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Moein S, Peterson EW, Rice LA. Factors associated with fear of falling and fall-related injuries among people who use wheelchairs and motorized mobility scooters: a cross-sectional study. Disabil Rehabil 2024:1-9. [PMID: 38910322 DOI: 10.1080/09638288.2024.2365984] [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: 01/04/2024] [Accepted: 06/05/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE To identify the factors associated with the fear of falling (FOF) and fall-related injuries (FRI) among full-time wheelchair and motorized mobility scooter (WC/S) users with various health conditions. METHODS This cross-sectional study included participants (≥18 years old) who used WC/S for at least one year for ≥ 75% of mobility and had a history of ≥ 1 fall in the past three years. Logistic regression models identified factors associated with FOF (yes/no) and FRI (yes/no) during the past year. Data on demographics, prior falls, mental health, environmental accessibility, and WC/S usage were used as independent variables. RESULTS Among 156 participants, 96% reported at least one fall within the past year, among whom 94.6% reported FOF, and 74% reported FRI within the same period. FOF was associated with fall incidence in the past year (OR = 17.75, p = 0.001). FRI was associated with higher levels of anxiety (OR = 1.15, p = 0.003) and fewer hours of WC/S use per week (OR = 0.98, p = 0.012). CONCLUSION This study highlights the high prevalence of FOF and FRI among WC/S users who had falls. The findings emphasized the relation between prior fall experiences and FOF and underscored the significance of addressing anxiety symptoms and WC/S usage in relation to FRI.
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Affiliation(s)
- Sahel Moein
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Elizabeth W Peterson
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Laura A Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Gao Y, Wang N, Liu Y, Liu N. Effectiveness of virtual reality in preventing falls in non-disabled older adults: A meta-analysis and systematic review. Geriatr Nurs 2024; 58:15-25. [PMID: 38729063 DOI: 10.1016/j.gerinurse.2024.04.010] [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: 01/02/2024] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE This study was conducted to evaluate the effectiveness of virtual reality interventions in preventing falls among non-disabled older adults. METHODS We conducted a librarian-designed database search. Two researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. RESULTS Virtual reality interventions can effectively improve gait and dynamic and static balance function, enhance lower limb muscle strength, and reduce the risk of falls in the non-disabled elderly. However, the effect of virtual reality on reducing the fear of falling remains controversial. CONCLUSION Virtual reality interventions can effectively prevent falls in nondisabled elderly individuals. Higher quality, larger sample size, and long-term follow-up studies are needed to further verify the long-term effectiveness of virtual reality training in preventing falls in non-disabled elderly individuals.
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Affiliation(s)
- Yan Gao
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China
| | - Nan Wang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu Liu
- School of Nursing, China Medical University, Shenyang, China
| | - Naiquan Liu
- Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, China.
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Meijer U, Flink M, Tuvemo Johnson S, Kierkegaard M, Gottberg K, Ytterberg C. Preventing falls in multiple sclerosis: a qualitative study on user requirements for a self-management programme. Disabil Rehabil 2024:1-8. [PMID: 38711397 DOI: 10.1080/09638288.2024.2348725] [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: 07/07/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE To explore perspectives of ambulatory and non-ambulatory people with MS (PwMS) and health care professionals (HCPs) on falls and falls management to gain a deeper understanding of how a self-management programme can be designed to fit the needs of end users. MATERIALS AND METHODS Twelve PwMS and seven HCPs participated in three four-hour workshops based on Design Thinking. Collected data were field notes and digital post-it notes gathered at the workshops. Data were analyzed using qualitative content analysis with an inductive approach. RESULTS Two main categories, "Managing the complexity of fall-risk behaviour" and "Embracing diversity to establish group engagement", comprising a total of seven categories were constructed from the analysis. The first main category reflects the challenges PwMS face in managing fall risk in their daily lives, and the support needed to address these challenges. The second main category highlights how engaging in peer learning activities can fulfil individual needs and improve learning outcomes for PwMS. CONCLUSION A self-management fall prevention programme that is relevant to PwMS regardless of ambulation level should include the development of self-tailored behavioural strategies to prevent falls along with interactive learning activities with other PwMS.
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Affiliation(s)
- Ulrika Meijer
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Maria Flink
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Susanna Tuvemo Johnson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Women's and children's health, Uppsala University, Uppsala, Sweden
| | - Marie Kierkegaard
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Academic Specialist Center, Center of Neurology, Stockholm Health Services, Stockholm, Sweden
| | - Kristina Gottberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Charlotte Ytterberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
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Choi J, Lee S, Park E, Ku S, Kim S, Yu W, Jeong E, Park S, Park Y, Kim HY, Kim SR. Psychometric Properties of the Fall Risk Perception Questionnaire-Short Version for Inpatients in Acute Care Hospitals. J Korean Acad Nurs 2024; 54:151-161. [PMID: 38863185 DOI: 10.4040/jkan.23127] [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: 10/05/2023] [Revised: 02/08/2024] [Accepted: 03/25/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE Patients' perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients. METHODS For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald's omega coefficient was used to examine the internal consistency of reliability. RESULTS In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald's omega coefficient was .90. CONCLUSION The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary.
