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Hirono T, Okudaira M, Takeda R, Ueda S, Nishikawa T, Igawa K, Kunugi S, Yoshimura A, Watanabe K. Association between physical fitness tests and neuromuscular properties. Eur J Appl Physiol 2024; 124:1703-1717. [PMID: 38193907 DOI: 10.1007/s00421-023-05394-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/07/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE While various fitness tests have been developed to assess physical performances, it is unclear how these tests are affected by differences, such as, in morphological and neural factors. This study was aimed to investigate associations between individual differences in physical fitness tests and neuromuscular properties. METHODS One hundred and thirty-three young adults participated in various general physical fitness tests and neuromuscular measurements. The appendicular skeletal muscle mass (ASM) was estimated by bioelectrical impedance analysis. Echo intensity (EI) was evaluated from the vastus lateralis. During submaximal knee extension force, high-density surface electromyography of the vastus lateralis was recorded and individual motor unit firings were detected. Y-intercept (i-MU) and slope (s-MU) from the regression line between the recruitment threshold and motor unit firing rate were calculated. RESULTS Stepwise multiple regression analyses revealed that knee extension strength could be explained (adjusted R2 = 0.712) by ASM (β = 0.723), i-MU (0.317), EI (- 0.177), and s-MU (0.210). Five-sec stepping could be explained by ASM (adjusted R2 = 0.212). Grip strength, side-stepping, and standing broad jump could be explained by ASM and echo intensity (adjusted R2 = 0.686, 0.354, and 0.627, respectively). Squat jump could be explained by EI (adjusted R2 = 0.640). Counter-movement jump could be explained by EI and s-MU (adjusted R2 = 0.631). On the other hand, i-MU and s-MU could be explained by five-sec stepping and counter-movement jump, respectively, but the coefficients of determination were low (adjusted R2 = 0.100 and 0.045). CONCLUSION Generally developed physical fitness tests were mainly explained by morphological factors, but were weakly affected by neural factors involved in performance.
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Affiliation(s)
- Tetsuya Hirono
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan.
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Masamichi Okudaira
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
- Faculty of Education, Iwate University, Morioka, Japan
| | - Ryosuke Takeda
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
| | - Saeko Ueda
- Department of Human Nutrition, School of Life Studies, Sugiyama Jogakuen University, Nagoya, Japan
| | - Taichi Nishikawa
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
| | - Kaito Igawa
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
| | - Shun Kunugi
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
- Center for General Education, Aichi Institute of Technology, Toyota, Japan
| | - Akane Yoshimura
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
- Faculty of Education and Integrated Arts and Sciences, Waseda University, Tokyo, Japan
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
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Falland L, Henwood T, Keogh JWL, Davison K. Prioritising restorative care programs in light of current age care reform. Australas J Ageing 2024; 43:191-198. [PMID: 38268330 DOI: 10.1111/ajag.13265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Short-term restorative care (STRC) aims to reduce the demand for long-term aged care services through 8 weeks of intensive, multidisciplinary services designed to enhance the independence of community-dwelling older Australians at risk of functional decline. Evidence surrounding the effectiveness and feasibility of STRC is limited. OBJECTIVE This study aimed to examine the effectiveness of an existing exercise-based STRC model and help inform successful service delivery to maximise participant outcomes nationally. METHODS An observational cohort study was conducted to evaluate the potential benefits accrued by community-dwelling older adults accessing Southern Cross Care's current exercise-based STRC model in Adelaide, South Australia. Program effectiveness was determined via improvements in outcome measures specific to functional decline risk factors from baseline (Week 0) to discharge (Week 8). RESULTS Results demonstrated significant improvements (p < 0.001) in participants' (n = 62) lower extremity function (44.9%), depressive symptoms (52.4%), anxiety (45.8%), frailty stage (57.9%), independence in activities of daily living (17.3%) and health-related quality of life (24.0%). No significant change was found for grip strength or BMI post-intervention. The most frequent services were exercise-based (54.3% of total services), with participants receiving an average of two to three exercise services per week. CONCLUSIONS An exercise-based STRC model is an effective mechanism to reverse functional decline and associated risk factors among community-dwelling older Australians. Adoption of multidisciplinary intervention as a standardised STRC service model could help improve client outcomes nationally and offset expected increases in community and long-term aged care demand.
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Affiliation(s)
- Laura Falland
- Southern Cross Care (SA, NT & VIC), Adelaide, South Australia, Australia
- Alliance for Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Tim Henwood
- Southern Cross Care (SA, NT & VIC), Adelaide, South Australia, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Justin W L Keogh
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
- Human Potential Centre, AUT University, Auckland, New Zealand
- Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kade Davison
- Alliance for Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Walsh W, Meyer C, Cyarto EV. Home care worker-supported exercise program to address falls: a feasibility study. Aust J Prim Health 2023; 29:650-660. [PMID: 37323031 DOI: 10.1071/py22248] [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: 10/28/2022] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Falls are a major concern for community-dwelling older adults. The Otago Exercise Program (OEP) is an evidence-based home program that reduces risk of falls. Exercise participation and program adherence can be challenging. Home care workers (HCWs) are well positioned to provide support for older adults. METHODS This feasibility study included: HCW training; HCW in-home support of a physiotherapist-tailored OEP; online physiotherapy consultations; older participant questionnaires and functional outcome measures; and HCW and older participant interviews. RESULTS Twelve older adults, eight HCWs and one physiotherapist participated. A small falls risk reduction, and improvement in falls efficacy, quality of life and functional improvement were noted. Thematic analysis showed formal and informal support was valued by older adults and HCWs. A role-ordered matrix synthesis highlighted variable ongoing independent program participation. CONCLUSIONS By Your Side, a physiotherapist-led and home care worker-supported modified OEP provides a feasible and acceptable option for falls prevention in home care services. Collaborative teamwork, and both formal and informal support, are key aspects to optimising engagement and benefits.
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Affiliation(s)
- Willeke Walsh
- At Home Support, Bolton Clarke, Melbourne, Vic. 3023, Australia; and Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Vic. 3199, Australia
| | - Claudia Meyer
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Vic. 3199, Australia; and Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Vic. 3131, Australia; and College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia; and Centre for Health Communication and Participation, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Elizabeth V Cyarto
- Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Vic. 3131, Australia; and Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld 4059, Australia; and Faculty of Health and Behavioural Sciences, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld 4067, Australia
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Guadaña J, Oyeneyin B, Moe CF, Tuntland H. Publication Trends in Reablement - A Scoping Review. J Multidiscip Healthc 2023; 16:1641-1660. [PMID: 37333025 PMCID: PMC10276570 DOI: 10.2147/jmdh.s407802] [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: 02/19/2023] [Accepted: 05/18/2023] [Indexed: 06/20/2023] Open
Abstract
Background Reablement is a holistic and multidisciplinary intervention that can facilitate achievement of service users' goals related to their independence in everyday activities. Reablement has been the subject of increasing scientific activity in recent years. Currently, no review has provided a broad overview of the extent and breadth of international publications in reablement. Objective The objectives were 1) to map the volume of reablement publications, how the publications had increased over time, and their geographical distribution, 2) to identify the publication types and designs, 3) to identify publication trends, and 4) to identify knowledge gaps in the current peer-reviewed literature. Methods The scoping review approach designed by Arksey and O'Malley was used to identify peer-reviewed articles on reablement. Information was obtained on scientific activity on reablement over a period of more than two decades from five electronic databases and without language restrictions. Data was extracted from the eligible articles and both descriptive analysis and thematic analysis of the data was performed. Results A total of 198 articles published from 1999 to August 2022 from 14 countries were identified. There is a continuous interest in the field from countries where reablement has been implemented. An international and historical overview among countries with peer-reviewed publications on reablement is presented, which also partly reflects the countries that have implemented reablement. Most of the research derives from Western countries, in particular from Norway. Varied approaches to publications in reablement were noted with the majority being empirical and quantitative in nature. Conclusion The scoping review confirms the continued expansion of the breadth of reablement-focused publications in terms of originating countries, target populations, and research designs. In addition, the scoping review contributes to the knowledge base regarding reablement's research front.
