independent variable, and age, sex, body mass index, number of drugs, sleep disorders, and depression as covariates. RESULTS After adjusting for covariates, chronic pain significantly influenced the occurrence of falls (odds ratio: 3.168, 95% confidence interval: 1.057-9.495, p = .04). CONCLUSION Chronic pain was related to the occurrence of falls in older adults with disabilities. There is a need to focus on chronic pain presence in falls' prevention among older adults with disabilities.
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Affiliation(s)
- Hiroya Honda
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Shizuoka, Japan
| | - Ryota Ashizawa
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Shizuoka, Japan
| | - Koki Take
- Visiting Nurse Station Sumiyoshi-daini, Shizuoka, Japan
| | - Tatsuya Hirase
- Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, Yokosuka-shi, Japan
| | - Shinichi Arizono
- School of Rehabilitation Science, Seirei Christopher University, Shizuoka, Japan
| | - Yoshinobu Yoshimoto
- School of Rehabilitation Science, Seirei Christopher University, Shizuoka, Japan
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Kim T, Yu X, Xiong S. A multifactorial fall risk assessment system for older people utilizing a low-cost, markerless Microsoft Kinect. ERGONOMICS 2024; 67:50-68. [PMID: 37079340 DOI: 10.1080/00140139.2023.2202845] [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: 11/10/2022] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
Falls among older people are a major health concern. This study aims to develop a multifactorial fall risk assessment system for older people using a low-cost, markerless Microsoft Kinect. A Kinect-based test battery was designed to comprehensively assess major fall risk factors. A follow-up experiment was conducted with 102 older participants to assess their fall risks. Participants were divided into high and low fall risk groups based on their prospective falls over a 6-month period. Results showed that the high fall risk group performed significantly worse on the Kinect-based test battery. The developed random forest classification model achieved an average classification accuracy of 84.7%. In addition, the individual's performance was computed as the percentile value of a normative database to visualise deficiencies and targets for intervention. These findings indicate that the developed system can not only screen out 'at risk' older individuals with good accuracy, but also identify potential fall risk factors for effective fall intervention.Practitioner summary: Falls are the leading cause of injuries in older people. We newly developed a multifactorial fall risk assessment system for older people utilising a low-cost, markerless Kinect. Results showed that the developed system can screen out 'at risk' individuals and identify potential risk factors for effective fall intervention.
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Affiliation(s)
- Taekyoung Kim
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
- KT R&D Center, Seoul, Republic of Korea
| | - Xiaoqun Yu
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
| | - Shuping Xiong
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
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3
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Wu X, Guo Q. Correspondence to comment on "Comparison of the relationship between cognitive function and future falls in Chinese community-dwelling older adults with and without diabetes mellitus". J Formos Med Assoc 2023; 122:1349-1350. [PMID: 37419752 DOI: 10.1016/j.jfma.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023] Open
Affiliation(s)
- Xinze Wu
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Qi Guo
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China.
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Melo RS, Cardeira CSF, Rezende DSA, Guimarães-do-Carmo VJ, Lemos A, de Moura-Filho AG. Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0291193. [PMID: 37683025 PMCID: PMC10490910 DOI: 10.1371/journal.pone.0291193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | | | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alberto Galvão de Moura-Filho
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Yang K, Yang S, Chen Y, Cao G, Xu R, Jia X, Hou L, Li J, Bi C, Wang X. Multimorbidity Patterns and Associations with Gait, Balance and Lower Extremity Muscle Function in the Elderly: A Cross-Sectional Study in Northwest China. Int J Gen Med 2023; 16:3179-3192. [PMID: 37533839 PMCID: PMC10392815 DOI: 10.2147/ijgm.s418015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose Fall is a common geriatric syndrome leading to various adverse outcomes in the elderly. Gait and balance disorders and decreased lower extremity muscle function are the major intrinsic risk factors of falls, and studies suggested that they were closely related to the underlying chronic conditions. This study aimed to explore the patterns of multimorbidity and determine the associations of these multimorbidity patterns with gait, balance and lower extremity muscle function. Patients and Methods A cross-sectional survey of 4803 participants aged ≥60 years in Shaanxi Province, China was conducted and the self-reported chronic conditions were investigated. The 6-m walk test, timed-up-and-go test (TUG) and 5-sit-to-stand test (5-STS) were conducted to evaluate gait, balance, and lower extremity muscle function respectively. Latent class analysis was used to explore patterns of multimorbidity, and multivariate regression analysis was used to determine the associations of multimorbidity patterns with gait, balance, and lower extremity muscle function. Results Five multimorbidity patterns were identified: Degenerative Disease Class, Cardio-metabolic Class, Stroke-Respiratory-Depression Class, Gastrointestinal Class, and Very sick Class, and they were differently associated with gait and balance disorders and decreased lower extremity muscle function. In particular, the multimorbidity patterns of Degenerative Disease Class and Stroke-Respiratory-Depression Class were closely associated with all the three risk factors of falls. Conclusion There are significant differences in the impact of different multimorbidity patterns on the major intrinsic risk factors of falls in the elderly population, and appropriate multimorbidity patterns are closely related to the prediction of falls and can help to develop fall prevention strategies in the elderly.
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Affiliation(s)
- Kaikai Yang
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Shanru Yang
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Yang Chen
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Guihua Cao
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Rong Xu
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Xin Jia
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Liming Hou
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Jinke Li
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Chenting Bi
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Xiaoming Wang
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
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Wada Y, Shojima K, Tamaki K, Mori T, Kusunoki H, Onishi M, Tsuji S, Matsuzawa R, Nagai K, Sano K, Hashimoto K, Goto M, Nagasawa Y, Shinmura K. Association Between Timed Up-and-Go Test and Future Changes in the Frailty Status in a Longitudinal Study of Japanese Community-Dwelling Older Adults. Clin Interv Aging 2023; 18:1191-1200. [PMID: 37534233 PMCID: PMC10392805 DOI: 10.2147/cia.s413513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose This study aimed to evaluate the relationship between timed up-and-go (TUG) test time and changes in frailty status in a longitudinal cohort study of rural Japanese older adults. Patients and Methods This prospective cohort study included 545 community-dwelling older adults. Initial and 2-year follow-up surveys were conducted. We compared the number of the Japanese version of the Cardiovascular Health Study components during the follow-up period and classified the participants into three groups: the favorable change, unchanged as prefrail, and unfavorable change groups. Associations between changes in frailty status and TUG time in the first survey were examined. The predictive ability of the TUG test was determined using the receiver operating characteristic (ROC) curve. Results The favorable change group comprised 315 individuals (57.8%), the unchanged as prefrail group 105 (19.2%), and the unfavorable change group 125 (22.9%). TUG time was associated with the favorable and unfavorable changes after adjustment for covariates (OR 0.79, 95% CI 0.68-0.92, P=0.001 and OR 1.27, 95% CI 1.09-1.49, P=0.002). The ROC curve of TUG time as a predictor of unfavorable changes showed an area under the curve of 0.59. A cut-off point of TUG was calculated as 6.3 s with 49.6% sensitivity and 66.0% specificity. Conclusion TUG time in the first survey was significantly associated with changes in frailty status 2 years later. However, its predictive value as a stand-alone test is limited and has the potential to predict future changes in the frailty status in older adults in combination with other tests.
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Affiliation(s)
- Yosuke Wada
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Roppou Clinic, Toyooka, Hyogo, Japan
| | - Kensaku Shojima
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Kayoko Tamaki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Takara Mori
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Amagasaki Medical COOP Honden Clinic, Amagasaki, Hyogo, Japan
| | - Hiroshi Kusunoki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of Internal Medicine, Osaka Dental University, Hirakata, Japan
| | - Masaaki Onishi
- Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Shotaro Tsuji
- Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of Orthopedic Surgery, Tatsuno City Hospital, Tatsuno, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Kyoko Sano
- Takarazuka Rehabilitation Hospital, Takarazuka, Japan
| | - Kana Hashimoto
- School of Pharmacy, Hyogo Medical University, Kobe, Japan
| | - Masashi Goto
- Department of General Medicine and Community Health Science, Hyogo Medical University, Sasayama Medical Center, Tambasasayama, Japan
| | - Yasuyuki Nagasawa
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Ken Shinmura
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
- Department of General Medicine and Community Health Science, Hyogo Medical University, Sasayama Medical Center, Tambasasayama, Japan
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Wu X, Guo J, Chen X, Han P, Huang L, Peng Y, Zhou X, Huang J, Wei C, Zheng Y, Zhang Z, Li M, Guo Q. Comparison of the relationship between cognitive function and future falls in Chinese community-dwelling older adults with and without diabetes mellitus. J Formos Med Assoc 2023; 122:603-611. [PMID: 36336606 DOI: 10.1016/j.jfma.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine whether cognitive function is associated with future falls in older patients with diabetes mellitus (DM) compared with those without DM. Cognitive function was divided into several domains to further analyze. METHODS A total of 678 individuals met the inclusion criteria and comprised the final study population. The mean age was 74.35 ± 5.35 years, and 58.9% of the participants were female (n = 400). At the baseline, cognitive function was measured by the Mini Mental State Examination (MMSE), and DM diagnoses were determined by medical records. The self-reported any falls data were obtained via face-to-face questioning at the 1-year follow-up. RESULTS At baseline, 15.6% of participants (n = 106) were diagnosed with DM. According to whether they had any falls during 1-year follow-up, there was a significant difference between the two group in fasting plasma glucose (p = 0.012) and DM (p = 0.036) at baseline. Among the older adults with DM, those who had experienced any falls had poorer cognitive function (p = 0.014). After adjusting for various covariates, we found that MMSE (95% CI 0.790-0.991, p = 0.034), orientation to place (95% CI 0.307-0.911, p = 0.022) and registration (95% CI 0.162-0.768, p = 0.009) were significantly associated with falls in the follow-up. CONCLUSION Our study found that in patients with DM, cognitive function is related to future falls. Not only overall cognitive function, but also orientation to place and registration were all associated with future falls in older adults with DM. When completing the fall risk assessment of elderly patients with DM, clinicians should give more attention to the testing of cognitive function.
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Affiliation(s)
- Xinze Wu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China; Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Jinlong Guo
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xinlong Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Liqin Huang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Youran Peng
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Xin Zhou
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Jiasen Huang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Chengyao Wei
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | | | | | - Ming Li
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Pudong New District, Shanghai, China.