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Affiliation(s)
- Jeeeun Choi
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Sujin Lee
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Eunjin Park
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Sangha Ku
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Sunhwa Kim
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Wonhye Yu
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Eunmi Jeong
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Sukhee Park
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Yusun Park
- College of Nursing, Korea University, Seoul, Korea
| | - Hye Young Kim
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
| | - Sung Reul Kim
- College of Nursing, Korea University Nursing Research Institute, Korea University, Seoul, Korea.
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Snyder MB, Zanotto T, Potts E, Sosnoff JJ. Characteristics and Consequences of Falls in People Who Use Wheelchairs in Long-Term Care Settings. J Am Med Dir Assoc 2024; 25:796-801. [PMID: 38643970 DOI: 10.1016/j.jamda.2024.03.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES The purpose of this study was to understand the characteristics and consequences of falls in individuals using wheelchairs in long-term care settings. DESIGN Observational analysis of real-world falls in long-term care. SETTING AND PARTICIPANTS Residents using wheelchairs from 2 long-term care facilities in British Columbia, Canada (n = 32 participants, mean age = 84.7 years, 12 women). METHODS Two raters used the validated Falls Video Analysis Questionnaire, adapted from the original version, to assess the causal, behavioral, and environmental aspects of falls from wheelchairs. RESULTS A total of 58 wheelchair fall videos were identified out of 300 total videos that were collected from 2007 to 2014. Wheelchair falls were most often caused by incorrect transfer or shift of body weight (70.7%). Participants most often fell backward with 89.7% striking their pelvis. Individuals using wheelchairs had limited protective response, with only 10.3% demonstrating a step response. Improper brake position contributed to 67.2% of falls. No serious fall-related injuries were reported. CONCLUSIONS AND IMPLICATIONS The findings highlight the unique nature of falls in older adults who use wheelchairs in long-term care settings. Overall, the results of this study support clinical practice and the critical need for developing specialized fall prevention and fall detection interventions for individuals who use wheelchairs in long-term care.
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Affiliation(s)
- Makenna B Snyder
- Mobility and Falls Laboratory, Human Performance Laboratory, University of Kansas Medical Center, Kansas City, KS, USA; Department of Occupational Therapy Education, University of Kansas Medical Center, Kansas City, KS, USA
| | - Tobia Zanotto
- Mobility and Falls Laboratory, Human Performance Laboratory, University of Kansas Medical Center, Kansas City, KS, USA; Department of Occupational Therapy Education, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, University of Kansas Medical Center, Kansas City, KS, USA; Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
| | - Emilia Potts
- Mobility and Falls Laboratory, Human Performance Laboratory, University of Kansas Medical Center, Kansas City, KS, USA; Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jacob J Sosnoff
- Mobility and Falls Laboratory, Human Performance Laboratory, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, University of Kansas Medical Center, Kansas City, KS, USA; Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA; Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA.
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Kacmaz KS, Unver B. The efficacy of taping on elbow proprioception in healthy individuals: A single-blinded randomized placebo-controlled study. J Hand Ther 2024; 37:201-208. [PMID: 38692994 DOI: 10.1016/j.jht.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/21/2024] [Accepted: 02/26/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Taping stimulates the mechanoreceptors, increases sensory information to the central nervous system, and improves sensorimotor synchronization, resulting in improved motor control. However, the efficacy of taping on elbow proprioception is not clear. PURPOSE This study aimed to evaluate the immediate effects of taping on elbow proprioception in healthy individuals. STUDY DESIGN This study was a two-arm, parallel-group, randomized, controlled, single-blinded study with a sham application. METHODS Fifty six healthy adults were randomized 1:1 to kinesio taping (n = 27) or sham taping (n = 29). Active joint position sense error (JPSE) was used to quantify proprioception using a universal goniometer at three-time points: baseline (BS), immediately after taping (IA), and 30 minutes after taping (30MA), with the tape still in place at 70° and 110° of elbow flexion. Participants were blinded to group assignments. The Friedman analysis assessed differences between evaluations within groups, and the Mann-Whitney U test determined differences between groups. RESULTS The study was completed with 56 participants and there were no dropouts. No skin reaction or adverse effect was observed in the participants and no test trial was excluded. The baseline scores of the groups were similar (p > 0.05). A significant difference was detected in the study group after kinesio taping at 70° (MD = -1.22; CI = (-2.33: -0.10; p < 0.005; d = 0.653) and 110° of elbow flexion (MD = -1.34; CI = 2,47: -0,21; p < 0.005; d = 0.73). This statistically significant difference was observed even at the 30MA evaluations at 70° (p < 0.05). Also, there was a statistically insignificant tendency to decrease in JPSE of both groups at both degrees following taping. CONCLUSIONS Elbow proprioception may be enhanced by kinesio taping, and this effect could last up to 30 minutes at 70° of elbow flexion. In contrast, sham taping did not produce such an improvement. Based on the differences in JPSE, kinesio taping proved more effective and had a longer-lasting impact than the sham application. The statistically insignificant tendency to decrease in JPSE may indicate that the 30-minute application period is inadequate to create a statistically significant effect on elbow proprioception. Longer usage periods can better reveal the effects of orthoses on proprioception.