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Affiliation(s)
- Jean Guadaña
- Department for Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Babatunde Oyeneyin
- Victoria Ward, Farnham Road Hospital, Surrey and Borders Partnership NHS Foundation Trust, Guildford, UK
| | | | - Hanne Tuntland
- Department for Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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Bennett C, Allen F, Hodge S, Logan P. An investigation of Reablement or restorative homecare interventions and outcome effects: A systematic review of randomised control trials. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6586-e6600. [PMID: 36461163 PMCID: PMC10107871 DOI: 10.1111/hsc.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/03/2022] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
The effect of Reablement, a multi-faceted intervention is unclear, specifically, which interventions improve outcomes. This Systematic Review evaluates randomised controlled trials (RCTs) describing Reablement investigating the population, interventions, who delivered them, the effect and sustainability of outcomes. Database search from inception to August 2021 included AMED, ASSIA, BNI, CINHALL, EMBASE, HMIC, MEDLINE, PUBMED, PsycINFO, Google Scholar, Web of Science, Clinicaltrials.gov. Two researchers undertook data collection and quality assessment, following the PRISMA (2020) statement. They measured effect by changed primary or secondary outcomes: no ongoing service, functional ability, quality of life and mobility. The reviewers reported the analysis narratively, due to heterogeneity of outcome measures, strengthened by the SWiM reporting guideline. The search criteria resulted in eight international studies, five studies had a risk of bias limitations in either design or method. Ongoing service requirement decreased in five studies, with improved effect at 3 months shown in studies with occupational therapist involvement. Functional ability increased statistically in four studies at 3 months. Increase in quality of life was statistically significant in three studies, at 6 and 7 months. None of the studies reported a statistically significant improvement in functional mobility. Reablement is effective in the context of Health and Social Care. The outcomes were sustained at 3 months, with less sustainability at 6 months. There was no statistical result for the professional role regarding assessment, delivery and evaluation of interventions, and further research is justified.
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Affiliation(s)
- Cate Bennett
- School of Medicine: Ageing and RehabilitationNottingham UniversityNottinghamUK
| | - Francis Allen
- School of Medicine: Ageing and RehabilitationNottingham UniversityNottinghamUK
| | - Sevim Hodge
- School of Medicine: Ageing and RehabilitationNottingham UniversityNottinghamUK
| | - Phillipa Logan
- School of Medicine: Ageing and RehabilitationNottingham UniversityNottinghamUK
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Hu YL, Keglovits M, Somerville E, Snyder M, Stark S. Translating a Functional Exercise Program for Fall Prevention among Diverse Older Adults in Urban, Medically Underserved Areas: A Feasibility Study. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2129906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Yi-Ling Hu
- Department of Occupational Therapy, Chang Gung University, Toayuan, Taiwan (R.O.C.)
| | - Marian Keglovits
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Emily Somerville
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Susan Stark
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
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Mjøsund HL, Uhrenfeldt L, Burton E, Moe CF. Promotion of physical activity in older adults: facilitators and barriers experienced by healthcare personnel in the context of reablement. BMC Health Serv Res 2022; 22:956. [PMID: 35897061 PMCID: PMC9327260 DOI: 10.1186/s12913-022-08247-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Being physically active is important for maintaining function and independence in older age. However, there is insufficient knowledge about how to successfully promote physical activity (PA) among home-dwelling older adults with functional challenges in real-life healthcare settings. Reablement is an interdisciplinary, person-centered approach to restoring function and independence among older adults receiving home care services; it also may be an opportunity to promote PA. However, reablement occurs in many different contexts that influence how PA can be integrated within reablement. This study aimed to identify facilitators and barriers experienced by healthcare professionals (HCPs) that influence the promotion of PA within the context of reablement. METHODS This exploratory qualitative study is guided by a realist perspective and analyzed through inductive content analysis. Sixteen HCPs, including occupational therapists, physical therapists, registered nurses, and home care workers, participated in semi-structured interviews. The HCPs were recruited from four Norwegian municipalities with diverse sizes and different organizational models of reablement. RESULTS The HCPs experienced several facilitators and barriers at the participant, professional, organizational, and system levels that influenced how they promoted PA through reablement. Factors related to the individual person and their goals were considered key to how the HCPs promoted PA. However, there were substantial differences among reablement settings regarding the degree to which facilitators and barriers at other levels influenced how HCPs targeted individual factors. These facilitators and barriers influenced how the HCPs reached out to people who could benefit from being more physically active; targeted individual needs, desires and progression; and promoted continued PA habits after reablement. CONCLUSIONS These findings exemplify the complexity of facilitators and barriers that influence the promotion of PA within the reablement context. These factors are important to identify and consider to develop and organize healthcare services that facilitate older adults to be active. We recommend that future practice and research in reablement acknowledge the variations between settings and consider mechanisms on a participant and professional level and within an integrated care perspective.
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Affiliation(s)
- Hanne Leirbekk Mjøsund
- Faculty of Nursing and Health Sciences, Nord University, Universitetsallèen 11, 8026, Bodø, Norway.
| | - Lisbeth Uhrenfeldt
- Faculty of Nursing and Health Sciences, Nord University, Universitetsallèen 11, 8026, Bodø, Norway
| | - Elissa Burton
- Curtin School of Allied Health, Curtin University, Perth, Australia.,enAble Institute, Curtin University, Perth, Australia
| | - Cathrine Fredriksen Moe
- Faculty of Nursing and Health Sciences, Nord University, Universitetsallèen 11, 8026, Bodø, Norway
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Lucas Molitor W, Feldhacker DR, Lohman H, Lampe AM, Jensen L. Occupational Therapy and the IMPACT Act: Part 1. A Systematic Review of Evidence for Fall Prevention and Reduction, Community Discharge and Reintegration, and Readmission Prevention Interventions. Am J Occup Ther 2022; 76:23116. [PMID: 34962516 DOI: 10.5014/ajot.121.049044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Interventions that prevent falls, facilitate discharge after hospitalization, and reduce hospital readmissions assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing costs. OBJECTIVE In this systematic review, we address three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: prevention and reduction of falls, facilitation of community discharge and reintegration, and prevention of hospital readmission. DATA SOURCES We conducted a search of the literature published between 2009 and 2019. Study Selection and Data Collection: We developed operational definitions to help us identify articles that answered the search question for each outcome area. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS We found 53 articles that address the three outcome areas. Regarding the prevention and reduction of falls, low strength of evidence is available for interventions focusing on a single fall risk and for customized interventions addressing multiple risks. Moderate strength of evidence supports structured community fall risk prevention interventions. Low strength of evidence was found for community discharge and reintegration interventions that include physical activity and educational programming. Low to moderate strength of evidence was found for readmission prevention interventions for patients with four types of condition. Conclusion and Relevance: Several intervention themes in the three outcome areas of interest are supported by few studies or by studies with a moderate risk of bias. Additional research is needed that supports the value of occupational therapy interventions in these outcome areas. What This Article Adds: Our study provides important insights into the state of the evidence related to occupational therapy interventions to address three outcome areas of the IMPACT Act.