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Liang J, Wang Y, Zhang W, Ding H, Gao Y, Wang R, Sun X, Peng Y, Gan L, Zuo L. Incidence and risk factors of falls in patients undergoing hemodialysis: A multicenter survey in northern China. Hemodial Int 2023; 27:155-164. [PMID: 36744400 DOI: 10.1111/hdi.13064] [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: 06/14/2022] [Revised: 10/30/2022] [Accepted: 01/10/2023] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Patients undergoing hemodialysis (HD) are at a higher risk of falls than healthy individuals. Further knowledge regarding the risk of falls could lead to better risk prevention strategies. We designed a multicenter, prospective cohort study according to the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines to investigate the incidence and risk factors of falls in patients undergoing hemodialysis in Northern China. METHODS Patients undergoing hemodialysis in six hemodialysis units were recruited from January 2019 to January 2020. Data on demographics and disease conditions were collected at baseline. Data on other variables, the incidence of falls, and related conditions were collected every 3 months during a 1-year follow-up. The Generalized Estimating Equation model was used to evaluate factors associated with falls. FINDINGS This study included 472 patients. The incidence of falls was 0.31 per patient year. In patients aged 45-64 years (p = 0.01; odds ratio [OR]: 14.801; 95% confidence interval [CI]: 1.897-115.453) and ≥ 65 years (p = 0.007; OR: 16.562; 95% CI: 2.118-129.521), anemia (p = 0.015; OR: 2.122; 95% CI: 1.154-3.902) and moderately (p = 0.003; OR: 5.439; 95% CI: 1.791-16.516) and severely abnormal timed up and go test (TUGT) levels (p = 0.001; OR: 7.032; 95% CI: 2.226-22.216) were identified as independent risk factors of falls. DISCUSSION Falls are prevalent among patients undergoing in-center hemodialysis. Advanced age, anemia, and moderately and severely abnormal TUGT levels may be risk factors of falls.
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Affiliation(s)
- Junqing Liang
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
| | - Ying Wang
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
| | - Weilin Zhang
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
| | - Hong Ding
- Beijing Miyun Hospital, Department of Nephrology, Beijing, Miyun, People's Republic of China
| | - Yanjun Gao
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, Xicheng, People's Republic of China
| | - Rui Wang
- Beijing Fengtai Hospital, Department of Nephrology, Beijing, Fengtai, People's Republic of China
| | - Xiaofei Sun
- Beijing Renhe Hospital, Department of Nephrology, Beijing, Daxing, People's Republic of China
| | - Ying Peng
- Department of Nephrology, Beijing Zhanlanlu Hospital, Beijing, Xicheng, People's Republic of China
| | - Liangying Gan
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, Beijing, Xicheng, People's Republic of China
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Mawarikado Y, Inagaki Y, Fujii T, Kubo T, Kido A, Tanaka Y. Relationship between fall history and toe grip strength in older adults with knee osteoarthritis in Japan: A cross-sectional study. PLoS One 2023; 18:e0282944. [PMID: 36913410 PMCID: PMC10010548 DOI: 10.1371/journal.pone.0282944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA), one of the most common musculoskeletal diseases in older adults, is associated with a high incidence of falls. Similarly, toe grip strength (TGS) is associated with a history of falls in older adults; however, the relationship between TGS and falls in older adults with KOA who are at risk of falling is not known. Therefore, this study aimed to determine if TGS is associated with a history of falls in older adults with KOA. METHODS The study participants, older adults with KOA scheduled to undergo unilateral total knee arthroplasty (TKA), were divided into two groups: non-fall (n = 256) and fall groups (n = 74). Descriptive data, fall-related assessments, modified Fall Efficacy Scale (mFES), radiographic data, pain, and physical function including TGS were evaluated. The assessment was conducted on the day before performing TKA. Mann-Whitney and chi-squared tests were performed to compare the two groups. Multiple logistic regression analysis was performed to determine the association of each outcome with the presence or absence of falls. RESULTS Mann-Whitney U test revealed that the fall group had statistically significantly lower height, TGS on the affected and unaffected sides, and mFES. Multiple logistic regression analysis revealed that the incidence of fall history is associated with TGS on the affected side; the weaker the affected TGS of the KOA, the more likely the individual is to fall. CONCLUSIONS Our results indicate that TGS on the affected side is related to a history of falls in older adults with KOA. The significance of evaluating TGS among patients with KOA in routine clinical practice was demonstrated.
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Affiliation(s)
- Yuya Mawarikado
- Graduate School of Medicine, Musculoskeletal Reconstructive Surgery, Nara Medical University, Nara, Japan
| | - Yusuke Inagaki
- Department of Rehabilitation Medicine, Nara Medical University, Nara, Japan
- * E-mail:
| | - Tadashi Fujii
- Department of Orthopeadic Surgery, Kashiba Asahigaoka Hospital, Nara, Japan
| | - Takanari Kubo
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Osaka, Japan
| | - Akira Kido
- Department of Rehabilitation Medicine, Nara Medical University, Nara, Japan
| | - Yasuhito Tanaka
- Graduate School of Medicine, Musculoskeletal Reconstructive Surgery, Nara Medical University, Nara, Japan
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
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Zhang Y, Ye M, Wang X, Wu J, Wang L, Zheng G. Age differences in factors affecting fear of falling among community-dwelling older adults: A cross-sectional study. Geriatr Nurs 2023; 49:74-80. [PMID: 36446148 DOI: 10.1016/j.gerinurse.2022.11.011] [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: 09/26/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022]
Abstract
Our objective was to explore the determining factors of fear of falling (FOF) in community-dwelling older adults of different ages. A total of 541 community-dwelling older adults aged 65 years and older were investigated and separated into a younger group (n=347) and an older group (n=194). FOF was measured and possible factors affecting FOF were investigated. The prevalence of high FOF in the older group was significantly higher than that in the younger group. Poor sleep quality, low muscle strength, and multimorbidity were independent risk factors for high FOF in the younger group. While poor gait and balance were independent risk factors for high FOF, other factors, such as sex, marital status, education level, drinking status, cognitive ability, and muscle strength were also found to have a significant association with high FOF in the older group. Therefore, differential prevention strategies for high FOF should be considered for community-dwelling older adults of different ages.
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Affiliation(s)
- Yu Zhang
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China; Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Mingzhu Ye
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Xiaoqian Wang
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Jiawei Wu
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Lecong Wang
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China.
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Boz K, Saka S, Çetinkaya İ. The relationship of respiratory functions and respiratory muscle strength with trunk control, functional capacity, and functional independence in post‐stroke hemiplegic patients. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2022; 28:e1985. [PMID: 36408866 DOI: 10.1002/pri.1985] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/30/2022] [Accepted: 11/05/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardiorespiratory system involvement and early fatigue observed in stroke patients complicate the rehabilitation process and affect their ability to perform daily activities and functional independence. AIM It was aimed to determine the relationship between respiratory functions and respiratory muscle strength with trunk control, functional capacity, and functional independence in hemiplegic patients after stroke. MATERIALS AND METHODS Twenty-five volunteers who were diagnosed with post-stroke hemiplegia were included in the study. Sociodemographic and physical characteristics were recorded. Pulmonary function test (PFT), respiratory muscle strength, Trunk Impairment Scale (TIS), Timed-Up and Go Test (TUG), and Barthel Index (BI) were applied. RESULTS There was a moderate negative correlation between TUG scores and PFT results (r = 0.413-0.502; p = 0.011-0.04), except for PEF (%) and FEV1/FVC. Also, there were statistically significant correlation between TIS scores and FEV1(%) (r = 0.505; p = 0.012), FVC(%) (r = 0.449; p = 0.024). On the other hand, there was no statistically significant relationship between BI results and any parameter of the PFT (p > 0.05). There was no statistically significant correlation between respiratory muscle strength and TUG, TIS, BI (p > 0.05). CONCLUSION It has been shown that respiratory functions are associated with functional capacity and trunk control. However, it was found that there was no relationship between respiratory muscle strength and functional capacity, trunk control, and functional independence. It is thought that considering these parameters in the assessment of patients will contribute to the creation of individual and effective rehabilitation programs. The respiratory system should be systematically assessed in stroke rehabilitation and considered as part of a holistic approach. CLINICAL TRIAL REGISTRATION NCT05290649 (retrospectively registered) (clinicaltrials.gov).
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Affiliation(s)
- Kübra Boz
- Physiotherapy Rehabilitation Department Institute for Graduate Studies Haliç University Istanbul Turkey
| | - Seda Saka
- Division of Physiotherapy and Rehabilitation Faculty of Health Sciences Halic University Istanbul Turkey
| | - İrem Çetinkaya
- Division of Physiotherapy and Rehabilitation Faculty of Health Sciences Halic University Istanbul Turkey
- Physiotherapy Rehabilitation Department Institute for Graduate Studies Marmara University Istanbul Turkey
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Li ZR, Ma YJ, Zhuang J, Tao XC, Guo CY, Liu ST, Zhu RR, Wang JX, Fang L. Ditangquan exercises based on safe-landing strategies prevent falls and injury among older individuals with sarcopenia. Front Med (Lausanne) 2022; 9:936314. [PMID: 36052330 PMCID: PMC9424729 DOI: 10.3389/fmed.2022.936314] [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: 05/06/2022] [Accepted: 07/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background Sarcopenia is the age-related loss of skeletal muscle mass and function; it is a risk factor for falls among older individuals. Few studies have focused on training such individuals to adopt a safe-landing strategy that would protect them from fall-related injuries. Ditangquan is a traditional Chinese martial art comprising movements that conform to the principles of safe landing. This study aims to investigate the effectiveness of Ditangquan in preventing fall-related injuries among older individuals with sarcopenia. Methods A total of 70 participants (21 males and 49 females with sarcopenia) between 60 and 80 years of age were recruited from three local communities and randomly assigned to the Ditangquan exercise group (DG) or the control group (CG) in a 1:1 ratio. Three times a week for 24 weeks, both the DG and CG received an hour of conventional exercise and an hour of Ditangquan exercise based on safe landing. Primary outcomes were the modified falls efficacy scale (MFES), the number of falls, and fall injuries; the secondary outcome was the Timed Up & Go (TUG) test. Results The DG had significantly fewer falls (1 vs. 8, P = 0.028) and fall injuries (0 vs. 6, P = 0.025) than the CG. Furthermore, at the end of the study, the DG had a significantly improved MFES (mean difference: 32.17 scores; 95% CI: 21.32, 43.02; P <0.001) and TUGT (mean difference: −4.94 s; 95% CI: −7.95, −1.93; P = 0.002) as compared with the CG. Conclusion Ditangquan exercise based on the safe-landing strategy effectively improves the functional mobility of the elderly, reduces the occurrence of falls and injuries, and increases the individual's confidence in preventing falls.
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Affiliation(s)
- Zhen-rui Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yun-jing Ma
- Department of Rehabilitation, Shanghai East Hospital, Shanghai, China
| | - Jie Zhuang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xun-chen Tao
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chao-yang Guo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shu-ting Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ran-ran Zhu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jin-xiang Wang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Fang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Lei Fang
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13
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Zhang N, Wang C, Li Y, Yang M, Yang J, Chen F, Yan P. Gender-Specific Association Between Nighttime Sleep Duration and Falls Among Community-Dwelling Middle-Aged and Older Adults in China. J Appl Gerontol 2022; 41:2511-2519. [PMID: 35943209 DOI: 10.1177/07334648221118904] [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: 11/15/2022] Open
Abstract
This study was conducted using the data from 2015 China Health and Retirement Longitudinal Study (CHARLS). Gender-specific association between nighttime sleep duration (NSD) and falls were evaluated through multiple logistic regression by adjusting for confounding variables. Of the 22,899 respondents, 18,446 were eligible and 3,144 (16.99%) had more than a single fall. Short and long NSD were associated with high occurrences of falls in the total and female population, but only a short NSD was associated with a high occurrence of falls in the male population. In conclusion, NSD was strongly and significantly associated with falls, but the association was gender-specific. Accordingly, increasing targeted, evidence-based and gender-specific preventions for NSD and sleep disturbance are necessary among primary care interventions to prevent falls.