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Affiliation(s)
- Kevser Sevik Kacmaz
- Department of Physical Therapy and Rehabilitation, Izmir Katip Celebi University, Cigli, Izmir, Turkey.
| | - Bayram Unver
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Balçova, Izmir, Turkey
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Kacmaz KS, Unver B, Karatosun V. The Reliability and Validity of the Lie-to-Sit-to-Stand-to-Walk Transfer (LSSWT) Test in Knee Osteoarthritis. Indian J Orthop 2023; 57:290-296. [PMID: 36777119 PMCID: PMC9880116 DOI: 10.1007/s43465-022-00802-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Background Several neuromuscular impairments may be observed in older patients with knee osteoarthritis (OA), increasing the risk of falling, which is common during transfer activities. The Lie-to-Sit-to- Stand-to-Walk Transfer (LSSWT) test was developed to evaluate complex transfer abilities. The study aims to investigate the reliability and validity of LSSWT in patients with knee OA. Methods Twenty-nine patients with knee OA were included in this study. The LSSWT, Timed up and go test (TUG), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were administered to the patients. Patients rested for at least an hour between the trials to avoid fatigue. Results The LSSWT has excellent reliability and high validity in patients with knee OA. The relative (ICC coefficient) and absolute (SEM and SRD95) reliability values are 0.96 (95% CI: 0.91-0.98), 1.00, and 2,75, respectively. The Pearson correlation coefficient of the LSSWT with the TUG is 0.73 (p < 0.01), and the Spearmen correlation coefficient of the LSSWT with the WOMAC is 0.54 (p < 0.05). Conclusions The LSSWT is highly reliable and valid in knee OA and is recommended for routine dynamic balance establishment. Having a low minimal clinically important difference shows the LSSWT's sensitivity. The LSSWT can easily identify dynamic balance deficits in knee OA patients and help prevent fall incidents.
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Affiliation(s)
- Kevser Sevik Kacmaz
- Department of Physical Therapy and Rehabilitation, Izmir Katip Celebi University, TR-35340 Cigli Izmir, Turkey
| | - Bayram Unver
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, TR-35340 Balçova Izmir, Turkey
| | - Vasfi Karatosun
- Department of Orthopaedics and Traumatology, School of Medicine, Dokuz Eylul University, TR-35340 Balçova-Izmir, Turkey
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Cheng M, Wang Y, Wang S, Cao W, Wang X. Network meta-analysis of the efficacy of four traditional Chinese physical exercise therapies on the prevention of falls in the elderly. Front Public Health 2023; 10:1096599. [PMID: 36684937 PMCID: PMC9846771 DOI: 10.3389/fpubh.2022.1096599] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction In recent years, traditional Chinese exercises have been passed down and reformed to play a significant role in the study of interventions for the treatment of falls in older people. However, few studies have evaluated the efficacy of various Chinese traditional exercises in the intervention of falls behavior in the elderly. In this study, four Chinese traditional exercises commonly used in clinical practice were selected as subjects to systematically evaluate the effectiveness of Tai Chi, Ba Duan Jin, Yi Jin Jing and Wu Qin Xi in intervening in the treatment of fall behavior in the elderly. Methods We conducted a systematic review in accordance with the PRISMA guidelines. Four published randomized controlled trials (RCTs) of traditional Chinese exercise interventions for the treatment of falls behavior in older adults were searched through authoritative databases such as CNKI, Web of Science, PubMed, EMbase and the Cochrane Library, all from the time of construction to November 2022. Results A total of 45 studies with 4 traditional interventions were included. Ba Duan Jin was more effective in improving TUGT [SMD = -1.93 (-2.49, -1.38), P < 0.05] and MFES [SMD = -33.45 (-63.93, -2.97), P < 0.05], while Yi Jin Jing was more effective in enhancing ECLSB [SMD = -0.19 (-5.12, -4.74), P < 0.05] and BBS [SMD = -5.79 (-10.80, -0.78), P < 0.05], both of which showed better effects. Discussion The present evidence suggests that all four traditional Chinese body-building exercise therapies have a preventive effect on fall behavior in older adults. In clinical treatment and daily physical exercise, two exercises, BaDuan Jin and Yi Jin Jing, may be preferred to reduce the risk of falls in the elderly, but the exercise regimen of Qigong should be selected scientifically and rationally according to their actual conditions. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#myprospero.