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Affiliation(s)
- Whitney Lucas Molitor
- Whitney Lucas Molitor, PhD, OTD, OTR/L, BCG, is Assistant Professor, Department of Occupational Therapy, and Undergraduate Public Health Program Director, University of South Dakota, Vermillion;
| | - Diana R Feldhacker
- Diana R. Feldhacker, OTD, OTR/L, BCPR, is Department Chair, Program Director, and Assistant Professor, Department of Occupational Therapy, Des Moines University, Des Moines, IA
| | - Helene Lohman
- Helene Lohman, OTD, OTR/L, is Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Angela M Lampe
- Angela M. Lampe, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Lou Jensen
- Lou Jensen, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
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Lucas Molitor W, Feldhacker DR, Lohman H, Lampe AM, Jensen L. Occupational Therapy and the IMPACT Act: Part 1. A Systematic Review of Evidence for Fall Prevention and Reduction, Community Discharge and Reintegration, and Readmission Prevention Interventions. Am J Occup Ther 2022; 76:23123. [PMID: 34967846 DOI: 10.5014/ajot.2022.049044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Interventions that prevent falls, facilitate discharge after hospitalization, and reduce hospital readmissions assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing costs. OBJECTIVE In this systematic review, we address three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: prevention and reduction of falls, facilitation of community discharge and reintegration, and prevention of hospital readmission. DATA SOURCES We conducted a search of the literature published between 2009 and 2019. Study Selection and Data Collection: We developed operational definitions to help us identify articles that answered the search question for each outcome area. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS We found 53 articles that address the three outcome areas. Regarding the prevention and reduction of falls, low strength of evidence is available for interventions focusing on a single fall risk and for customized interventions addressing multiple risks. Moderate strength of evidence supports structured community fall risk prevention interventions. Low strength of evidence was found for community discharge and reintegration interventions that include physical activity and educational programming. Low to moderate strength of evidence was found for readmission prevention interventions for patients with four types of condition. Conclusion and Relevance: Several intervention themes in the three outcome areas of interest are supported by few studies or by studies with a moderate risk of bias. Additional research is needed that supports the value of occupational therapy interventions in these outcome areas. What This Article Adds: Our study provides important insights into the state of the evidence related to occupational therapy interventions to address three outcome areas of the IMPACT Act.
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Affiliation(s)
- Whitney Lucas Molitor
- Whitney Lucas Molitor, PhD, OTD, OTR/L, BCG, is Assistant Professor, Department of Occupational Therapy, and Undergraduate Public Health Program Director, University of South Dakota, Vermillion;
| | - Diana R Feldhacker
- Diana R. Feldhacker, OTD, OTR/L, BCPR, is Department Chair, Program Director, and Assistant Professor, Department of Occupational Therapy, Des Moines University, Des Moines, IA
| | - Helene Lohman
- Helene Lohman, OTD, OTR/L, is Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Angela M Lampe
- Angela M. Lampe, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Lou Jensen
- Lou Jensen, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
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Chi YC, Wu CL, Liu HT. Effect of a multi-disciplinary active aging intervention among community elders. Medicine (Baltimore) 2021; 100:e28314. [PMID: 34941126 PMCID: PMC8701881 DOI: 10.1097/md.0000000000028314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 11/26/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Active aging has been the paradigm of the old-age lifestyle. We aimed to investigate the efficacy of a multi-disciplinary intervention program in community-based elderly. METHODS We conducted a 2-arm trial comparing the effectiveness between the study group and the control group. The intervention contents included active aging concepts and preparation, physical activity, health care management, cognitive training, emotional awareness and coping skills, family relationship and resilience, and internet use. A questionnaire tapping into the constructs of the expanded healthy life, mental health, social participation, and active aging was administered at baseline, 7th week, and 19th week. RESULTS The generalized estimating equations analysis revealed that the study group exhibited significant improvements in healthy life, mental health, social participation, and active aging compared with the control group (P < .001). CONCLUSIONS This study provided a good evidence supporting the effectiveness of a multi-disciplinary intervention program in improving the cognition of healthy life, mental health status, social participation activities, and active aging. A promotion of similar intervention is recommended.
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Affiliation(s)
- Ying-Chen Chi
- Department of Healthcare Information and Management, Ming Chuan University, 5 De Ming Rd., Gui Shan District, Taoyuan City, Taiwan
| | - Chen-Long Wu
- Department of Healthcare Information and Management, Ming Chuan University, 5 De Ming Rd., Gui Shan District, Taoyuan City, Taiwan
- Department of Family Medicine, Landseed International Hospital Shanghai Hexin Branch, China
- Department of Pediatrics, Taipei City Hospital, Taipei, Taiwan
| | - Hsiang-Te Liu
- Department of Public Affairs, Ming Chuan University, Taoyuan, Taiwan
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Associations Between Planned Exercise, Walking, Incidental Physical Activity, and Habit Strength in Older People: A Cross-Sectional Study. J Aging Phys Act 2021; 30:813-823. [PMID: 34929661 DOI: 10.1123/japa.2021-0284] [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: 07/07/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022]
Abstract
Habits play an important role in physical activity (PA) engagement; however, these associations in older people are not well understood. The present study aimed to investigate the relationship between engagement in types of PA and their automaticity in older people, using an observational, cross-sectional design. Current hours engaged in planned exercise (excluding walking), planned walking, and incidental activities and the automaticity of those PA behaviors were measured in 127 community-dwelling Australians aged 65 years and older via an online questionnaire. After controlling for demographic and health factors (age, gender, education level, body mass index, history of falls, and anxiety and depression symptoms), higher automaticity scores were associated with more hours undertaking planned walking and incidental activity but not planned exercise. Although preliminary, these findings indicate that the role of habit in maintaining PA in older people may, therefore, differ depending on the type of activity.
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The Lifestyle-integrated Functional Exercise (LiFE) program and its modifications: a narrative review. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [DOI: 10.1007/s12662-021-00770-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AbstractLifestyle-integrated exercise is a promising approach to increase adherence levels of older adults compared to structured exercise programs as it saves time and effort and supports older adults in preventing falls and functional decline. The Lifestyle-integrated Functional Exercise (LiFE) program embodies this approach by integrating physical activity, balance, and strength activities into daily tasks of community-dwelling older adults aged 70+. A randomized controlled trial shows strong effectiveness of the original, resource-intensive one-on-one format of the LiFE program in terms of reducing falls, improving motor performance, and increasing physical activity. The positive effects of the original LiFE program have yet stimulated adaptions to group-based and information and communications technology-based formats, to younger seniors, for multicomponent interventions, and to populations with disabilities which resulted in 16 known studies about LiFE modifications. Evidence for the effectiveness of specific LiFE modifications exists for four programs, while seven adaptions are in the feasibility stage and one is still in the early development phase. A decade of existing LiFE research is summarized in this narrative review that, to the best of our knowledge, does not exist until now. The aim of this article is (1) to provide an overview of the number of LiFE modifications and their specifications, (2) to describe the current evidence regarding feasibility and effectiveness, and (3) to present challenges and potential of the different LiFE modifications. All adaptions of the LiFE program embody the benefits of the lifestyle-integrated approach and enable an enhancement of the successful LiFE concept.