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Affiliation(s)
- Nan Zhang
- School of Nursing, 74790Xinjiang Medical University, Urumqi, China
| | - Cui Wang
- School of Nursing, 12465Peking University, Beijing, China
| | - Yuli Li
- School of Nursing and Rehabilitaion, 12589Shandong University, Jinan, China
| | - Mei Yang
- Xingfu road Community Health Service Center, 418584Xinjiang Traditional Chinese Medicine Hospital, Urumqi, China
| | - Jing Yang
- 426111Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Fenghui Chen
- School of Nursing, 74790Xinjiang Medical University, Urumqi, China
| | - Ping Yan
- School of Nursing, 74790Xinjiang Medical University, Urumqi, China
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Fear of Falling, Cognition, and Physical Function in Community-Dwelling Older Adult. Nurs Res 2022; 71:387-393. [PMID: 35776095 DOI: 10.1097/nnr.0000000000000608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Fear of falling (FOF) might be associated with physical and cognitive function, but there is a lack of understanding of the specific relationship between the three variables. OBJECTIVES To accurately investigate the association of FOF with cognitive and physical function in community-dwelling older adults. METHODS A total of 669 older adults (> 60 years) participated in this study. A self-report questionnaire collected information about demographic characteristics, lifestyle, and behavioral habits. FOF was evaluated through the Shortened Version of the Falls Efficacy Scale International. Global cognitive function and the subdomains of cognitive function (including memory, visual-spatial, language, attention, and executive function) were assessed using the Montreal Cognitive Assessment (MoCA) scale, the Auditory Verbal Learning Test (AVLT), the Clock-Drawing Test (CDT), the Verbal Fluency Test, and the Trail Making Test. Subjective memory complaints were assessed using the Subjective Memory Complaints Questionnaire (SMCQ). Physical function was evaluated by measuring muscle strength and balance ability, and muscle strength was indicated by hand grip strength. In contrast, balance was assessed using the Timed Up and Go (TUG) Test. RESULTS After adjustment for potential confounding factors, the linear or ordinal regression analysis showed that the values of hand grip strength, MoCA, AVLT, and CDT were significantly and negatively correlated with the score of FOF. On the other hand, SMCQ and TUG Test values showed significant positive correlations with FOF scores. Moreover, compared with other cognitive or physical measures, the CDT and TUG Test values showed a greater association with the FOF scores. DISCUSSION Low subjective or objective cognitive ability and low physical function, especially low visuospatial and balance ability, were positively associated with the risk of FOF in a community-dwelling older population.
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Wang Z, Rong Y, Gu L, Yang Y, Du X, Zhou M. Reliability and validity of the fall risk self-assessment scale for community-dwelling older people in China: a pilot study. BMC Geriatr 2022; 22:272. [PMID: 35365082 PMCID: PMC8976342 DOI: 10.1186/s12877-022-02962-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background Falls are a common and serious public health issue among older adults, contributing to the loss of independence, psychological distress, and incapability to engage in meaningful occupations, etc. However, there is a lack of abundant information about the fall risk self-evaluation scale for community-dwelling older people. Therefore, this study aimed to evaluate the preliminary reliability and validity of the fall risk self-assessment scale (FRSAS) among community-dwelling older adults. Methods A cross-sectional study was conducted. A total of 230 individuals aged 65 years and over were recruited by a convenience sampling between October and December 2020 from three communities in Haidian district, Beijing. Eligible participants were required to fill in the general condition questionnaire and the fall risk self-assessment scale. The reliability and validity were analyzed by using SPSS 20.0. Results Two hundred twenty-two participants completed the assessment as required (the completion rate was 96.52%). The most items of FRSAS were understood by older adults, which was completed in 10 min. Cronbach’s α and intraclass correlation coefficient ICC (2,1) of the scale were 0.757 and 0.967 respectively, suggesting good internal consistency and test-retest reliability. Exploratory factor analysis yielded 14 factors that explained 61.744% of the variance. Five items failed to be categorized into any factors because the factor loading of these items was less than 0.4. A future large-sample study needs to be conducted to explore its construct validity. The total scores and dimensional scores except for C-dimension showed significant differences between participants who had experienced a fall in the previous 6 months and those who had not (P < 0.05), indicating good discriminant validity. Conclusions The fall risk self-assessment scale including 41 items demonstrated relatively high feasibility as well as satisfactory results in the internal consistency, test-retest reliability, and discriminant validity. Trial registration Registration number: ChiCTR2000038856; Date of registration: 7 Oct 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02962-3.
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Affiliation(s)
- Zhizhuo Wang
- Department of Rehabilitation Medicine, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China
| | - Yuetong Rong
- Department of Rehabilitation Medicine, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China
| | - Li Gu
- Department of Rehabilitation Medicine, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China
| | - Yanyan Yang
- Department of Rehabilitation Medicine, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China
| | - Xinmin Du
- Jimenli Community Health Service Center, North Third Ring West Road, Haidian District, Beijing, 100088, China
| | - Mouwang Zhou
- Department of Rehabilitation Medicine, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China.
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Marín-Jiménez N, Cruz-León C, Perez-Bey A, Conde-Caveda J, Grao-Cruces A, Aparicio VA, Castro-Piñero J, Cuenca-García M. Predictive Validity of Motor Fitness and Flexibility Tests in Adults and Older Adults: A Systematic Review. J Clin Med 2022; 11:jcm11020328. [PMID: 35054020 PMCID: PMC8779466 DOI: 10.3390/jcm11020328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.
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Affiliation(s)
- Nuria Marín-Jiménez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Carolina Cruz-León
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alejandro Perez-Bey
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
- Correspondence: ; Tel.: +34-65-7588624
| | - Julio Conde-Caveda
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alberto Grao-Cruces
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Virginia A. Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, 18071 Granada, Spain;
- Sport and Health University Research Centre, University of Granada, 18007 Granada, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Magdalena Cuenca-García
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
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Wang J, Chen X, Sun X, Ma H, Yu Y, Yao C, Li Z, Huang L, Zhao Q. The Application of 'Timed up and Go' Test in Fall Screening of Elderly People in Shanghai: A Cross-Sectional Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:2567-2575. [PMID: 36317036 PMCID: PMC9577144 DOI: 10.18502/ijph.v50i12.7940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/23/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND We aimed to evaluate the predictive value of the 'Timed Up and Go' test (TUGT) for identifying fall risk in community-dwelling elderly. METHODS From Aug 2016 to Feb 2017, cluster sampling was conducted among residents aged over 60 from 15 communities in Songjiang district, Shanghai. Face-to-face questionnaire interviews and TUGT measures were conducted to collect data. RESULTS 6,014 participants were enrolled, with an average age 72.7±7.0 years. 637 (10.6%) elderly people had a fall experience in the past year. TUGT for the non-fall group, one-fall group and recurrent-fall group was 9.02±4.39, 10.00±5.26 and 10.78±4.51 seconds respectively (P<0.001). ROC analysis showed that the TUGT cut-off point for the elderly was 12.5 seconds and AUC was 0.573 for any-fall group and 0.613 for recurrent-fall group respectively. After adjusting for age and gender, the predictive value was not high for any-fall group (AUC=0.614) and recurrent-fall group (AUC=0.648). The TUGT cut-off point for the elderly aged below 65, 65-74, 75-84 and 85 and above was 13.52s, 12.51s, 12.51s, 12.00s, respectively. After adjustment of the confounding factors, the OR values for the risk of fall for the elderly men and women who completed TUGT longer than the cut-off point was 2.404 and 2.075 times higher than those who completed TUGT shorter than the cut-off point, respectively. CONCLUSION TUGT with the cut-off score of 12.5s has limited capability in predicting fall risk in community-dwelling elderly.
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Affiliation(s)
- Jian Wang
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiuqin Chen
- Injury Prevention Division, Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Xiaoming Sun
- Department of General Practice, Shanghai Medical College, Fudan University, Shanghai, China
| | - Huifen Ma
- Injury Prevention Division, Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Yan Yu
- Injury Prevention Division, Shanghai Municipal Center for Disease Control and Prevetion, Shanghai, China
| | - Chunxia Yao
- Injury Prevention Division, Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Zhipeng Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Limei Huang
- Injury Prevention Division, Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
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Wang L, Song P, Cheng C, Han P, Fu L, Chen X, Yu H, Yu X, Hou L, Zhang Y, Guo Q. The Added Value of Combined Timed Up and Go Test, Walking Speed, and Grip Strength on Predicting Recurrent Falls in Chinese Community-dwelling Elderly. Clin Interv Aging 2021; 16:1801-1812. [PMID: 34675495 PMCID: PMC8502011 DOI: 10.2147/cia.s325930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/11/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose To determine whether combined performance-based models could exert better predictive values toward discriminating community-dwelling elderly with high risk of any-falls or recurrent-falls. Participants and Methods This prospective cohort study included a total of 875 elderly participants (mean age: 67.10±5.94 years) with 513 females and 362 males, recruited from Hangu suburb area of Tianjin, China. All participants completed comprehensive assessments. Methods We documented information about sociodemographic information, behavioral characteristics and medical conditions. Three functional tests—timed up and go test (TUGT), walking speed (WS), and grip strength (GS) were used to create combined models. New onsets of any-falls and recurrent-falls were ascertained at one-year follow-up appointment. Results In total 200 individuals experienced falls over a one-year period, in which 66 individuals belonged to the recurrent-falls group (33%). According to the receiver operating characteristic curve (ROC), the cutoff points of TUGT, WS, and GS toward recurrent-falls were 10.31 s, 0.9467 m/s and 0.3742 kg/kg respectively. We evaluated good performance as “+” while poor performance as “–”. After multivariate adjustment, we found “TUGT >10.31 s” showed a strong correlation with both any-falls (adjusted odds ratio (OR)=2.025; 95% confidence interval (CI)=1.425–2.877) and recurrent-falls (adjusted OR=2.150; 95%CI=1.169–3.954). Among combined functional models, “TUGT >10.31 s, GS <0.3742 kg/kg, WS >0.9467 m/s” showed strongest correlation with both any-falls (adjusted OR=5.499; 95%CI=2.982–10.140) and recurrent-falls (adjusted OR=8.260; 95%CI=3.880–17.585). And this combined functional model significantly increased discriminating abilities on screening recurrent-fallers than a single test (C-statistics=0.815, 95%CI=0.782–0.884, P<0.001), while not better than a single test in predicting any-fallers (P=0.083). Conclusion Elderly people with poor TUGT performance, weaker GS but quicker WS need to be given high priority toward fall prevention strategies for higher risks and frequencies. Meanwhile, the combined “TUGT–, GS–, WS+” model presents increased discriminating ability and could be used as a conventional tool to discriminate recurrent-fallers in clinical practice.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Peiyu Song
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Cheng Cheng
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China.,Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, People's Republic of China
| | - Peipei Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Liyuan Fu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaoyu Chen
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Hairui Yu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xing Yu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Lin Hou
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yuanyuan Zhang
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Qi Guo
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China.,College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
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Singh DKA, Goh JW, Shaharudin MI, Shahar S. A Mobile App (FallSA) to Identify Fall Risk Among Malaysian Community-Dwelling Older Persons: Development and Validation Study. JMIR Mhealth Uhealth 2021; 9:e23663. [PMID: 34636740 PMCID: PMC8548966 DOI: 10.2196/23663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/20/2021] [Accepted: 06/02/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Recent falls prevention guidelines recommend early routine fall risk assessment among older persons. OBJECTIVE The purpose of this study was to develop a Falls Screening Mobile App (FallSA), determine its acceptance, concurrent validity, test-retest reliability, discriminative ability, and predictive validity as a self-screening tool to identify fall risk among Malaysian older persons. METHODS FallSA acceptance was tested among 15 participants (mean age 65.93 [SD 7.42] years); its validity and reliability among 91 participants (mean age 67.34 [SD 5.97] years); discriminative ability and predictive validity among 610 participants (mean age 71.78 [SD 4.70] years). Acceptance of FallSA was assessed using a questionnaire, and it was validated against a comprehensive fall risk assessment tool, the Physiological Profile Assessment (PPA). Participants used FallSA to test their fall risk repeatedly twice within an hour. Its discriminative ability and predictive validity were determined by comparing participant fall risk scores between fallers and nonfallers and prospectively through a 6-month follow-up, respectively. RESULTS The findings of our study showed that FallSA had a high acceptance level with 80% (12/15) of older persons agreeing on its suitability as a falls self-screening tool. Concurrent validity test demonstrated a significant moderate correlation (r=.518, P<.001) and agreement (k=.516, P<.001) with acceptable sensitivity (80.4%) and specificity (71.1%). FallSA also had good reliability (intraclass correlation .948; 95% CI .921-.966) and an internal consistency (α=.948, P<.001). FallSA score demonstrated a moderate to strong discriminative ability in classifying fallers and nonfallers. FallSA had a predictive validity of falls with positive likelihood ratio of 2.27, pooled sensitivity of 82% and specificity of 64%, and area under the curve of 0.802. CONCLUSIONS These results suggest that FallSA is a valid and reliable fall risk self-screening tool. Further studies are required to empower and engage older persons or care givers in the use of FallSA to self-screen for falls and thereafter to seek early prevention intervention.