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Affiliation(s)
- Meichao Cheng
- School of Physical Education, Shandong University, Jinan, China
| | - Ya Wang
- School of Physical Education, Huaibei Normal University, Huaibei, China
| | - Shun Wang
- School of Physical Education, Huaibei Normal University, Huaibei, China
| | - Wenxiao Cao
- School of Physical Education, Huaibei Normal University, Huaibei, China
| | - Xianliang Wang
- School of Physical Education, Shandong University, Jinan, China
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Van Denend T, Peterson EW, McArthur AR, Yarnot R, Kish J, Steinkellner S, Sandhu A, Rice LA. A process evaluation of an on-line fall prevention and management program for individuals who use wheelchairs or scooters living with multiple sclerosis. Front Public Health 2022; 10:1042668. [PMID: 36579061 PMCID: PMC9791181 DOI: 10.3389/fpubh.2022.1042668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Background Falls and resulting injury are a significant concern for individuals living with multiple sclerosis (MS) that use a wheelchair and/or scooter to support mobility. Effective fall prevention efforts are vital to support the health, wellbeing, and participation for these individuals. Aims This study reports the findings from the process evaluation conducted in association with a pilot study evaluating the efficacy of Individualized Reduction of FaLLs-Online (iROLL-O), an online, group fall prevention, and management program specifically designed for community-based people living with multiple sclerosis (pwMS) who are full-time wheelchair or scooter users. Methods A mixed-methods process evaluation was conducted, with specific attention to the impact of online delivery on intervention implementation, participant satisfaction, and mechanisms of change (MOC). Multiple data sources were utilized, including post-session and post-intervention participant and trainer feedback forms and participant qualitative interview data. Descriptive analysis was conducted using Microsoft Excel. Close-ended questions were analyzed by examining five-point Likert scale responses. Qualitative interview data was explored using thematic analysis. Results Twelve participants and three trainers (one occupational therapist and two physical therapists) contributed to the study. Online delivery did not compromise session fidelity, which averaged 95%. No significant adaptations to the intervention were made during delivery. Participant satisfaction was high at 4.6/5.0. Post-course Trainer Feedback Forms indicate trainer satisfaction with the group dynamic, ability to address unique group needs, and program content. Reach improved with online delivery as transportation barriers were removed and recruitment from a broader geographic area was enabled. Three themes reflecting key MOC emerged from the analysis: group context, motivation for participant engagement, and the multifaceted nature of the program. The COVID-19 pandemic was identified as a contextual factor impacting community participation. Both participants and trainers identified the group dynamic as a strength. The trainers valued the program's flexibility in allowing them to address individual and/or group-specific fall prevention needs. Conclusion Feedback from key stakeholders was essential to a meaningful process evaluation. Online delivery supported program implementation, including reach, and resulted in high levels of satisfaction among participants and trainers. Future iterations should aim to uphold the positive group context, recruit, and train skilled interventionists who are licensed as occupational or physical therapists and continue to provide the program's diverse approach to fall prevention and management.
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Affiliation(s)
- Toni Van Denend
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
| | - Elizabeth W. Peterson
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
| | - Amy Roder McArthur
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States,Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, United States
| | - Rebecca Yarnot
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Jacqueline Kish
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States,Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, United States
| | - Sydney Steinkellner
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Arman Sandhu
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Laura A. Rice
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States,*Correspondence: Laura A. Rice
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Sessford JD, Chan K, Kaiser A, Singh H, Munce S, Alavinia M, Musselman KE. Protocol for a single group, mixed methods study investigating the efficacy of photovoice to improve self-efficacy related to balance and falls for spinal cord injury. BMJ Open 2022; 12:e065684. [PMID: 36600385 PMCID: PMC9743364 DOI: 10.1136/bmjopen-2022-065684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Many individuals living with spinal cord injury (SCI) experience falls and a fear of falling, both of which can impact participation in daily activities and quality of life. A single group, convergent mixed methods study will be conducted to examine the effects of a photovoice intervention on falls self-efficacy among individuals living with chronic SCI. Secondary objectives include examining the effects of photovoice on fear of falling, participation and quality of life and exploring participants' experiences and perceptions of the photovoice intervention through qualitative interviews. METHODS AND ANALYSIS Adults with SCI (n=40) will be divided into groups according to their mobility status (ie, those who ambulate and those who primarily use a wheelchair). The study will be conducted virtually over three consecutive phases, totalling 30 weeks. Each group will self-report falls for 12 weeks prior to and following the intervention (phases 1 and 3, respectively). The 6-week photovoice intervention (phase 2) will be comprised of two photo assignments, two individual interviews with a researcher and a peer mentor, and four group meetings. Participants will discuss these photos at the interviews and group meetings. Standardised questionnaires of falls self-efficacy, fear of falling, participation and life satisfaction will be administered at four time points (ie, beginning of each phase and the end of phase 3). Questionnaire scores will be examined over time using repeated-measures analysis of variance. A semistructured interview will be completed at the end of phase 3 to gain feedback on the photovoice intervention. Qualitative data will be analysed using reflexive thematic analysis. ETHICS AND DISSEMINATION Ethics approval was obtained prior to study enrolment. Findings will be shared through peer-reviewed scientific publications and participant-directed knowledge translation activities. TRIAL REGISTRATION NUMBER NCT04864262.