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Mjøsund HL, Moe CF, Burton E, Uhrenfeldt L. Promotion of Physical Activity Through Reablement for Older Adults: Exploring Healthcare Professionals' Clinical Reasoning. J Multidiscip Healthc 2021; 14:1623-1635. [PMID: 34234450 PMCID: PMC8254412 DOI: 10.2147/jmdh.s315553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Reablement is an interdisciplinary, multifactorial, and individualized intervention aimed at improving function and maintaining the independence of community-dwelling older adults who receive home care services. Physical activity (PA) is important for functional ability in older adults, but it is unclear how PA is promoted through reablement. Healthcare professionals' (HCPs) clinical reasoning and decision-making are essential and determine how reablement is delivered to individuals. Exploring how HCPs integrate PA into their clinical reasoning is critical to understanding how PA is integrated within reablement. To gain knowledge of how PA is integrated within reablement, there is a need to explore how HCPs integrate PA into their clinical reasoning. Purpose The study aimed to explore how PA is integrated into HCPs' clinical reasoning in a Norwegian reablement setting. Methods Sixteen HCPs, including occupational and physical therapists, registered nurses, and other home care staff, were recruited from four Norwegian municipalities. They participated in semi-structured interviews that were transcribed verbatim, and an interpretive content analysis approach was used. Results PA was integrated into multifaceted clinical reasoning captured by the main theme: "Improving the person's ability to participate in meaningful activities." Within this overall theme, two sub-themes emerged with a primary focus on either i) increasing physical capacity or ii) improving activity performance. Each subtheme encompassed different aspects of clinical reasoning and diverse perspectives on how to integrate PA in reablement. Conclusion HCPs' decision-making in reablement builds upon complex clinical reasoning and incorporates diverse perspectives on integrating PA in the delivery of reablement. This broad approach may be useful in targeting different needs, preferences, and contexts. There is a need to further investigate how PA is appropriately promoted through reablement, how it meets the needs and preferences of participants, and which contextual factors influence PA promotion through reablement.
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Affiliation(s)
| | - Cathrine Fredriksen Moe
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Nordland Hospital Trust, Bodø, Norway
| | - Elissa Burton
- Curtin School of Allied Health, Curtin University, Perth, Australia
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14
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Zingmark M, Norström F. Transitions between levels of dependency among older people receiving social care - a retrospective longitudinal cohort study in a Swedish municipality. BMC Geriatr 2021; 21:342. [PMID: 34078277 PMCID: PMC8173751 DOI: 10.1186/s12877-021-02283-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background Knowledge is scarce on how needs for home help and special housing evolve among older people who begin to receive support from municipal social care. The purpose of this study was to describe baseline distributions and transitions over time between levels of dependency among older persons after being granted social care in a Swedish municipality. Methods Based on a longitudinal cohort study in a Swedish municipality, data was collected retrospectively from municipal records. All persons 65 years or older who received their first decision on social care during 2010 (n = 415) were categorized as being in mild, moderate, severe, or total dependency, and were observed until the end of 2013. Baseline distributions and transitions over time were described descriptively and analysed with survival analysis, with the Kaplan-Meier estimator, over the entire follow-up period. To test potential differences in relation to gender, we used the Cox-Proportional hazards model. Results Baseline distributions between mild, moderate, severe, and total dependency were 53, 16, 24, and 7.7%. During the first year, between 40 and 63% remained at their initial level of dependency. Among those with mild and moderate levels of dependency at baseline, a large proportion declined towards increasing levels of dependency over time; around 40% had increased their dependency level 1 year from baseline and at the end of the follow-up, 75% had increased their dependency level or died. Conclusions Older people in Sweden being allocated home help are at high risk for decline towards higher levels of dependency, especially those at mild or moderate dependency levels at baseline. Taken together, it is important that municipalities make use of existing knowledge so that they implement cost-effective preventative interventions for older people at an early stage before a decline toward increasing levels of dependency.
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Affiliation(s)
- Magnus Zingmark
- Municipality of Östersund, Health and Social Care Administration, 83182, Östersund, Sweden. .,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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15
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Clotworthy A, Kusumastuti S, Westendorp RGJ. Reablement through time and space: a scoping review of how the concept of 'reablement' for older people has been defined and operationalised. BMC Geriatr 2021; 21:61. [PMID: 33446093 PMCID: PMC7809765 DOI: 10.1186/s12877-020-01958-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 11/25/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND While the field of rehabilitation has determined a common definition of professional practice, legislators and healthcare professionals in various Western countries have struggled to reach consensus about how the newer offer of 'reablement' should be organised, operationalised, and understood as a health service for older adults. International research indicates that there is confusion, ambiguity, and disagreement about the terminology and the structure of these programmes, and they may not be adequately supporting older people's self-identified goals. Could an analysis of the concept's genealogy illuminate how reablement can be more effective and beneficial in theory and in practice? METHODS We conducted a qualitative and quantitative scoping review to determine how reablement has developed through time and space. Eligible articles (N=86) had to focus on any of the defined features of current reablement programmes; there were no restrictions on study designs or publication dates. In articles published from 1947 to 2019, we identified themes and patterns, commonalities, and differences in how various countries described and defined reablement. We also performed an analysis using computer software to construct and visualise term maps based on significant words extracted from the article abstracts. RESULTS The fundamental principles of reablement have a long history. However, these programmes have undergone a widespread expansion since the mid-2000s with an intention to reduce costs related to providing long-term care services and in-home assistance to growing older populations. Despite theoretical aspirations to offer person-centred and goal-directed reablement, few countries have been able to implement programmes that adequately promote older people's goals, social involvement, or participation in their local community in a safe, culturally sensitive and adaptable way. CONCLUSIONS Reablement is meant to support older people in attaining their self-defined goals to be both more physically independent at home and socially involved in their communities. However, until legislators, health professionals, and older people can collectively reach consensus about how person-centred reablement can be more effectively implemented and supported in professional home-care practice, it will be difficult to determine a conceptual description of reablement as a service that is unique, separate, and distinct from standard rehabilitation.
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Affiliation(s)
- Amy Clotworthy
- Department of Public Health, University of Copenhagen, Bartholinsgade 6Q, 1014, Copenhagen K, Denmark.
| | - Sasmita Kusumastuti
- Department of Public Health, University of Copenhagen, Bartholinsgade 6Q, 1014, Copenhagen K, Denmark
| | - Rudi G J Westendorp
- Department of Public Health, University of Copenhagen, Bartholinsgade 6Q, 1014, Copenhagen K, Denmark
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16
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Mjøsund HL, Moe CF, Burton E, Uhrenfeldt L. Integration of Physical Activity in Reablement for Community Dwelling Older Adults: A Systematic Scoping Review. J Multidiscip Healthc 2020; 13:1291-1315. [PMID: 33154647 PMCID: PMC7606358 DOI: 10.2147/jmdh.s270247] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/03/2020] [Indexed: 12/29/2022] Open
Abstract
Background Reablement is a rehabilitative intervention provided to homecare receivers with the aim of improving function and independence. There is limited evidence of the effectiveness of reablement, and the content of these interventions is variable. Physical activity (PA) is known to be important for improving and maintaining function among older adults, but it is unclear how PA is integrated in reablement. Purpose To map existing evidence of how PA strategies are integrated and explored in studies of reablement for community dwelling older adults and to identify knowledge gaps. Methods An a priori protocol was published. Studies of time-limited, interdisciplinary reablement for community-dwelling older adults were considered for inclusion. Eight databases were searched for studies published between 1996 and June 2020, in addition to reference and citation searches. Study selection and data extraction were made independently by two reviewers. Results Fifty-one studies were included. Exercise strategies and practice of daily activities were included in the majority of intervention studies, but, in most cases, little information was provided about the intensity of PA. Interventions aiming to increase general PA levels or reduce sedentary behavior were rarely described. None of the studies explored older adults’, healthcare providers’ or family members’ experiences with PA in a reablement setting, but some of the studies touched upon themes related to PA experiences. Some studies reported outcomes of physical fitness, including mobility, strength, and balance, but there was insufficient evidence for any synthesis of these results. None of the studies reported PA levels among older adults receiving reablement. Conclusion There is limited evidence of how PA is integrated and targeted to older adults’ individual needs and preferences in a reablement setting. The feasibility and effectiveness of PA interventions, as well as experiences or barriers related to PA in a reablement setting, should be further investigated.