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Affiliation(s)
- Devinder Kaur Ajit Singh
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jing Wen Goh
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Iqbal Shaharudin
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Faculty of Health Sciences, Cawangan Pulau Pinang, Kampus Bertam, Universiti Teknologi Majlis Amanah Rakyat, Penang, Malaysia
| | - Suzana Shahar
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Meekes WM, Korevaar JC, Leemrijse CJ, van de Goor IA. Practical and validated tool to assess falls risk in the primary care setting: a systematic review. BMJ Open 2021; 11:e045431. [PMID: 34588228 PMCID: PMC8483054 DOI: 10.1136/bmjopen-2020-045431] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Although several falls risk assessment tools are available, it is unclear which have been validated and which would be most suitable for primary care practices. This systematic review aims to identify the most suitable falls risk assessment tool for the primary care setting (ie, requires limited time, no expensive equipment and no additional space) and that has good predictive performance in the assessment of falls risk among older people living independently. DESIGN A systematic review based on prospective studies. METHODS An extensive search was conducted in the following databases: PubMed, Embase, CINAHL, Cochrane and PsycINFO. Tools were excluded if they required expensive and/or advanced software that is not usually available in primary care units and if they had not been validated in at least three different studies. Of 2492 articles published between January 2000 and July 2020, 27 were included. RESULTS Six falls risk assessment tools were identified: Timed Up and Go (TUG) test, Gait Speed test, Berg Balance Scale, Performance Oriented Mobility Assessment, Functional Reach test and falls history. Most articles reported area under the curve (AUC) values ranging from 0.5 to 0.7 for these tools. Sensitivity and specificity varied substantially across studies (eg, TUG, sensitivity:10%-83.3%, specificity:28.4%-96.6%). CONCLUSIONS Given that none of the falls risk assessment tools had sufficient predictive performance (AUC <0.7), other ways of assessing high falls risk among independently living older people in primary care should be investigated. For now, the most suitable way to assess falls risk in the primary care setting appears to involve asking patients about their falls history. Compared with the other five tools, the falls history requires the least amount of time, no expensive equipment, no training and no spatial adjustments. The clinical judgement of healthcare professionals continues to be most important, as it enables the identification of high falls risk even for patients with no falls history. TRIAL REGISTRAION NUMBER The Netherlands Trial Register, NL7917; Pre-results.
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Affiliation(s)
- Wytske Ma Meekes
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | | | | | - Ien Am van de Goor
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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21
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Tsekoura M, Stasi S, Gliatis J, Sakellari V. Methodology of a home-based motor control exercise and ergonomic intervention programme for community-dwelling older people: The McHeELP study. J Frailty Sarcopenia Falls 2021; 6:153-162. [PMID: 34557615 PMCID: PMC8419848 DOI: 10.22540/jfsf-06-153] [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] [Accepted: 02/15/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this research (Motor control Home ergonomics Elderlies' Prevention of falls; McHeELP study) was to develop a novel intervention combining motor control home-based exercises and a home ergonomic safety-improvement strategy in order to reduce falls in frail ambulatory older adults. A randomized controlled trial of a novel intervention is proposed including motor control exercises and home ergonomic assessment and modification in older adults who have at least one fall experience. Participants are randomized to control or intervention group in a 1:1 ratio. Participants will be assessed three times: at baseline, at 3rd month (end of intervention period) and again at 6th month (follow-up measurement). The primary outcome is of the effect on functional mobility using the Timed Up and Go test. Secondary outcomes include assessments of functionality, fear of falling and quality of life. This will be the first study to develop an exercise intervention approach that combines home-based motor control exercise intervention with home assessment and modification. This study is expected to explore a low-cost, easy-to-popularize, and effective exercise intervention approach for improving functional mobility and prevent falls among older adults.
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Affiliation(s)
- Maria Tsekoura
- Department of Physical Therapy, Faculty of Health and Care Sciences, University of West Attica (UniWA), Egaleo, Attica, Greece
- Department of Physical Therapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Sophia Stasi
- Department of Physical Therapy, Faculty of Health and Care Sciences, University of West Attica (UniWA), Egaleo, Attica, Greece
| | - John Gliatis
- Department of Medicine, School of Health Sciences, University of Patras, Rio, Patra, Greece
| | - Vasiliki Sakellari
- Department of Physical Therapy, Faculty of Health and Care Sciences, University of West Attica (UniWA), Egaleo, Attica, Greece
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22
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Gait Flexibility among Older Persons Significantly More Impaired in Fallers Than Non-Fallers-A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137074. [PMID: 34281011 PMCID: PMC8297078 DOI: 10.3390/ijerph18137074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 01/12/2023]
Abstract
Gait disorders are a relevant factor for falls and possible to measure with wearable devices. If a wearable sensor can detect differences in gait parameters between fallers and non-fallers has not yet been studied. The aim of this study was to measure and compare gait parameters, vestibular function, and balance performance between fallers and non-fallers among a group of older persons. Participants were senior members (n = 101) of a Swedish non-profit gymnastic association. Gait parameters were obtained using an inertial measurement unit (IMU) that the participants wore on the leg while walking an obstacle course and on an even surface. Vestibular function was assessed by the Head-shake test, the Head impulse test, and the Dix-Hallpike maneuver. Balance was assessed by the Timed Up and Go, the Timed Up and Go manual, and the Timed Up and Go cognitive tests. Falls during the 12-month follow-up period were monitored using fall diaries. Forty-two persons (41%) had fallen during the 12-month follow-up. Fallers had more limited ability to vary their gait (gait flexibility) than non-fallers (p < 0.001). No other differences between fallers and non-fallers were found. The use of gait flexibility, captured by an IMU, seems better for identifying future fallers among healthy older persons than Timed Up and Go or Timed Up and Go combined with a cognitive or manual task.
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Balance Measurement Using Microsoft Kinect v2: Towards Remote Evaluation of Patient with the Functional Reach Test. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11136073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To prevent falls, it is important to measure periodically the balance ability of an individual using reliable clinical tests. As Red Green Blue Depth (RGBD) devices have been increasingly used for balance rehabilitation at home, they may also be used to assess objectively the balance ability and determine the effectiveness of a therapy. For this, we developed a system based on the Microsoft Kinect v2 for measuring the Functional Reach Test (FRT); one of the most used balance clinical tools to predict falls. Two experiments were conducted to compare the FRT measures computed by our system using the Microsoft Kinect v2 with those obtained by the standard method, i.e., manually. In terms of validity, we found a very strong correlation between the two methods (r = 0.97 and r = 0.99 (p < 0.05), for experiments 1 and 2, respectively). However, we needed to correct the measurements using a linear model to fit the data obtained by the Kinect system. Consequently, a linear regression model has been applied and examining the regression assumptions showed that the model works well for the data. Applying the paired t-test to the data after correction indicated that there is no statistically significant difference between the measurements obtained by both methods. As for the reliability of the test, we obtained good to excellent within repeatability of the FRT measurements tracked by Kinect (ICC = 0.86 and ICC = 0.99, for experiments 1 and 2, respectively). These results suggested that the Microsoft Kinect v2 device is reliable and adequate to calculate the standard FRT.
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24
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Strini V, Schiavolin R, Prendin A. Fall Risk Assessment Scales: A Systematic Literature Review. NURSING REPORTS 2021; 11:430-443. [PMID: 34968219 PMCID: PMC8608097 DOI: 10.3390/nursrep11020041] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Falls are recognized globally as a major public health problem. Although the elderly are the most affected population, it should be noted that the pediatric population is also very susceptible to the risk of falling. The fall risk approach is the assessment tool. There are different types of tools used in both clinical and territorial settings. Material and methods: In the month of January 2021, a literature search was undertaken of MEDLINE, CINHAL and The Cochrane Database, adopting as limits: last 10 years, abstract available, and English and Italian language. The search terms used were “Accidental Falls” AND “Risk Assessment” and “Fall Risk Assessment Tool” or “Fall Risk Assessment Tools”. Results: From the 115 selected articles, 38 different fall risk assessment tools were identified, divided into two groups: the first with the main tools present in the literature, and the second represented by tools of some specific areas, of lesser use and with less supporting literature. Most of these articles are prospective cohort or cross-sectional studies. All articles focus on presenting, creating or validating fall risk assessment tools. Conclusion: Due to the multidimensional nature of falling risk, there is no “ideal” tool that can be used in any context or that performs a perfect risk assessment. For this reason, a simultaneous application of multiple tools is recommended, and a direct and in-depth analysis by the healthcare professional is essential.