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Affiliation(s)
- James D Sessford
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Katherine Chan
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Anita Kaiser
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Hardeep Singh
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Munce
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Mohammad Alavinia
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Kristin E Musselman
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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11
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Van Denend T, Peterson EW, Sung J, Rice LA. Process evaluation findings of a fall prevention and management program for wheelchair and scooter users with multiple sclerosis. PEC INNOVATION 2022; 1:100081. [PMID: 37213774 PMCID: PMC10194268 DOI: 10.1016/j.pecinn.2022.100081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 08/16/2022] [Accepted: 09/01/2022] [Indexed: 05/23/2023]
Abstract
Objective To describe process evaluation findings of a clinical trial to evaluate the Individualized Reduction of Falls (iROLL) program, a 6-session, group-based intervention designed to reduce fall incidence among people living with multiple sclerosis (MS) who use a wheelchair or scooter full-time. Methods A mixed-methods process evaluation focusing on implementation and mechanisms of impact (MOI) was conducted. Both iROLL participants and trainers (licensed occupational or physical therapists) provided input. Results Seventeen iROLL participants and nine trainers participated. The overall session attendance rate was 93%. Content and logistics fidelity were 95% and 90%, respectively and average overall participant satisfaction rating was 4.7/5.0. Five MOI themes emerged: group dynamic, comprehensive nature of the program, strong program development, role of a skilled interventionist, and motivated participants. Recruitment challenged program reach. Conclusion iROLL is acceptable to the target audience, can be delivered with high fidelity and has diverse and interacting mechanisms of impact operating. Remote delivery may improve reach. Innovation Effective iROLL delivery requires trainers with strong group management skills who can also individualize material while maintaining program fidelity. Comprehensive training and on-going support of the occupational and physical therapists delivering iROLL bolsters program effectiveness. Program access may improve with online delivery.
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Affiliation(s)
- Toni Van Denend
- Department of Occupational Therapy, University of Illinois Chicago, IL, USA
| | | | - JongHun Sung
- Department of Kinesiology, College of Arts & Sports, Inha University, Incheon, South Korea
| | - Laura A. Rice
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Corresponding author at: 219 Freer Hall, 906 S. Goodwin Ave. Urbana, IL 61801, USA.
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Frechette M, Fanning J, Hsieh K, Rice L, Sosnoff J. The Usability of a Smartphone-Based Fall Risk Assessment App for Adult Wheelchair Users: Observational Study. JMIR Form Res 2022; 6:e32453. [PMID: 36112405 PMCID: PMC9526126 DOI: 10.2196/32453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 04/22/2022] [Accepted: 06/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background Individuals who use wheelchairs and scooters rarely undergo fall risk screening. Mobile health technology is a possible avenue to provide fall risk assessment. The promise of this approach is dependent upon its usability. Objective We aimed to determine the usability of a fall risk mobile health app and identify key technology development insights for aging adults who use wheeled devices. Methods Two rounds (with 5 participants in each round) of usability testing utilizing an iterative design-evaluation process were performed. Participants completed use of the custom-designed fall risk app, Steady-Wheels. To quantify fall risk, the app led participants through 12 demographic questions and 3 progressively more challenging seated balance tasks. Once completed, participants shared insights on the app’s usability through semistructured interviews and completion of the Systematic Usability Scale. Testing sessions were recorded and transcribed. Codes were identified within the transcriptions to create themes. Average Systematic Usability Scale scores were calculated for each round. Results The first round of testing yielded 2 main themes: ease of use and flexibility of design. Systematic Usability Scale scores ranged from 72.5 to 97.5 with a mean score of 84.5 (SD 11.4). After modifications were made, the second round of testing yielded 2 new themes: app layout and clarity of instruction. Systematic Usability Scale scores improved in the second iteration and ranged from 87.5 to 97.5 with a mean score of 91.9 (SD 4.3). Conclusions The mobile health app, Steady-Wheels, has excellent usability and the potential to provide adult wheeled device users with an easy-to-use, remote fall risk assessment tool. Characteristics that promoted usability were guided navigation, large text and radio buttons, clear and brief instructions accompanied by representative illustrations, and simple error recovery. Intuitive fall risk reporting was achieved through the presentation of a single number located on a color-coordinated continuum that delineated low, medium, and high risk.
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Affiliation(s)
- Mikaela Frechette
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Siebel Center for Design, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Katherine Hsieh
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Laura Rice
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Illinois Multiple Sclerosis Research Collaborative, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Center on Health, Aging, and Disability, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jacob Sosnoff
- Illinois Multiple Sclerosis Research Collaborative, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States
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Rice LA, Yarnot R, Sung J, Sosnoff JJ, Backus D, Abou L, Shen S, Peterson EW. Pilot Study of a Fall Prevention and Management Intervention Program for People With Multiple Sclerosis Who Use a Wheelchair or Scooter Full-Time. Arch Rehabil Res Clin Transl 2022; 4:100225. [PMID: 36545518 PMCID: PMC9761259 DOI: 10.1016/j.arrct.2022.100225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective To examine the efficacy of a fall prevention/management intervention among persons with multiple sclerosis (PwMS) who use a wheelchair (WC) or scooter full-time. Design Pre-post/follow-up trial. Setting Community and research laboratory. Participants Twenty-one PwMS who used a WC or scooter full-time, self-reported at least 1 fall/12 months, and could transfer independently or with minimal/moderate assistance (N=21). Intervention Six-week, group and community-based fall prevention and management intervention. The intervention included six 2-hour in-person weekly sessions led by a physical or occupational therapist featuring interactive group discussions, skill practice, and action planning opportunities. Main Outcome Measures Fall frequency tracked 12 weeks pre- and 24 weeks post intervention. Outcomes were assessed pre- and post intervention and 12 weeks post intervention. Measures included surveys to examine fear of falling (FOF), fall prevention/management, quality of life, community participation, and assessment of functional mobility skills. Semistructured interviews were administered post intervention to ascertain overall experiences with the program and effect on daily life. A Friedman test with signed-rank post hoc analysis was run to determine differences across the 3 study visits. Results After the intervention, fall incidence did not significantly change, but fall management strategies (P=.01-0.05), importance of community participation (P=.01), and transfer quality (P=.02) significantly improved. Moderate effect sizes were noted among concerns about falling, activity curtailment because of to FOF, and WC skills. Qualitative results indicate that participants found the intervention beneficial and applied intervention content in their daily lives. Conclusions This study is the first to describe the effect of a multicomponent fall prevention/management intervention designed specifically for PwMS who use a WC or scooter full-time. Results indicate the program has potential to reduce fall risk; however, further testing is needed to fully examine the effect of the program.