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Affiliation(s)
| | - Cathrine Fredriksen Moe
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
| | - Elissa Burton
- School of Physiotherapy & Exercise Science, Curtin University, Perth, Australia
| | - Lisbeth Uhrenfeldt
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Danish Centre of Systematic Review, a JBI Centre of Excellence, Center of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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17
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Zingmark M, Evertsson B, Haak M. Characteristics of occupational therapy and physiotherapy within the context of reablement in Swedish municipalities: A national survey. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1010-1019. [PMID: 31876081 DOI: 10.1111/hsc.12934] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 11/14/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Reablement is a multidisciplinary, home-based intervention implemented for people at risk of functional decline and losing independence aiming to optimise functioning and independence in activities of daily living. There is limited knowledge about what characterises the intervention and the role of different professionals. The purpose of this study was to explore the characteristics and differences of occupational therapy and physiotherapy interventions in terms of focus, content and duration within the context of reablement in Swedish municipalities. Web-based surveys were used to collect data from 43 municipalities representing 25% of the population in Sweden. Data on intervention characteristics were reported for all cases receiving occupational therapy (n = 1,395) and physiotherapy (n = 1,006) over a 15-week period. Data were presented descriptively, and differences between occupational therapy and physiotherapy were analysed using Chi-square tests. The results indicated that reablement in Sweden was implemented for adults in all ages (19-103 years, median 81.0 years); 72% had home help. For both professions, a baseline assessment was made in fewer than half of all cases. There were significant differences between occupational therapists and physiotherapists regarding the focus and content as well as the number of contacts and duration of the intervention. For occupational therapists, walking indoors and self-care were the largest focus areas, whereas for physiotherapists walking indoors and body function were the largest focus areas. For most cases, the intervention was completed within five sessions over a 6-week period. This study provides the first picture of occupational therapy and physiotherapy within Swedish reablement contexts. In relation to the results, the focus of interventions, how assessments are made and how the intervention is implemented over time are issues that can be further elaborated.
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Affiliation(s)
- Magnus Zingmark
- Head of Research and Development Health and Social Care Administration, Municipality of Östersund, Östersund, Sweden
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Bodil Evertsson
- Local Authority Senior Rehabilitation Advisor, Health and Social Care Administration, Municipality of Östersund, Östersund, Sweden
| | - Maria Haak
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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18
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Effects of Reablement on the Independence of Community-Dwelling Older Adults with Mild Disability: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203954. [PMID: 31627337 PMCID: PMC6843923 DOI: 10.3390/ijerph16203954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/04/2019] [Accepted: 10/14/2019] [Indexed: 11/29/2022]
Abstract
We aimed to assess the efficacy of a reablement program in improving the independence from long-term care services of older adults with mild disability. This parallel, two-arm, randomized controlled, superiority trial was conducted in Neyagawa, a local government area in Osaka, Japan. Eligible participants were community-dwelling individuals aged ≥65 years certified as support-required level. They were assigned in a 1:1 ratio to receive either a community-based, multicomponent, multidisciplinary, individualized goal-directed, and time-limited intervention (the CoMMIT program) plus standard care or standard care alone. The primary outcome was independence, that is, the nonuse of long-term care services during the three-month follow-up period. The study was terminated early due to slow enrollment. A total of 375 participants were enrolled and randomized to either the intervention (n = 190) or control (n = 185) group. The proportions of independence were 11.1% and 3.8% in the intervention and control groups, respectively (absolute difference: 7.3; 95% confidence interval: 2.0–12.5). There was no difference in the risk of serious adverse events between the groups. The CoMMIT program plus standard care was found superior to standard care alone in enhancing the independence from long-term care services of older adults with mild disability.
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Boulton E, Weber M, Hawley-Hague H, Bergquist R, Van Ancum J, Jonkman NH, Taraldsen K, Helbostad JL, Maier AB, Becker C, Todd C, Clemson L, Schwenk M. Attitudes Towards Adapted Lifestyle-Integrated Functional Exercise Developed for 60-70-Year-Olds: Perceptions of Participants and Trainers. Gerontology 2019; 65:599-609. [PMID: 31216533 DOI: 10.1159/000500778] [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: 01/23/2019] [Accepted: 05/06/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Time commitments, limited access, or unwillingness to join a group are some of the many reasons for low adherence to structured exercise in older adults. A promising alternative approach is integrating exercise into daily routines. OBJECTIVE This study tested whether an adapted Lifestyle-integrated Functional Exercise (aLiFE) programme is suitable for adults aged 60-70 years. METHODS The aLiFE approach was evaluated by interviews and focus-groups with participants and trainers following 4-week pre-post intervention pilot study. For data analyses, Framework Approach was used. Coding was managed using NVivo, and subsequently organised into overarching themes. RESULTS Twenty women and 11 men (mean age 66.4 ± 2.7 years) and 6 trainers (30.0 ± 6.2 years; 5 women) participated. Both participants and trainers were positive about the programme. Participants understood the concept of integrating balance, strength and physical activities into daily lives and valued the individual tailoring in the programme, the preventive approach, and the support of trainers. Trainers valued the flexible approach and peer support between trainers. However, both participants and trainers disliked the extensive study paperwork and reported some challenges to integrate activities into daily routines during the compressed intervention: busy and varied lifestyles, embarrassment performing activities in public, pain, difficulty of specific activities. Participants noted habitualisation of some activities within the short intervention period, even without continuous self-monitoring. CONCLUSIONS aLiFE is a highly acceptable intervention amongst adults aged 60-70 years. Trainers are especially relevant as motivators and support providers. The effectiveness of the aLiFE approach should be tested in a randomised controlled trial.
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Affiliation(s)
- Elisabeth Boulton
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, and Manchester Academic Health Science Centre, Manchester, United Kingdom,
| | - Michaela Weber
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Helen Hawley-Hague
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, and Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Ronny Bergquist
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jeanine Van Ancum
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Nini H Jonkman
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Kristin Taraldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Clemens Becker
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, and Manchester Academic Health Science Centre, Manchester, United Kingdom.,Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Lindy Clemson
- Faculty of Health Sciences, and Centre of Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
| | - Michael Schwenk
- Network Aging Research, Heidelberg University, Heidelberg, Germany.,Department of Clinical Gerontology and Geriatric Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany
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Burton E, Farrier K, Galvin R, Johnson S, Horgan NF, Warters A, Hill KD. Physical activity programs for older people in the community receiving home care services: systematic review and meta-analysis. Clin Interv Aging 2019; 14:1045-1064. [PMID: 31239654 PMCID: PMC6559239 DOI: 10.2147/cia.s205019] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/30/2019] [Indexed: 12/31/2022] Open
Abstract
The proportion of older adults is increasing around the world and most wish to live in their home until they die. To achieve this, many will require services in the home to remain living independently. To maintain function (ie, strength, balance, and endurance), physical activity needs to be undertaken on a regular basis, and is essential as a person ages. Unfortunately, as people age there is a tendency to reduce activity levels, which often leads to loss of function and frailty, and the need for home care services. This updated systematic review includes a mix of study methodologies and meta-analysis, and investigated the effectiveness of physical activity/exercise interventions for older adults receiving home care services. Eighteen studies including ten randomized controlled trials meeting the selection criteria were identified. Many of the studies were multi-factorial interventions with the majority reporting aims beyond solely trying to improve the physical function of home care clients. The meta-analysis showed limited evidence for effectiveness of physical activity for older adults receiving home care services. Future exercise/physical activity studies working with home care populations should consider focusing solely on physical improvements, and need to include a process evaluation of the intervention to gain a better understanding of the association between adherence to the exercise program and other factors influencing effectiveness.