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Affiliation(s)
- Veronica Strini
- Clinical Research Unit, University-Hospital of Padua, 35128 Padua, Italy;
| | - Roberta Schiavolin
- Continuity of Care Service-University-Hospital of Padua, 35128 Padua, Italy;
| | - Angela Prendin
- Independent Research, University-Hospital of Padua, 35128 Padua, Italy
- Correspondence:
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25
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Wang RH, Hsu HC, Chen SY, Lee CM, Lee YJ, Ma SM, Chen WY. Risk factors of falls and the gender differences in older adults with diabetes at outpatient clinics. J Adv Nurs 2021; 77:2718-2727. [PMID: 33615509 DOI: 10.1111/jan.14795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/08/2020] [Accepted: 01/30/2021] [Indexed: 11/29/2022]
Abstract
AIMS To explore the risk factors of falls and the gender differences based on demographic and disease characteristics, physical capability, and fear of falling in older adults with diabetes visiting outpatient clinics in Taiwan. DESIGN Cross-sectional design. METHODS A total of 485 patients with type 2 diabetes aged between 65 and 80 years were recruited from three endocrine outpatient clinics in Taiwan. Demographic and disease characteristics, fall history in the previous one year and fear of falling were collected by a self-reported questionnaire. Calf circumference, handgrip strength, one-leg standing and time up-and-go tests were all performed to assess the physical capability of participants. Data were collected from May 2019 to May 2020. RESULTS Female gender (OR = 1.75), handgrip strength (OR = 2.43) and fear of falling (OR = 3.38) were important risk factors of falls overall, although fear of falling (OR = 4.69) was the only important risk factor of falls in males, while handgrip strength (OR = 3.48) and fear of falling (OR = 2.86) were important risk factors of falls in females. The sensitivity of simultaneous screening handgrip strength and fear of falling were 85.7, 86.4 and 86.2 in males, females and older adults overall with diabetes, respectively. CONCLUSION Fear of falling was an important risk factor of falls in both genders, especially in males. Handgrip strength was an important risk factor of falls specifically for females. By simultaneously screening fear of falling and handgrip strength, risk of falls in older adults with diabetes at outpatient clinics could be identified in a more timely manner. Impact Nurses could periodically and simultaneously assess fear of falling and handgrip strength of older adults with diabetes at outpatient clinics. For those are identified at risk of falls on either fear of falling or handgrip strength, nurses could provide corresponding interventions to reduce the fear of falling or improve muscle strength to prevent such falls.
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Affiliation(s)
- Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | - Shi-Yu Chen
- Tri-Service General Hospital, Taipei, Taiwan
| | | | | | | | - Wan-Yi Chen
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
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26
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Born Lopes P, Rodacki ALF, Wolf R, Fisher K, Bento PCB, Pereira G. Can Age Influence Functional Tests Differently to Predict Falls in Nursing Home and Community-Dwelling Older Adults? Exp Aging Res 2021; 47:192-202. [PMID: 33423605 DOI: 10.1080/0361073x.2020.1871277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Aim: The aim of this cross-sectional study was to determine which functional tests are able to predict falls in nursing home residents (NHR) and community-dwelling (CDW) older adults grouped by age. Methods: Two hundred and fifty-two older adults were assessed in the following tests, Mini-Mental State Examination, anthropometric characteristics, fall history and functional tests. The participants were assigned to one of the following groups: Young Older Adults (YOA; 60-69 years, n = 102; 27.5% NHR), Old Older Adults (OOA; 70-79 years; n = 100; 23.5% NHR) and Very Older Adults (VOA, ≥80 years; n = 50; 52% NHR). Results: The five times sit-to-stand showed 1.41 odds to experience a fall in the NHR of the VOA. In the CDW, the handgrip strength score decreased the odds to fall occurrence (0.92 odds) in the YOA, while the low score in timed up and go test of the OOA showed 1.21 odds to experience a fall. Conclusions: Therefore, the five times sit-to-stand test can predict falls in NHR of VOA groups, while handgrip strength and timed up and go tests can predict falls in CDW of YOA and OOA groups, respectively.
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Affiliation(s)
- Paula Born Lopes
- Núcleo de Ciências Biologicas da Saúde, Positivo University , Curitiba, Brazil.,Physical Education Department, Federal University of Parana , Curitiba, Brazil
| | | | - Renata Wolf
- Physical Education Department, Federal University of Parana , Curitiba, Brazil
| | - Koren Fisher
- Department of Kinesiology, California State University, Fullerton , Fullerton, California, USA
| | | | - Gleber Pereira
- Physical Education Department, Federal University of Parana , Curitiba, Brazil
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27
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Grazioli E, Nigro E, Cerulli C, Borriello G, Mancini A, Tranchita E, Polito R, Parisi A, Buono P, Daniele A. Case Report: Concurrent Resistance and Aerobic Training Regulate Adiponectin Expression and Disease Severity in Multiple Sclerosis: A Case Study. Front Neurosci 2021; 14:567302. [PMID: 33414700 PMCID: PMC7783198 DOI: 10.3389/fnins.2020.567302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022] Open
Abstract
Adapted exercise is an effective non-pharmacological tool to improve functional, cognitive, and psychological parameters in multiple sclerosis (MS), in association with increased quality of life (QoL) and decreased disease severity. Adipose tissue, through the production of different adipokines, is involved in regulating energy metabolism and inflammation. Adiponectin, increased in MS, circulates as oligomers of low (LMW), medium (MMW), and high molecular weight (HMW), the latter mediating the main biological effects. The aim of study was to evaluate the effects of 4 months training at moderate intensity [65% heart rate reserve (HRR)] on BMI, adiponectin, and QoL in a volunteer with secondary progressive MS. The parameters were evaluated before (T0), after 4 months training (T1), and 6 months after the end of training (T2); total serum adiponectin and its oligomeric profile were evaluated. We found a reduction in BMI (−0.9%) and FAT (−2.6%), an improvement in perceived QoL and a reduced expression of total adiponectin and HMW oligomers together with decreased MS disability level at T1 measured by EDSS. Despite the limitations of a case study, this represent a starting point to understand the influence of exercise in MS and the relationship with adiponectin expression.
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Affiliation(s)
- Elisa Grazioli
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy
| | - Ersilia Nigro
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta, Italy.,CEINGE Advanced Biotechnologies, Naples, Italy
| | - Claudia Cerulli
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy
| | - Giovanna Borriello
- Department of Neurological Sciences, Sapienza University of Rome, Rome, Italy
| | - Annamaria Mancini
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Eliana Tranchita
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy
| | - Rita Polito
- CEINGE Advanced Biotechnologies, Naples, Italy
| | - Attilio Parisi
- Department of Exercise, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy
| | - Pasqualina Buono
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Aurora Daniele
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta, Italy.,CEINGE Advanced Biotechnologies, Naples, Italy
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Ziegl A, Hayn D, Kastner P, Löffler K, Weidinger L, Brix B, Goswami N, Schreier G. Quantitative falls risk assessment in elderly people: results from a clinical study with distance based timed up-and-go test recordings. Physiol Meas 2020; 41:115006. [PMID: 33086193 DOI: 10.1088/1361-6579/abc352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE A third of people over 65 years experiences at least one fall a year. The Timed Up-and-Go (TUG) test is commonly used to assess gait and balance and to evaluate an individual's risk of falling. APPROACH We conducted a clinical study with 46 older participants for evaluating the fall risk assessment capabilities of an ultra-sound based TUG test device. The fall protocols over a period of one year were used to classify participants as fallers and non-fallers. For frailty evaluation, state-of-the-art questionnaires were used. Fall recordings were compared to six TUG test measurements that were recorded in fallers and non-fallers. MAIN RESULTS TUG test data were available for 39 participants (36 f, age 84.2 ± 8.2, BMI 26.0 ± 5.1). Twenty-three participants did fall at least once within the fall screening period. We fitted two different regression and probability models into a region of interest of the distance over time curve as derived from the TUG device. We found that the coefficient of determination for Gaussian bell-shaped curves (p < 0.05, AUC = 0.71) and linear regression lines (p < 0.02, AUC = 0.74) significantly separated fallers from non-fallers. Subtasks of the TUG test like the sit-up time showed near significance (p < 0.07, AUC = 0.67). SIGNIFICANCE We found that specific features calculated from the TUG distance over time curve were significantly different between fallers and non-fallers in our study population. Automatic recording and analysis of TUG measurements could, therefore, reduce time of measurements and improve precision as compared to other methods currently being used in the assessments of fall risk.
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Affiliation(s)
- Andreas Ziegl
- AIT Austrian Institute of Technology GmbH, Graz, Austria. Institute of Neural Engineering, Graz University of Technology, Graz, Austria
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Abel B, Bongartz M, Eckert T, Ullrich P, Beurskens R, Mellone S, Bauer JM, Lamb SE, Hauer K. Will We Do If We Can? Habitual Qualitative and Quantitative Physical Activity in Multi-Morbid, Older Persons with Cognitive Impairment. SENSORS 2020; 20:s20247208. [PMID: 33339293 PMCID: PMC7766414 DOI: 10.3390/s20247208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/04/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022]
Abstract
This study aimed to identify determinants of quantitative dimensions of physical activity (PA; duration, frequency, and intensity) in community-dwelling, multi-morbid, older persons with cognitive impairment (CI). In addition, qualitative and quantitative aspects of habitual PA have been described. Quantitative PA and qualitative gait characteristics while walking straight and while walking turns were documented by a validated, sensor-based activity monitor. Univariate and multiple linear regression analyses were performed to delineate associations of quantitative PA dimensions with qualitative characteristics of gait performance and further potential influencing factors (motor capacity measures, demographic, and health-related parameters). In 94 multi-morbid, older adults (82.3 ± 5.9 years) with CI (Mini-Mental State Examination score: 23.3 ± 2.4), analyses of quantitative and qualitative PA documented highly inactive behavior (89.6% inactivity) and a high incidence of gait deficits, respectively. The multiple regression models (adjusted R2 = 0.395–0.679, all p < 0.001) identified specific qualitative gait characteristics as independent determinants for all quantitative PA dimensions, whereas motor capacity was an independent determinant only for the PA dimension duration. Demographic and health-related parameters were not identified as independent determinants. High associations between innovative, qualitative, and established, quantitative PA performances may suggest gait quality as a potential target to increase quantity of PA in multi-morbid, older persons.
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Affiliation(s)
- Bastian Abel
- Department of Geriatric Research, AGAPLESION Bethanien Hospital Heidelberg, Geriatric Center at the University of Heidelberg, 69126 Heidelberg, Germany; (B.A.); (M.B.); (T.E.); (P.U.); (R.B.); (J.M.B.)