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Affiliation(s)
- Laura A. Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL,College of Applied Health Sciences, Center on Health, Aging, and Disability, Champaign, IL,Corresponding author Laura A. Rice, PhD, MPT, ATP, 219 Freer Hall, 906 S. Goodwin Ave, Urbana, IL 61801
| | - Rebecca Yarnot
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
| | - JongHun Sung
- Department of Kinesiology, Inha University, Incheon, Korea
| | - Jacob J. Sosnoff
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS
| | - Deborah Backus
- Virginia Crawford Research Institute, Shepherd Center, Atlanta, GA
| | - Libak Abou
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL,Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Sa Shen
- College of Applied Health Sciences, Center on Health, Aging, and Disability, Champaign, IL
| | - Elizabeth W. Peterson
- Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
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Fields BE, Whitney RL, Bell JF. Using a Mechanical Lift at Home: Preparing family caregivers to use lifts for transfers. Home Healthc Now 2022; 40:190-195. [PMID: 35777939 DOI: 10.1097/nhh.0000000000001084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.
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Affiliation(s)
- Bronwyn E Fields
- Bronwyn E. Fields is an assistant professor in the School of Nursing at California State University, Sacramento; Robin L. Whitney is an assistant professor at the Valley Foundation School of Nursing at San Jose State University, San Jose, CA; and Janice F. Bell is a professor and associate dean for research at the Betty Irene Moore School of Nursing, University of California Davis, Sacramento. Contact author: Bronwyn E. Fields, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Hsieh KL, Frechette ML, Fanning J, Chen L, Griffin A, Sosnoff JJ. The Developments and Iterations of a Mobile Technology-Based Fall Risk Health Application. Front Digit Health 2022; 4:828686. [PMID: 35574255 PMCID: PMC9091349 DOI: 10.3389/fdgth.2022.828686] [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: 12/03/2021] [Accepted: 03/28/2022] [Indexed: 11/19/2022] Open
Abstract
Falls are a prevalent and serious health concern across clinical populations. A critical step in falls prevention is identifying modifiable risk factors, but due to time constraints and equipment costs, fall risk screening is rarely performed. Mobile technology offers an innovative approach to provide personalized fall risk screening for clinical populations. To inform future development, this manuscript discusses the development and testing of mobile health fall risk applications for three unique clinical populations [older adults, individuals with Multiple Sclerosis (MS), and wheeled-device users]. We focus on key lessons learned and future directions to improve the field of fall risk mHealth. During the development phase, we first identified fall risk factors specific to each population that are measurable with mobile technology. Second, we determined whether inertial measurement units within smartphones can measure postural control within the target population. Last, we developed the interface of each app with a user-centered design approach with usability testing through iterative semi-structured interviews. We then tested our apps in real-world settings. Our cumulative work demonstrates that mobile technology can be leveraged to provide personalized fall risk screening for different clinical populations. Fall risk apps should be designed and tailored for the targeted group to enhance usefulness and feasibility. In addition, fall risk factors measured with mobile technology should include those that are specific to the population, are measurable with mobile technology, and can accurately measure fall risk. Future work should improve fall risk algorithms and implement mobile technology into fall prevention programs.
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Affiliation(s)
- Katherine L. Hsieh
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Mikaela L. Frechette
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Lingjun Chen
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States
| | - Aileen Griffin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Jacob J. Sosnoff
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States
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16
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Alencar MA, Guedes MCB, Pereira TAL, Rangel MFDA, Abdo JS, Souza LCD. Functional ambulation decline and factors associated in amyotrophic lateral sclerosis. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.35127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Amyotrophic lateral sclerosis (ALS) is a disabling neurodegenerative disease, which compromises locomotion and functional independence. As the goal of physical therapy is to maintain the individual's locomotion capacity and independence as long as possible, it is necessary to gain a better understanding of the possible factors associated with the loss of this capacity. Objective: To evaluate functional ambulation in patients with ALS and possible factors associated with its decline. Methods: A cross-sectional study was conducted with sporadic ALS patients. Demographic and clinical/functional aspects were evaluated. ALS Functional Rating Scale-Revised (ALSFRS-R), Functional Ambulation Category, Medical Research Council scale and Fatigue Severity Scale were used. Descriptive and comparative analyses were conducted of the groups capable and incapable of functional ambulation. Binary logistic regression (stepwise forward method) was performed to determine potential factors associated with the loss of functional ambulation. Results: Among the 55 patients (mean age: 56.9 ± 11.2 years), 74.5% were able to walk functionally. Differences were found between groups regarding time of diagnosis, number of falls, pain, use of noninvasive ventilation, gastrostomy, ability to turn in bed, mobility aids, home adaptations, functional performance, muscle strength and fatigue. The possible predictors of walking disability were overall muscle strength (OR = 0.837; p = 0.003) and fatigue (OR =1.653; p = 0.034). Conclusion: Muscle strength and fatigue are associated with the decline in ambulation capacity in patients with ALS. In view of the complexity of elements involved in walking, further studies are needed to investigate the influence of these aspects in this population.