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Affiliation(s)
- Elissa Burton
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Kaela Farrier
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Shanthi Johnson
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - N Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Austin Warters
- Health Service Executive, Dublin North City and County Healthcare Organisation, Dublin, Ireland
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
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21
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Elliott S, Leland NE. Occupational Therapy Fall Prevention Interventions for Community-Dwelling Older Adults: A Systematic Review. Am J Occup Ther 2019; 72:7204190040p1-7204190040p11. [PMID: 29953828 DOI: 10.5014/ajot.2018.030494] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Accidental falls among community-dwelling older adults are preventable and increase the risk of morbidity, hospitalization, and institutionalization. We updated and broadened a 2008 systematic review examining the evidence for the effectiveness of fall prevention interventions in improving fall-related outcomes, occupational performance, quality of life, and health care facility readmissions for community-dwelling older adults. METHOD We searched and analyzed literature published from 2008 to 2015 from five electronic databases. RESULTS Fifty articles met the inclusion criteria and were critically appraised and synthesized-37 provided Level I; 5, Level II; and 8, Level III evidence. Analysis was organized into four intervention themes: single component, multicomponent, multifactorial, and population based. Mixed evidence was found for single-component and multifactorial interventions, strong evidence was found for multicomponent interventions, and moderate evidence was found for population-based interventions. CONCLUSION These findings can inform the delivery and integration of fall prevention interventions from acute care to community discharge.
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Affiliation(s)
- Sharon Elliott
- Sharon Elliott, DHS, GCG, OTR/L, BCG, FAOTA, is Healthy Aging Specialist, Pitt County Council on Aging, Greenville, NC;
| | - Natalie E Leland
- Natalie E. Leland, PhD, OTR/L, BCG, FAOTA, is Associate Professor, Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, and Adjunct Faculty, Department of Health Services, Policy, and Practice, Brown University, Providence, RI
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22
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Schwenk M, Bergquist R, Boulton E, Van Ancum JM, Nerz C, Weber M, Barz C, Jonkman NH, Taraldsen K, Helbostad J, Vereijken B, Pijnappels M, Maier A, Zhang W, Becker C, Todd C, Clemson L, Hawley-Hague H. The Adapted Lifestyle-Integrated Functional Exercise Program for Preventing Functional Decline in Young Seniors: Development and Initial Evaluation. Gerontology 2019; 65:362-374. [DOI: 10.1159/000499962] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/28/2019] [Indexed: 11/19/2022] Open
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23
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active@home: Investigating the Value of a Home Care Worker–Led Exercise Program for Older Adults With Complex Care Needs. J Aging Phys Act 2019; 27:284-289. [DOI: 10.1123/japa.2017-0443] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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24
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Langeland E, Tuntland H, Folkestad B, Førland O, Jacobsen FF, Kjeken I. A multicenter investigation of reablement in Norway: a clinical controlled trial. BMC Geriatr 2019; 19:29. [PMID: 30700255 PMCID: PMC6354362 DOI: 10.1186/s12877-019-1038-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 01/17/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reablement is an emerging approach in rehabilitation services, but evidence for its efficacy is rather weak and inconsistent. The purpose of the present study is therefore to investigate the health effects of reablement in home-dwelling adults. METHODS A multicenter, clinical controlled trial involving 47 municipalities in Norway, with assessments at baseline, and after 10 weeks and at 6 and 12 months. The sample consisted of 707 persons that received a 4-10 week reablement program and 121 underwent treatment as usual. Primary outcomes were activity performance and satisfaction with performance measured by the Canadian Occupational Performance Measure (COPM, 1-10). Secondary outcomes included the Short Physical Performance Measure Battery (SPPB), the European Quality of Life Scale (EQ-5D-5 L), and the Sense of Coherence Questionnaire (SOC). Overall treatment effects were estimated with mixed-model repeated measures analyses. RESULTS Significant treatment effects in the rehabilitation group compared with the control group were found in COPM-Performance and COPM-Satisfaction scores at 10 weeks (mean differences between groups (MD), 1.61, 95% confidence interval (CI), 1.13, 2.10 and MD 1.47, CI 0.98, 1.97, respectively), and at 6 months (MD 1.42; CI 0.82,2.02 and MD 1.37; CI 0.77,1.98, respectively). There were also significant treatment effects in the SPPB-subscales for balance and walking after 6 months, in the total SPPB score and in the subscale for sit-to-stand after 12 months. In the EQ-5D-5 L assessment, significant treatment effects were found in the subscales for mobility, and for usual activities and health after 6 months. There was a significant difference in the SOC after six months. CONCLUSION Reablement seems to be a more effective rehabilitation service for persons with functional decline than traditional home-based services after six months. After 12 months, the differences between the groups decreased. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov on October 24, 2014, (retrospectively registered) identifier: NCT02273934 .
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Affiliation(s)
- E Langeland
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway. .,Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway.
| | - H Tuntland
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway.,Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway
| | - B Folkestad
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway.,Uni Research Rokkan Centre, Bergen, Norway
| | - O Førland
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway.,Faculty of Health Studies, VID Specialized University, Campus Bergen, Ulriksdal 10, 5009, Bergen, Norway
| | - F F Jacobsen
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway.,Faculty of Health Studies, VID Specialized University, Campus Bergen, Ulriksdal 10, 5009, Bergen, Norway
| | - I Kjeken
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, P.O. Box 23, Vinderen, 0319, Oslo, Norway.,Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway
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25
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Effects of Physical Activity Governmental Programs on Health Status in Independent Older Adults: A Systematic Review. J Aging Phys Act 2018; 27:265-275. [PMID: 29989461 DOI: 10.1123/japa.2017-0396] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This systematic review analyzes the evidence of the effects of physical activity governmental programs oriented toward the health of independent older adults. Medline, Web of Science, PsycINFO, and Psychology & Behavioral Sciences Collection databases were used for data mining, and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations were followed. Five studies (n = 2,545 participants) fulfilled the established inclusion criteria. The physical activity programs had beneficial effects on the older adults' quality of life, fall risk, activities of daily living, physical activity levels, nutritional risk, body mass index, arterial pressure, resting heart rate, blood glucose, triglycerides, and/or cholesterol, but did not significantly alter their body fat mass percentage. Programs involving diverse physical capacities seem to be more effective for healthy aging. It is recommended that governments start to disseminate the outcomes of these programs within society and the scientific community.