- Center for Geriatric Medicine, Heidelberg University, 69126 Heidelberg, Germany
| | - Martin Bongartz
- Department of Geriatric Research, AGAPLESION Bethanien Hospital Heidelberg, Geriatric Center at the University of Heidelberg, 69126 Heidelberg, Germany; (B.A.); (M.B.); (T.E.); (P.U.); (R.B.); (J.M.B.)
- Network Aging Research (NAR), Heidelberg University, 69115 Heidelberg, Germany
| | - Tobias Eckert
- Department of Geriatric Research, AGAPLESION Bethanien Hospital Heidelberg, Geriatric Center at the University of Heidelberg, 69126 Heidelberg, Germany; (B.A.); (M.B.); (T.E.); (P.U.); (R.B.); (J.M.B.)
- Department for Social and Health Sciences in Sport, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Phoebe Ullrich
- Department of Geriatric Research, AGAPLESION Bethanien Hospital Heidelberg, Geriatric Center at the University of Heidelberg, 69126 Heidelberg, Germany; (B.A.); (M.B.); (T.E.); (P.U.); (R.B.); (J.M.B.)
| | - Rainer Beurskens
- Department of Geriatric Research, AGAPLESION Bethanien Hospital Heidelberg, Geriatric Center at the University of Heidelberg, 69126 Heidelberg, Germany; (B.A.); (M.B.); (T.E.); (P.U.); (R.B.); (J.M.B.)
- Department of Health and Social Affairs, FHM Bielefeld, University of Applied Sciences, 33602 Bielefeld, Germany
| | - Sabato Mellone
- Department of Electrical, Electronic, and Information Engineering, University of Bologna, 40136 Bologna, Italy;
| | - Jürgen M. Bauer
- Department of Geriatric Research, AGAPLESION Bethanien Hospital Heidelberg, Geriatric Center at the University of Heidelberg, 69126 Heidelberg, Germany; (B.A.); (M.B.); (T.E.); (P.U.); (R.B.); (J.M.B.)
- Center for Geriatric Medicine, Heidelberg University, 69126 Heidelberg, Germany
| | - Sallie E. Lamb
- Institute of Health Research, University of Exeter, South Cloisters, St. Luke’s Campus, Exeter EX1 2LU, UK;
| | - Klaus Hauer
- Department of Geriatric Research, AGAPLESION Bethanien Hospital Heidelberg, Geriatric Center at the University of Heidelberg, 69126 Heidelberg, Germany; (B.A.); (M.B.); (T.E.); (P.U.); (R.B.); (J.M.B.)
- Correspondence: ; Tel.: +49-6221-319-1532
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Canan Outdoor Multisurface Terrain Enhance the Effects of Fall Prevention Exercise in Older Adults? A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197023. [PMID: 32992927 PMCID: PMC7579330 DOI: 10.3390/ijerph17197023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/17/2020] [Accepted: 09/22/2020] [Indexed: 11/17/2022]
Abstract
Walking on complex surface conditions in outdoor environments is important for active aging. This study aimed at examining whether fall prevention exercise integrated with an outdoor multisurface terrain compared with indoor solid ground was more beneficial for older adults. Twenty-two older nursing home residents were randomly assigned to outdoor multisurface terrain (n = 11, 79.5 ± 2.1 years) or indoor solid ground (n = 11, 78.8 ± 5.2 years) groups. Training occurred five times per week (30 min) for 3 weeks. The following performance test outcomes were measured: 10 m walk test (10 mWT), multisurface terrain walk test (MTWT), 2 min walk test (2 MWT), timed up and go test (TUGT), single-leg standing test with eyes open (SLSTEO), single-leg standing test with eyes closed (SLSTEC), and closed cycles test (CCT). Compared with baseline, the outdoor multisurface terrain training significantly improved performance in all tests (p < 0.01). The improvements of the outdoor multisurface terrain group after intervention were significantly higher than those of the indoor solid group in the 10 mWT (p = 0.049), MTWT (p = 0.02), and 2 MWT (p = 0.000). Exercise combined with outdoor multisurface terrain training may be an efficacious approach and a feasible environmental intervention for fall prevention in older adults.
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Zhang YJ, Fu SH, Zhu Q, Ning CX, Luan FX, Zhang F, Zhao YL, Yao Y. Underweight in Men had a Closer Relationship with Falls than Women in Centenarians. J Nutr Health Aging 2020. [DOI: 10.1007/s12603-020-1508-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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32
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Batko-Szwaczka A, Wilczyński K, Hornik B, Janusz-Jenczeń M, Włodarczyk I, Wnuk B, Szołtysek J, Durmała J, Szuster-Kowolik K, Antoniak-Sobczak K, Dulawa J, Szewieczek J. Predicting Adverse Outcomes in Healthy Aging Community-Dwelling Early-Old Adults with the Timed Up and Go Test. Clin Interv Aging 2020; 15:1263-1270. [PMID: 32801674 PMCID: PMC7402859 DOI: 10.2147/cia.s256312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/26/2020] [Indexed: 11/23/2022] Open
Abstract
Background Simple, easy-to-perform, safe and cost-effective methods for the prediction of adverse outcomes in older adults are essential for the identification of patients who are most likely to benefit from early preventive interventions. Methods The study included 160 community-dwelling individuals aged 60-74 years, with 44.4% women. A comprehensive geriatric assessment was performed in all participants. Bioimpedance body composition analysis included 149 subjects. Among other tests, functional assessment included the Barthel Index of Activities of Daily Living (Barthel Index), Mini-Mental State Examination (MMSE), Timed Up and Go (TUG) and Fried frailty phenotype. Follow-up by telephone was made after at least 365 days. The composite endpoint (CE) included fall, hospitalization, institutionalization and death. Results Cohort characteristics: age 66.8±4.2 years (mean±SD), 3.81±2.23 diseases, 4.29±3.60 medications or supplements, and good functional status (MMSE 29.0±1.5, Barthel Index 98.1±8.2, prevalence of Fried frailty phenotype 2.5%). During one-year follow-up, 34 subjects (21.3%; 95% confidence interval [CI] =14.9-27.6%) experienced CE: hospitalizations (13.8%; 95% CI=8.41-19.1), falls (9.38%; 95% CI=4.86-13.9), death (0.63%; 95% CI=0-1.85) and no institutionalization. A higher probability of CE was associated with age ≥70 years (P=0.018), taking any medication or supplements (P=0.007), usual pace gait speed ≤0.8 m/s (P=0.028) and TUG >9 s (P<0.002). TUG was the only independent measure predicting one-year CE occurrence (OR=1.22, 95% CI=1.07-1.40, P=0.003) in multivariate logistic regression. However, its predictive power was poor; the area under the receiver operating characteristic curve was 0.659 (95% CI 0.551-0.766, P=0.004) and Youden's J statistic for a TUG cut-off of 9.0 s was 0.261 (sensitivity 0.618 and specificity 0.643). Conclusion The TUG test was superior to frailty phenotype measures in predicting one-year incidence of a CE consisting of fall, hospitalization, institutionalization and death in a cohort of healthy-aging community-dwelling early-old adults, although its value as a stand-alone test was limited.
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Affiliation(s)
- Agnieszka Batko-Szwaczka
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Wilczyński
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Hornik
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Janusz-Jenczeń
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Iwona Włodarczyk
- Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bartosz Wnuk
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Szołtysek
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jacek Durmała
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Karolina Szuster-Kowolik
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Antoniak-Sobczak
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Dulawa
- Department of Internal Medicine and Metabolic Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Szewieczek
- Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Aljehani MS, Crenshaw JR, Rubano JJ, Dellose SM, Zeni JA. Falling risk in patients with end-stage knee osteoarthritis. Clin Rheumatol 2020; 40:3-9. [PMID: 32500227 DOI: 10.1007/s10067-020-05165-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
Although 25% of patients with end-stage knee osteoarthritis (OA) have reported a fall, there is limited information about risk factors for falling in patients awaiting total knee arthroplasty (TKA). The purpose of this study was to identify clinical and functional measures related to fall risk. A total of 259 participants awaiting TKA for OA participated in this secondary cross-sectional study. Participants were divided into fallers and non-fallers based on falling history in the prior 6 months. Clinical measures (hip and knee pain, neck and low back pain (LBP), knee range of motion, and quadriceps strength) and functional measures (six-minute walk test (6MWT), timed up and go test, and Knee Injury and Osteoarthritis Outcome Score (KOOS)) were assessed in patients 2-4 weeks prior to TKA. Independent t tests were used to examine differences between groups. Odds ratio was calculated to identify clinical risk factors for falling. Of all participants, 47 (18%) reported a fall in the previous 6 months. Fallers had 30% greater LBP (3.0 ± 2.5 vs. 2.1 ± 2.6; p = 0.025). Fallers walked 12% shorter distance in the 6MWT than non-fallers (378 ± 100 vs. 422 ± 105 m; p = 0.010). For every 1-point increase in LBP on a 0-10 scale, there was a 14% greater risk of falling (p = 0.028). For every 10-m increase in 6MWT, there was a 3.8% reduction in fall risk (p = 0.011). Greater LBP and worse walking endurance are associated with falls in individuals with end-stage OA. Future studies should determine if interventions that reduce LBP and improve walking performance also reduce the chance of falling.
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Affiliation(s)
- Moiyad S Aljehani
- Department of Physical Therapy, University of Delaware, 540 South College Avenue, Newark, DE, 19713, USA. .,Department of Physical Therapy, Umm Al-Qura University, P.O. Box 715, Makkah, 21421, Saudi Arabia.