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Piccione F, Maccarone MC, Cortese AM, Rocca G, Sansubrino U, Piran G, Masiero S. Rehabilitative management of pelvic fractures: a literature-based update. Eur J Transl Myol 2021; 31. [PMID: 34533018 PMCID: PMC8495369 DOI: 10.4081/ejtm.2021.9933] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/15/2021] [Indexed: 11/22/2022] Open
Abstract
A comprehensive rehabilitation program is required after Pelvic Fracture (PF). In a PF rehabilitation setting an effective treatment and a proper management of complications is supplied by an appropriate and reliable clinical assessment. In this literature-based update, we search on MEDLINE, EMBASE, and the Cochrane Database of Systematic reviews to find articles, scientific society guidelines and practioners experiences defining the rehabilitative management of clinically PF outcomes. Based on literature evidences and expert opinions, a set of key topics was collated to generate advices and recommendations to put into daily practice. Even if there are no high-quality evidence for rehabilitative interventions after PF in terms of duration and modality of therapy, rehabilitation setting, care pathways, and long-term functional outcomes, it is strongly recommended an early multidisciplinary intervention to improve recovery from PF.
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Affiliation(s)
- Francesco Piccione
- Department of Neuroscience, Rehabilitation Unit, University of Padova, Padova.
| | | | | | | | - Umberto Sansubrino
- Department of Neuroscience, Rehabilitation Unit, University of Padova, Padova.
| | - Giovanni Piran
- Physical Medicine and Rehabilitation School, University of Padova, Padua.
| | - Stefano Masiero
- Department of Neuroscience, Rehabilitation Unit, University of Padova, Padova, Italy; Physical Medicine and Rehabilitation School, University of Padova, Padua.
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Abou L, Fliflet A, Hawari L, Presti P, Sosnoff JJ, Mahajan HP, Frechette ML, Rice LA. Sensitivity of Apple Watch fall detection feature among wheelchair users. Assist Technol 2021; 34:619-625. [PMID: 33900885 DOI: 10.1080/10400435.2021.1923087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
A reliable fall detection device is crucial to minimize long-term consequences of falls among wheelchair users. This study examines the sensitivity of Apple Watch to detect intentional falls from a wheelchair. Twenty-five able bodied (age: 21.9 ± 2.5 years) participated in a protocol in which they intentionally fell out of a wheelchair in a laboratory setting. Each participant wore an Apple Watch Series 5 and performed 3 falls in the forward, right and left sideways, and backward directions onto a crash pad totaling 12 falls each. The Apple Watch was manually checked after each fall to determine if the device registered a fall. From 300 fall trials captured, the Apple Watch detected 14 falls showing a sensitivity of 4.7%, a false negative rate of 95.3%. Logistic regression showed that participant's height, impact force, lower limb functioning, and fall direction are parameters that may influence the ability of the Apple Watch to detect falls from a wheelchair. The Apple Watch fall detection feature presented with a very poor sensitivity to detect intentional falls from a wheelchair among able bodied young adults. Due to the high incidence and consequences of falls, a reliable fall detection device specific for wheelchair users is warranted.
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Affiliation(s)
- Libak Abou
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Alexander Fliflet
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Lina Hawari
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Peter Presti
- Interactive Media Technology Center, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Jacob J Sosnoff
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,Center for Health, Aging and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Harshal P Mahajan
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,Center for Health, Aging and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Mikaela L Frechette
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Laura A Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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19
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Péculo-Carrasco JA, Rodríguez-Bouza M, Casal-Sánchez MDM, de-la-Fuente-Rodríguez JM, Puerta-Córdoba A, Rodríguez-Ruiz HJ, Sánchez-Almagro CP, Failde I. Development and Validation of a Safety Scale Perceived by the Witness of Prehospital Emergency Care. J Patient Saf 2021; 17:101-107. [PMID: 30672763 DOI: 10.1097/pts.0000000000000567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to design and validate a new tool to measure the security perceived by witnesses of patient care and hospital transfers, after requesting urgent assistance via the "061" phone number. METHODS This is a descriptive observational, cross-sectional, design, and validation study of a scale conducted by telephone interview. Witnesses of urgent assistance and transfers by prehospital emergency medical services in the province of Cadiz, in the south of Spain, were the subjects of study. A questionnaire was designed after focus groups with patients, witnesses, and professionals. It consisted of 10 items, with Likert-type answers, and a range of 0 to 50 points. In addition to basic criteria (frequency of endorsement and ability to discriminate between groups), their validity (content and construct) and reliability (stability and homogeneity) were evaluated. Stability was evaluated by test-retest and homogeneity by means of two properties: internal consistency of items (corrected item-scale correlation coefficient) and internal consistency of the scale (Cronbach α coefficient). RESULTS A total of 849 questionnaires were obtained, with scores between 0 and 50 points, with an average of 47.31 (median of 50). The exploratory factor analysis detected a component that explained 61.1% of the total variance. The intraclass correlation coefficient was 0.933 with 95% confidence interval between 0.900 and 0.954. The corrected item-scale correlation coefficient was greater than 0.596, and the Cronbach α coefficient was 0.927 (95% confidence interval, 0.919-0.934). CONCLUSIONS The ESPT10 Witness Perceived Safety Scale is valid and reliable for quantifying the safety perception of witnesses of emergency assistance and transfers.