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Hsu HC, Kuo T, Lin JP, Hsu WC, Yu CW, Chen YC, Xie WZ, Hsu WC, Hsu YL, Yu MT. A Cross-Disciplinary Successful Aging Intervention and Evaluation: Comparison of Person-to-Person and Digital-Assisted Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E913. [PMID: 29734674 PMCID: PMC5981952 DOI: 10.3390/ijerph15050913] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 04/29/2018] [Accepted: 05/02/2018] [Indexed: 01/23/2023]
Abstract
Background: Successful aging has been the paradigm of old-age life. The purpose of this study was to implement and evaluate a cross-disciplinary intervention program using two approaches for community-based older adults in Taichung, Taiwan. Methods: The content of the intervention included successful aging concepts and preparation, physical activity, chronic disease and health management, dietary and nutrition information, cognitive training, emotional awareness and coping skills, family relationship and resilience, legal concepts regarding financial protection, and Internet use. The traditional person-to-person (P2P) intervention approach was implemented among participants at urban centers, and the personal-and-digital (P&D) intervention approach was implemented among participants at rural centers; before the P&D group received the intervention, participants were assessed as the control group for comparison. Results: Healthy behavior and nutrition improved for the P2P group, although not significantly. Strategies for adapting to old age and reducing ineffective coping were significantly improved in the P2P group. The ability to search for health information improved in the P&D group, and knowledge of finance-related law increased in the P2P group. Conclusion: A continuous, well-designed and evidence-based intervention program is beneficial for improving the health of older adults, or at least delaying its decline.
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Affiliation(s)
- Hui-Chuan Hsu
- Department of Health Care Administration, Asia University, Taichung 41354, Taiwan.
| | - Tsuann Kuo
- Department of Medical Sociology and Social Work, Chung Shang Medical University, Taichung 40201, Taiwan.
| | - Ju-Ping Lin
- Department of Human Development and Family Studies, National Taiwan Normal University, Taipei 10610, Taiwan.
| | - Wei-Chung Hsu
- Department of Radiation Oncology, Chung-Kang Branch, Cheng-Ching General Hospital, Taichung 40764, Taiwan.
| | - Chia-Wen Yu
- Department of Human Development and Family Studies, National Taiwan Normal University, Taipei 10610, Taiwan.
| | - Yen-Cheng Chen
- Department of Health Care Administration, Asia University, Taichung 41354, Taiwan.
| | - Wan-Zhen Xie
- Department of Health Care Administration, Asia University, Taichung 41354, Taiwan.
| | - Wei-Chiang Hsu
- Department of Health Care Administration, Asia University, Taichung 41354, Taiwan.
| | - Ya-Lan Hsu
- Department of Health Care Administration, Asia University, Taichung 41354, Taiwan.
| | - Mu-Ting Yu
- Department of Health Care Administration, Asia University, Taichung 41354, Taiwan.
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Burton E, Lewin G, O'Connell H, Petrich M, Boyle E, Hill KD. Can community care workers deliver a falls prevention exercise program? A feasibility study. Clin Interv Aging 2018; 13:485-495. [PMID: 29618925 PMCID: PMC5875587 DOI: 10.2147/cia.s162728] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Almost half of older people receiving community care fall each year and this rate has not improved in the last decade. Falls prevention programs targeted at this group are uncommon, and expensively delivered by university trained allied health professionals. Purpose To investigate the feasibility of community care workers delivering a falls prevention exercise program to older clients, at low or medium risk of falling, as part of an existing service provision. Patients and methods Community care workers from 10 community care organizations participated in the training for, and delivery to their clients of, an 8-week evidence-based falls prevention exercise program. Community care workers included assessment staff (responsible for identifying the need for community care services through completing an assessment) and support workers (responsible for providing support in the home). Clients were surveyed anonymously at the completion of the intervention and workers participated in a semi-structured interview. Results Twenty-five community care workers participated in the study. The falls prevention program was delivered to 29 clients, with an average age of 82.7 (SD: 8.72) years and consisting of 65.5% female. The intervention was delivered safely with no adverse events recorded, and the eligibility and assessment tools were completed by the majority of community care workers (93.1%). Assessment staff found it difficult to find time to deliver the intervention. Support workers were able to complete the intervention within their current service delivery period, with the initial assessment taking a small amount of additional time. Support workers reported enjoying the additional responsibility afforded by delivering the falls prevention program and seeing changes in their clients. The majority of clients (82%) reported enjoying the exercises, with 59% reporting that they felt it made a positive change in their health. Clients completed the exercises on average 4.8 (SD: 2.2) days per week. Conclusion Community care workers who have completed appropriate training are able to deliver a falls prevention exercise program to their clients as part of their current services. Further research is required to determine whether the program reduces the rate of falls for community care clients and whether integration of a falls prevention program into an existing service is cost-effective.
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Affiliation(s)
- Elissa Burton
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Gill Lewin
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Hilary O'Connell
- Independent Living Centre Western Australia, Perth, Western Australia, Australia
| | - Mark Petrich
- Western Australian Department of Health, Perth, Western Australia, Australia.,School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Eileen Boyle
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Mobilität im Altern fördern – (nahezu) immer und überall. Z Gerontol Geriatr 2017; 50:473-474. [DOI: 10.1007/s00391-017-1250-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hsu HC, Chuang SH, Hsu SW, Tung HJ, Chang SC, Lee MM, Wang JY, Kuo LT, Tseng FY, Po AT. Evaluation of a successful aging promotion intervention program for middle-aged adults in Taiwan. Glob Health Promot 2017; 26:81-90. [PMID: 28704138 DOI: 10.1177/1757975917702087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study was to implement and evaluate a successful aging intervention program for middle-aged private insurance beneficiaries. METHODS The participants were recruited from the staff and middle-aged clients for the experimental and control groups of a private insurance company. The two client (experimental and control) groups were matched by comparable age groups, gender, education, and purchased insurance types. The intervention program provided for the staff and the experimental group consisted of a series of educational courses on the topics about successful aging and preparation for 4 months. In total, there were 40 staff members, in addition to the 74 members of the experimental group and 60 members of the control group participating in the study. RESULTS After the intervention, the rate of physical activity and exercise significantly improved for the staff and for the intervention group. There were significant improvements in behaviors associated with doing exercise and living a less sedentary lifestyle and in the utilization of health examinations, and improvements in fitness and blood pressure. CONCLUSION The successful aging intervention program significantly improved awareness of successful aging, exercise behavior and fitness.
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Affiliation(s)
- Hui-Chuan Hsu
- 1. Department of Health Care Administration, Asia University, Taichung, Taiwan
- 2. Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Shu-Hui Chuang
- 1. Department of Health Care Administration, Asia University, Taichung, Taiwan
| | - Shang-Wei Hsu
- 1. Department of Health Care Administration, Asia University, Taichung, Taiwan
| | - Ho-Jui Tung
- 1. Department of Health Care Administration, Asia University, Taichung, Taiwan
| | - Shu-Ching Chang
- 3. Department of Health and Welfare, University of Taipei, Taipei, Taiwan
| | - Ming-Ming Lee
- 4. Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
| | - Jiun-Yi Wang
- 1. Department of Health Care Administration, Asia University, Taichung, Taiwan
| | - Li-Ting Kuo
- 1. Department of Health Care Administration, Asia University, Taichung, Taiwan
| | - Fang-Ya Tseng
- 1. Department of Health Care Administration, Asia University, Taichung, Taiwan
| | - An-Ting Po
- 1. Department of Health Care Administration, Asia University, Taichung, Taiwan
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De Coninck L, Bekkering GE, Bouckaert L, Declercq A, Graff MJL, Aertgeerts B. Home- and Community-Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review. J Am Geriatr Soc 2017; 65:1863-1869. [PMID: 28369719 DOI: 10.1111/jgs.14889] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community-dwelling physically frail older people. DESIGN We conducted a systematic review and meta-analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. MEASUREMENTS Meta-analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. RESULTS Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of -0.30 (95% CI -0.50 to -0.11; P = .002), for social participation -0.44 (95% CI -0.69, -0.19; P = .0007) and for mobility -0.45 (95% CI -0.78 to -0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. CONCLUSION There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people.