| | - Jeremy R Crenshaw
- Department of Kinesiology and Applied Physiology, University of Delaware, 540 South College Avenue, Newark, DE, 19713, USA
| | - James J Rubano
- Center for Advanced Joint Replacement, Christiana Care Health Systems, 200 Hygeia Drive, Newark, DE, 19713, USA.,Delaware Orthopaedic Specialists, 1096 Old Churchmans Rd, Newark, DE, 19713, USA
| | - Steven M Dellose
- Center for Advanced Joint Replacement, Christiana Care Health Systems, 200 Hygeia Drive, Newark, DE, 19713, USA.,Delaware Orthopaedic Specialists, 1096 Old Churchmans Rd, Newark, DE, 19713, USA
| | - Joseph A Zeni
- Department of Rehabilitation and Movement Sciences, Physical Therapy Program North, Rutgers, School of Health Professions, The State University of New Jersey, 65 Bergen Street - Office 714A, Newark, NJ, 07107, USA
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Wang L, Wang X, Song P, Han P, Fu L, Chen X, Yu H, Hou L, Yu X, Zhang Y, Zhang W, Guo Q. Combined Depression and Malnutrition As an Effective Predictor of First Fall Onset in a Chinese Community-Dwelling Population: A 2-Year Prospective Cohort Study. Rejuvenation Res 2020; 23:498-507. [PMID: 32303149 DOI: 10.1089/rej.2019.2188] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This study aims to explore the single and joint effects of depression and malnutrition on the incidence of first fall onset in a Chinese community-dwelling elderly population. This cohort study consisted of 739 residents without a history of falls who were aged 60 years and older (mean age: 67.08 ± 5.79 years, female: 58.2%). Depression was defined with the Geriatric Depression Scale (GDS)-30; a score of ≥11 was considered to be depressed, while malnutrition was defined with the Mini Nutritional Assessment where a score <17 was defined as malnourished. Over a 2-year follow-up period, older adults who experienced at least one fall were allocated to the first fall onset group. The prevalence of baseline falls was 21.36%. During the 2-year follow-up, incidence of first fall onset was 13.13%. After adjusting for all confounders, depression alone (adjusted odds ratio [OR] = 3.545, 95% confidence interval [CI] = 1.318-9.535) and malnutrition alone (adjusted OR = 2.204, 95% CI = 1.183-4.108) were observed to be independent risk factors for first fall onset, while comorbidity of depression and malnutrition showed progressively increased risk of promoting first fall (adjusted OR = 8.161, 95% CI = 3.591-18.545) than those with only depression or malnutrition or without both depression and malnutrition. Malnutrition mediated 56% effects in the association between depression and first fall onset, while depression mediated 76% effects in the promoting role of malnutrition in first fall. Depression and malnutrition were found to be independent causes for promoting first fall, while mental health and nutrition should be treated as commonly prior interventions to delay first fall onset. Meanwhile, for malnourished Chinese community-dwelling older adults, avoidance or treatment of depression should be addressed at first.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China.,Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Wang
- Department of neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Peiyu Song
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Liyuan Fu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xioayu Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Hairui Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lin Hou
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Wen Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Qi Guo
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Montgomery G, McPhee J, Pääsuke M, Sipilä S, Maier AB, Hogrel JY, Degens H. Determinants of Performance in the Timed Up-and-Go and Six-Minute Walk Tests in Young and Old Healthy Adults. J Clin Med 2020; 9:E1561. [PMID: 32455757 PMCID: PMC7290512 DOI: 10.3390/jcm9051561] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to assess associations between performance in the timed up-and-go (TUG) and six-minute walk distance (6MWD) with physiological characteristics in young and old healthy adults. Thereto, we determined TUG, 6MWD, normalised jump power, centre of pressure displacement during 1-leg standing, forced expiratory volume in 1 s, percentage of age-predicted maximal heart rate (HR%) and height in 419 healthy young (men: 23.5 ± 2.8 years, women: 23.2 ± 2.9 years) and old (men: 74.6 ± 3.2 years, women: 74.1 ± 3.2 years) adults. Normalised jump power explained 8% and 19% of TUG in young (p = 0.025) and older men (p < 0.001), respectively. When fat mass percentage and age were added to normalised jump power, 30% of TUG was explained in older men (R2adj = 0.30, p < 0.001 to 0.106). Appendicular lean muscle mass percentage (ALM%) and age were the best determinants of TUG for older women (R2adj = 0.16, p < 0.001 to 0.01). HR% explained 17-39% of 6MWD across all groups (R2adj = 0.17 to 39, p < 0.001). In conclusion, in men, jump power was a key determinant for TUG, while in old women only it was the ALM%. As HR% was the most important determinant of 6MWD, motivational bias needs to be considered in the interpretation of this test.
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Affiliation(s)
- Gallin Montgomery
- Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Jamie McPhee
- Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 51014 Tartu, Estonia;
| | - Sarianna Sipilä
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvsäkylä, FI-40014 Jyvsäkylä, Finland;
| | - Andrea B Maier
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands;
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Victoria 3010, Australia
| | - Jean-Yves Hogrel
- Neuromuscular Investigation Center, Institute of Myology, Pitié-Salpêtrière Hospital, 73013 Paris, France;
| | - Hans Degens
- Musculoskeletal Science and Sports Medicine, School of Healthcare Science, Manchester Metropolitan University, Manchester M1 5GD, UK;
- Institute of Sport Science and Innovations, Lithuanian Sports University, LT-44221 Kaunas, Lithuania
- University of Medicine and Pharmacy of Targu Mures, 540142 Targu Mures, Romania
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Kang MG, Kang CH, Lee H, Yoo YC, Lee YR, Kim KI, Kim CH. A medical care model using comprehensive geriatric assessment for community-dwelling older Korean adults. Arch Gerontol Geriatr 2020; 89:104064. [PMID: 32428786 DOI: 10.1016/j.archger.2020.104064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/19/2020] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The quality of life of older adults deteriorates when they lose their ability to perform activities of daily living. Therefore, the older adults should be assessed to identify risk factors for functional decline and to correct these factors so that they may live as independently as possible in the community. We developed a medical care model using comprehensive geriatric assessment (CGA) for community-dwelling older patients. METHODS Three hundred and ninety-one older adults who were frail or likely to be frail were selected. CGA was performed before and after the interventions to determine the effect of the interventions. Three interventions-exercise training, nutritional education, and medication reconciliation-were performed for 5.1 ± 0.6 months. RESULTS A comparison of the results of the first and second assessments revealed that the participants showed improvement in physical function, quality of life, medication, and nutrition. The average gait speed had increased from 0.77 ± 0.17 m/s to 0.89 ± 0.20 m/s (P < 0.001). For health-related quality of life, the average EuroQol-5 dimension-3L score for each domain decreased significantly. The number of patients with polypharmacy decreased from 181(50 %) to 155(43 %) (P = 0.001). The number of patients who were at risk of malnutrition or malnourished decreased from 72(20 %) to 45(12 %) (P < 0.001). The majority of participants were highly satisfied and were willing to participate again. CONCLUSION Our medical model based on CGA showed a significantly positive effect on the physical function and quality of life of community-dwelling older adults. Our model may be a promising strategy for improving the care of them.
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Affiliation(s)
- Min-Gu Kang
- Department of Internal Medicine, Chonnam National University Bitgoeul Hospital, Republic of Korea.
| | - Chul-Hwan Kang
- Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, Republic of Korea.
| | - Heeyoung Lee
- Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Republic of Korea.
| | - Young-Chul Yoo
- Health & Welfare Bureau, Gyeonggi Provincial Government, Republic of Korea.
| | - You-Rim Lee
- Public Health Team, Gyeonggi Provincial Medical Center, Republic of Korea.
| | - Kwang-Il Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea.
| | - Cheol-Ho Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea.
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Development of a fall-risk assessment profile for community-dwelling older adults by using the National Health Interview Survey in Taiwan. BMC Public Health 2020; 20:234. [PMID: 32059657 PMCID: PMC7023681 DOI: 10.1186/s12889-020-8286-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/27/2020] [Indexed: 12/19/2022] Open
Abstract
Background Falls represent a global health issue among older adults and cause a considerable burden on medical systems. In this study, a fall-risk assessment profile was developed for community-dwelling older adults. Method The data of survey participants aged > 65 years were obtained from three rounds (2005, 2009, and 2013) of the National Health Interview Survey in Taiwan. In total, 8356 older participants were included in this study. Logistic regression analyses were used to determine potential predictors associated with falls. The regression coefficients of the predictors in the final model were translated into scores (by multiplying by 5) and then summed to obtain a total risk-score for falls. A receiver operating characteristic (ROC) curve was used to evaluate the discriminative performance of the risk assessment profile. Result Self-reported falls within 1 year accounted for 19.1% of the total falls. The predictors that were included in the risk profile according to the logistic regression analysis results were as follows: female sex (adjusted odds ratio = 1.57; risk-score = 2), living alone (adjusted odds ratio = 1.56; risk-score = 2), urinary incontinence (adjusted odds ratio = 1.36; risk-score = 2), perceived unhealthiness (adjusted odds ratio = 1.32; risk-score = 1), perceived pain (adjusted odds ratio = 1.51; risk-score = 2), hospital admission in the past year (adjusted odds ratio = 2.42; risk-score = 4), low activity of daily living (ADL) scores (adjusted odds ratio = 1.29; risk-score = 1), and low mobility function scores (adjusted odds ratio = 1.68; risk-score = 3). At a total risk-score cutoff point of 6 (range 0–17), the model predicted falls with a sensitivity and specificity of 75.16 and 52.75%, respectively (area under the ROC curve = 0.70). Conclusion The fall-risk assessment profile comprising eight predictors—female sex, living alone, incontinence, perceived unhealthiness, perceived pain, hospital admission in the past year, low ADL scores, and low mobility function scores—may serve as an assessment tool for identification of older adults with a high risk of falling, and assessment results can be used to facilitate community-based intervention.
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Yu X, Hou L, Guo J, Wang Y, Han P, Fu L, Song P, Chen X, Yu H, Zhang Y, Wang L, Zhang W, Zhu X, Yang F, Guo Q. Combined Effect of Osteoporosis and Poor Dynamic Balance on the Incidence of Sarcopenia in Elderly Chinese Community Suburban-Dwelling Individuals. J Nutr Health Aging 2020; 24:71-77. [PMID: 31886811 DOI: 10.1007/s12603-019-1295-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Given the increasing prevalence of osteoporosis and the important role dynamic balanced plays in the assessment of muscle function, we aimed to examine the joint and separate effects of osteoporosis and poor dynamic balance on the incidence of sarcopenia in Chinese elderly individuals. DESIGN This study was conducted on 658 (44.4% male) Chinese suburban-dwelling participants with a mean age of 68.42 ± 5.43 years who initially had no sarcopenia and were aged ≥60 years. A quantitative ultrasound scan of each participant's calcaneus with a T score less than -2.5 was used to identify the prevalence of osteoporosis. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia criteria. We assessed dynamic balance using the Timed Up and Go Test (TUGT). Participants who scored in the top 20% on the TUGT were defined as having poor dynamic balance. RESULTS After a follow-up of three years, the incidence of sarcopenia in the general population was 8.1% (9.6% in males, 6.8% in females). The incidence of sarcopenia was progressively greater in people suffering from both osteoporosis and poor dynamic balance (OR=2.416, 95%CI=1.124-5.195) compared to those who only had osteoporosis (OR=0.797, 95%CI=0.378-1.682) or poor dynamic balance (OR=1.226, 95%CI=0.447-3.363) in models without adjustments. Even after adjusting for potential confounders, the result still held true (OR=2.431, 95%CI=1.053-5.614). CONCLUSIONS In our study, we found individuals who suffered from both osteoporosis and poor dynamic balance simultaneously had a significantly higher incidence of sarcopenia than those who suffered from either one or the other.