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Affiliation(s)
- Leen De Coninck
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,CEBAM Belgian Centre for Evidence-based Medicine vzw, Leuven, Belgium.,Department of Occupational Therapy, University College Artevelde, Ghent, Belgium
| | | | - Leen Bouckaert
- Department of Occupational Therapy, University College Artevelde, Ghent, Belgium
| | - Anja Declercq
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Maud J L Graff
- Scientific Institute for Quality of Health Care and Department of Rehabilitation, Donders Center for Cognition, Brain and Behavior, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Bert Aertgeerts
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,CEBAM Belgian Centre for Evidence-based Medicine vzw, Leuven, Belgium
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Youssef EF, Shanb AAE. Supervised Versus Home Exercise Training Programs on Functional Balance in Older Subjects. Malays J Med Sci 2016; 23:83-93. [PMID: 28090182 PMCID: PMC5181995 DOI: 10.21315/mjms2016.23.6.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 08/02/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Aging is associated with a progressive decline in physical capabilities and a disturbance of both postural control and daily living activities. The aim of this study was to evaluate the effects of supervised versus home exercise programs on muscle strength, balance and functional activities in older participants. METHODS Forty older participants were equally assigned to a supervised exercise program (group-I) or a home exercise program (group-II). Each participant performed the exercise program for 35-45 minutes, two times per week for four months. Balance indices and isometric muscle strength were measured with the Biodex Balance System and Hand-Held Dynamometer. Functional activities were evaluated by the Berg Balance Scale (BBS) and the timed get-up-and-go test (TUG). RESULTS The mean values of the Biodex balance indices and the BBS improved significantly after both the supervised and home exercise programs (P < 0.05). However, the mean values of the TUG and muscle strength at the ankle, knee and hip improved significantly only after the supervised program. A comparison between the supervised and home exercise programs revealed there were only significant differences in the BBS, TUG and muscle strength. CONCLUSIONS Both the supervised and home exercise training programs significantly increased balance performance. The supervised program was superior to the home program in restoring functional activities and isometric muscle strength in older participants.
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Affiliation(s)
- Enas Fawzy Youssef
- Physical Therapy Department, College of Applied Medical Sciences, University of Dammam, Alkhobar, Dammam City, Kingdom of Saudi Arabia
| | - Alsayed Abd elhameed Shanb
- Physical Therapy Department, College of Applied Medical Sciences, University of Dammam, Alkhobar, Dammam City, Kingdom of Saudi Arabia
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Keogh JWL, Henwood T, Gardiner P, Tuckett A, Hodgkinson B, Rouse K. Examining evidence based resistance plus balance training in community-dwelling older adults with complex health care needs: Trial protocol for the Muscling Up Against Disability project. Arch Gerontol Geriatr 2016; 68:97-105. [PMID: 27728839 DOI: 10.1016/j.archger.2016.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 10/20/2022]
Abstract
Progressive resistance plus balance training (PRBT) has been demonstrated as effective in reducing later life physical disability, falls risk and poor health, even among those with complex health care needs. However, few studies have examined the influence of PRBT on health service utilisation, cognitive wellbeing and training modality acceptance or undertaken a cost benefit analysis. This project will investigate the broad scope benefits of PRBT participation among community-dwelling older Australians receiving Government supported aged care packages for their complex health care needs. Using a modified stepped-wedge design, 248 community-dwelling adults 65 years and older with some level of government support aged care have been randomised into the study. Those randomised to exercise undertake six months of twice weekly machine-based, moderate to high intensity, supervised PRBT, followed by a six month unsupervised, unsupported follow-up. Controls spend six months undertaking usual activities, before entering the PRBT and follow-up phases. Data are collected at baseline and after each of the six month phases. Measures include level of and change in health and care needs, body composition, muscle capacity, falls, sleep, quality of life, nutritional and mental health status. In addition, acceptance and engagement is determined through telephone and focus group interviews complementing a multi-model health cost benefit evaluation. It is hypothesised this study will demonstrate the feasibility and efficacy of PRBT in improving primary and secondary health outcomes for older adults with aged care needs, and will support the value of this modality of exercise as an integral evidence-based service model of care.
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Affiliation(s)
- Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia; Human Potential Centre, AUT University, Auckland, New Zealand; Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Queensland, Australia.
| | - Tim Henwood
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia; AgeFIT Solutions, Brisbane, Australia; The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia.
| | - Paul Gardiner
- The University of Queensland, School of Public Health, Brisbane, QLD, Australia; The University of Queensland, Mater Research Institute, Brisbane, QLD, Australia.
| | - Anthony Tuckett
- The University of Queensland, School of Nursing, Midwifery and Social Work, Brisbane, Australia; College of Nursing, Yonsei University, Seoul, South Korea; School of Nursing, University of British Columbia, Vancouver, Canada.
| | | | - Kevin Rouse
- The Chermside Senior Citizens Centre, Burnie Brae, Australia.
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Potential analysis for research on occupational therapy-led physical exercise programmes and home environment adaptation programmes to prevent falls for elderly people living at home / Potenzialanalyse zu ergotherapeutischen körperlichen Trainingsprogrammen und Wohnraumanpassungen zur Vermeidung von Stürzen bei zu Hause lebenden älteren Menschen. INTERNATIONAL JOURNAL OF HEALTH PROFESSIONS 2016. [DOI: 10.1515/ijhp-2016-0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
In Germany, four to five million community-dwelling people aged 65 years or older fall every year. The presented potential analysis evaluates the potential of occupational therapy-led physical exercise programs and home environment adaptations to reduce the frequency of falling and as well as intrinsic and extrinsic risk factors for falling of older people living at home.
Methods
The potential analysis was compiled according to a method guideline (p.11-22) available as follows: http://www.cochrane. de/news/leitfaden-f%C3%BCr-gesundheitsfachberufe-mai-2013. The research question of fall prevention was considered as very relevant for health care and specified according to the PICOS-system. A Cochrane review was systematically searched and the body of evidence was assessed using the GRADE-system. In addition, studies after the search period of the Cochrane review were identified using the search strategy of this review. Both the studies within and after the review were assessed regarding their transferability to the German health care context.
Corpus of evidence
A Cochrane review from 2012 revealed that occupational therapy-led physical exercise programs reduced the frequency of falling of older people living at home (7 studies, 951 participants, 0.68 RaR; 95%-KI [0.58-0.80]), the number of fallers (6 studies, 714 participants, 0.78 RaR, 95%-KI [0.64-0.94]) and the fractures (6 studies, 810 participants, 0.34 RaR, 95%-KI [0.18-0.63]). Further studies showed that home environment adaptation programs significantly reduced the number of falls (4 studies, 1443 participants, 0.69 RaR, 95%-KI [0.55-0.86]) and the number of fallers (5 studies, 1153 participants, 0.79 RaR, 95%-KI [0.70-0.91]). However, direct implementation into the German healthcare context is not recommendable.
Implication for research
It is recommended (1) to manualise identified home environment adaptation programmes for the German healthcare context and (2) to pilot-test the physical exercise programmes ‘LiFE’ with regard to theoretical framework, acceptance, applicability and feasibility and to examine both interventions as part of a feasibility study. If this trial results in a feasible treatment programme well accepted by patients and their treating occupational therapists, a large-scaled randomized clinical trial in terms of comparative effectiveness research may follow.
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