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Affiliation(s)
- X Yu
- Qi Guo, M.D., Ph.D. College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China, 279 Zhouzhu Highway, Pudong New Area, Shanghai, 201318, China, E-mail:
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Cudejko T, Gardiner J, Akpan A, D'Août K. Minimal footwear improves stability and physical function in middle-aged and older people compared to conventional shoes. Clin Biomech (Bristol, Avon) 2020; 71:139-145. [PMID: 31739197 DOI: 10.1016/j.clinbiomech.2019.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/09/2019] [Accepted: 11/09/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Effects of minimal shoes on stability and physical function in older people are under-researched. No studies have systematically explored effects of a range of minimal footwear features on these factors in older people. METHODS A within-participant repeated-measures design was used. Participants were subjected to thirteen footwear conditions: (i) barefoot, (ii) a conventional shoe, (iii) a control minimal shoe, (iv-xiii) minimal shoes differing from the control minimal shoe by one design feature. The outcomes were: (i) postural stability expressed with movement of the center of pressure (CoP) during standing (ii) dynamic stability expressed with the CoP movement during walking, (iv) physical function assessed with the Timed Up and Go test (TUG), and (iv) perceptions of footwear assessed with the Monitor Orthopaedic Shoes questionnaire. Linear Mixed Models were applied for statistical analyses. FINDINGS Twenty-two people participated in the study. Compared to the conventional shoe, participants: (i) were more stable during standing and walking in the majority of minimal shoes, and (ii) completed the TUG test faster when wearing the minimal shoe with wider sole. Compared to the control minimal shoe, participants: (i) completed the TUG test faster when wearing the minimal shoe with wider sole; and (ii) perceived features such as a split toe and a higher ankle collar as less fashionable and wearable. INTERPRETATION Wearing minimal shoes might be more beneficial for stability and physical function in older adults than wearing conventional shoes. The results will be highly valuable for the design of minimal footwear for older adults.
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Affiliation(s)
- Tomasz Cudejko
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - James Gardiner
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - Asangaedem Akpan
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom; Department of Medicine for the Elderly, Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom.
| | - Kristiaan D'Août
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
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Long J, Cai T, Huang X, Zhou Y, Kuang J, Wu L. Reference value for the TUGT in healthy older people: A systematic review and meta-analysis. Geriatr Nurs 2019; 41:325-330. [PMID: 31810729 DOI: 10.1016/j.gerinurse.2019.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 01/30/2023]
Abstract
The timed up and go test (TUGT) was recently proposed as a strong predictor of adverse outcomes. Few reviews have been conducted to identify a standard for the TUGT in healthy older people, and the aims of this study were to explore the source of heterogeneity and evaluate the range of reference values for the TUGT in healthy people over 60 years old stratified by age and sex. The VIP, EMBASE, Web of Science and PubMed databases were searched from January 1, 2000, to December 31, 2018. A subgroup analysis and meta-regression were used to assess heterogeneity. Thirty-four eligible studies were included. The mean TUGT results for the total population, males and females in the sample were 9.21 s [95% CI (9.11, 9.31)], 9.33 s [95% CI (7.82, 11.08)] and 8.87 s [95% CI (8.40, 9.38)], respectively. The mean TUGT results for older people in their 60 s, 70 s, and 80 s were 7.91 s [95% CI (6.62, 9.20)], 8.67 s [95% CI (7.23, 10.12)] and 11.68 s [95% CI (8.11, 15.26)], respectively. The meta-regression analysis results showed that the heterogeneity was related to age (P < 0.01). Age affects the results of the TUGT, and it is necessary to take age into consideration when conducting stratified physical evaluations for the evaluation of older people individuals' physical fitness.
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Affiliation(s)
- JingWen Long
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China
| | - TianPan Cai
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China
| | - XiaoYing Huang
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China
| | - YuePing Zhou
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China
| | - Jie Kuang
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China.
| | - Lei Wu
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China.
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Hsiao YH, Chien SH, Tu HP, Fu JCM, Tsai ST, Chen YS, Chen YJ, Chen CH. Early Post-Operative Intervention of Whole-Body Vibration in Patients After Total Knee Arthroplasty: A Pilot Study. J Clin Med 2019; 8:jcm8111902. [PMID: 31703305 PMCID: PMC6912668 DOI: 10.3390/jcm8111902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/03/2019] [Accepted: 11/05/2019] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Knee osteoarthritis causes pain, weakness, muscle atrophy, and disability. The application of whole-body vibration in patients with knee osteoarthritis can improve strength, balance, and functional activities. The purpose of the study is to evaluate the effects of early whole-body vibration intervention in patients after total knee arthroplasty. (2) Method: A single-blinded randomized control trial. Fifty-two patients with knee osteoarthritis post total knee replacement from a medical center in southern Taiwan were randomly assigned to either a whole-body vibration group or control group. Main outcome measures included pain severity, leg circumference, knee range of motion, knee extensor strength, a five-times sit to stand test, and a timed up and go test. (3) Results: Immediately post treatment, the patients in the vibration group showed a significant increase in knee extensor strength and improvement in calf swelling compared to the control group. A trend toward decrease in pain severity and improvement in functional performance were observed in both groups without a significant difference between the groups. There was no significant difference in knee range of motion (ROM) and functional performance between the groups. (4) Conclusions: The whole-body vibration intervention in patients early post total knee arthroplasty showed significant immediate effect in increasing knee extensor strength and decreasing calf swelling.
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Affiliation(s)
- Yu-Hsuan Hsiao
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
| | - Song-Hsiung Chien
- Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jimmy Chun-Ming Fu
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
| | - Shih-Ting Tsai
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
| | - Ying-Shan Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
| | - Yi-Jen Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (Y.-J.C.); (C.-H.C.); Tel.: +886-7-312-1101 (ext. 5962) (Y.-J.C.); +886-7-312-1101 (ext. 5962) (C.-H.C.)
| | - Chia-Hsin Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Physical Medicine and Rehabilitation, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan
- Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (Y.-J.C.); (C.-H.C.); Tel.: +886-7-312-1101 (ext. 5962) (Y.-J.C.); +886-7-312-1101 (ext. 5962) (C.-H.C.)
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Singh DKA, Shahar S, Vanoh D, Kamaruzzaman SB, Tan MP. Diabetes, arthritis, urinary incontinence, poor self‐rated health, higher body mass index and lower handgrip strength are associated with falls among community‐dwelling middle‐aged and older adults: Pooled analyses from two cross‐sectional Malaysian datasets. Geriatr Gerontol Int 2019; 19:798-803. [DOI: 10.1111/ggi.13717] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Devinder Kaur Ajit Singh
- Center for Healthy Aging and Wellness, Faculty of Health SciencesUniversiti Kebangsaan Malaysia Kuala Lumpur Malaysia
| | - Suzana Shahar
- Center for Healthy Aging and Wellness, Faculty of Health SciencesUniversiti Kebangsaan Malaysia Kuala Lumpur Malaysia
| | - Divya Vanoh
- Center for Healthy Aging and Wellness, Faculty of Health SciencesUniversiti Kebangsaan Malaysia Kuala Lumpur Malaysia
- Program of Nutrition and Dietetics, School of Health Sciences, Health CampusUniversiti Sains Malaysia Kubang Kerian Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Department of Medicine, Faculty of MedicineUniversity of Malaya Kuala Lumpur Malaysia
- Aging and Age‐Associated Disorders Research Group, Faculty of MedicineUniversity of Malaya Kuala Lumpur Malaysia
| | - Maw Pin Tan
- Department of Medicine, Faculty of MedicineUniversity of Malaya Kuala Lumpur Malaysia
- Aging and Age‐Associated Disorders Research Group, Faculty of MedicineUniversity of Malaya Kuala Lumpur Malaysia
- Center for Innovation in Medical EngineeringUniversity of Malaya Kuala Lumpur Malaysia
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Overcash J. Comprehensive Geriatric Assessment: Interprofessional Team Recommendations for Older Adult Women With Breast Cancer. Clin J Oncol Nurs 2019; 22:304-315. [PMID: 29781467 DOI: 10.1188/18.cjon.304-315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Geriatric oncology incorporates comprehensive geriatric assessment (CGA) and traditional oncology care. OBJECTIVES The aims are to identify limitations reflected by mean scores on the CGA instruments and describe the CGA recommendations documented in the medical record. METHODS CGA was administered and consisted of the Timed Up and Go Test, the Activities of Daily Living Scale, the Instrumental Activities of Daily Living Scale, grip strength, falls, pain, the Brief Fatigue Inventory, the Pittsburgh Sleep Quality Index, the Geriatric Depression Scale, the Mini-Cog, and the Mini Nutritional Assessment. CGA recommendations were obtained from the medical record. Descriptive statistics were used to analyze the data. FINDINGS Most recommendations were for general cancer treatment, followed by fall referral/education.
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Kang L, Chen X, Han P, Ma Y, Jia L, Fu L, Yu H, Wang L, Hou L, Yu X, An Z, Wang X, Li L, Zhang Y, Zhao P, Guo Q. A Screening Tool Using Five Risk Factors Was Developed for Fall-Risk Prediction in Chinese Community-Dwelling Elderly Individuals. Rejuvenation Res 2018; 21:416-422. [PMID: 29191108 DOI: 10.1089/rej.2017.2005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Li Kang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation Medicine, Tianjin Children Hospital, Tianjin, China
| | - Xiaoyu Chen
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Yixuan Ma
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Liye Jia
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Liyuan Fu
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Hairui Yu
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Lu Wang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Lin Hou
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Yu
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Zongyang An
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Xuetong Wang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Lu Li
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Zhang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Peng Zhao
- Department of Rehabilitation Medicine, Tianjin Children Hospital, Tianjin, China
| | - Qi Guo
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
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Khant N, Dani VB, Patel P, Rathod R. Establishing the reference value for "timed up-and-go" test in healthy adults of Gujarat, India. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:62. [PMID: 29922691 PMCID: PMC5963216 DOI: 10.4103/jehp.jehp_12_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/06/2018] [Indexed: 05/27/2023]
Abstract
CONTEXT Timed up-and-go (TUG) test is a valid, reliable, and an objective test for quantifying functional mobility and assessing the fall risk in all age groups. The analysis of patient scores on TUG test is limited by lack of data, having a wide range of performance scores among people without disabilities. AIM The objective of the study was to provide the reference value for TUG test in healthy individuals of Gujarat, India. SUBJECTS AND METHODS It was a cross-sectional observational study. Five hundred and twenty healthy individuals, aged 40-70 years, were recruited from various regions of Gujarat based on convenient sampling. All the participants were made to perform TUG test in a controlled environment in community. Three readings of the actual test were obtained and averaged. RESULTS Data were analyzed with mean, standard deviation, confidence intervals (CIs 95%) and Pearson's correlation coefficient (r) with α = 0.05 by age groups (40-50, 51-60, and 61-70 years) and gender. The mean (CI 95%) TUG time for healthy adults of Gujarat was 8.46 (8.35-8.57) s and demonstrated age-related decline for both male and female participants. TUG time also demonstrated strong correlation with the height of individuals. CONCLUSION This preliminary data can be used as a reference only for specific population with specific age groups due to variability in test results among the different population due to age, gender, anthropometric measures such as height, weight, and body mass index, geographical variation, nutritional support, and cognitive status.
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Affiliation(s)
- Nency Khant
- Physiotherapy Department, B N Patel College of Physiotherapy, Anand, Gujarat, India
| | - Vyoma Bharat Dani
- Physiotherapy Department, KM Patel Institute of Physiotherapy, Shree Krishna Hospital, Anand, Gujarat, India
| | - Purvi Patel
- Physiotherapist, NCD Cell, CHC-Charada, Mansa, Gandhinagar, Gujarat, India
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