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Affiliation(s)
- Juan-Antonio Péculo-Carrasco
- From the Provincial Service 061 in Cadiz, Public Company for Health Emergencies EPES-061, Regional Government of Andalusia
| | - Mónica Rodríguez-Bouza
- From the Provincial Service 061 in Cadiz, Public Company for Health Emergencies EPES-061, Regional Government of Andalusia
| | | | | | - Antonio Puerta-Córdoba
- From the Provincial Service 061 in Cadiz, Public Company for Health Emergencies EPES-061, Regional Government of Andalusia
| | - Hugo-José Rodríguez-Ruiz
- From the Provincial Service 061 in Cadiz, Public Company for Health Emergencies EPES-061, Regional Government of Andalusia
| | - César-Pedro Sánchez-Almagro
- From the Provincial Service 061 in Cadiz, Public Company for Health Emergencies EPES-061, Regional Government of Andalusia
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Fields BE, Whitney RL, Bell JF. Using a Mechanical Lift at Home. Am J Nurs 2021; 121:57-62. [PMID: 33497130 DOI: 10.1097/01.naj.0000734140.20556.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.
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Affiliation(s)
- Bronwyn E Fields
- Bronwyn E. Fields is an assistant professor in the School of Nursing at California State University, Sacramento; Robin L. Whitney is an assistant professor at the Valley Foundation School of Nursing at San Jose State University, San Jose, CA; and Janice F. Bell is a professor and associate dean for research at the Betty Irene Moore School of Nursing, University of California Davis, Sacramento. Contact author: Bronwyn E. Fields, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Rice LA, Yarnot R, Peterson EW, Backus D, Sosnoff J. Fall Prevention for People With Multiple Sclerosis Who Use Wheelchairs and Scooters. Arch Phys Med Rehabil 2021; 102:801-804. [PMID: 33461727 DOI: 10.1016/j.apmr.2020.10.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 11/26/2022]
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Fear of Falling, Community Participation, and Quality of Life Among Community-Dwelling People Who Use Wheelchairs Full Time. Arch Phys Med Rehabil 2020; 102:1140-1146. [PMID: 33347892 DOI: 10.1016/j.apmr.2020.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/15/2020] [Accepted: 11/16/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine the differences in community participation and quality of life (QOL) among individuals who use wheelchairs full time with and without fear of falling (FOF). DESIGN Cross-sectional study design. SETTING University research laboratory. PARTICIPANTS Individuals (N=85) who use a manual or power wheelchair full time who are living with various health conditions and have a history of at least 1 fall in the past 12 months (age, 45.4±15.8y; disability duration, 21.5±13.6y) were included. Forty-six (54%) were manual wheelchair users. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES To quantify FOF, participants responded (yes/no) to the question: "Are you worried or concerned that you might fall?" Community participation and QOL were indexed by the Community Participation Indicator (CPI) and the World Health Organization Quality of Life-Brief version (WHOQOL-BREF), respectively. A multivariate analysis of variance (MANOVA) was performed to examine the differences in CPI and WHOQOL-BREF scores among wheelchair users who reported FOF and no FOF. RESULTS A total of 54 participants (63.5%) reported that they were worried or concerned about falling. The MANOVA revealed significant differences in overall CPI (F2,82=4.714; P=.012; Wilks' λ=0.897) and WHOQOL-BREF (F4,63=3.32; P=.016; Wilks' λ=.826) scores. Participants who reported FOF demonstrated significantly lower CPI and WHOQOL-BREF scores compared with those who did not report FOF. CONCLUSIONS FOF and associated activity curtailment are prevalent and may be a factor influencing full time wheelchair users' community participation and QOL. Prospective research is needed to better understand how FOF influences community participation and QOL among individuals who use wheelchairs full time. Findings would support the development of interventions, specifically for individuals who use wheelchairs full time, to reduce FOF and improve community participation and QOL.
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Frechette ML, Abou L, Rice LA, Sosnoff JJ. The Validity, Reliability, and Sensitivity of a Smartphone-Based Seated Postural Control Assessment in Wheelchair Users: A Pilot Study. Front Sports Act Living 2020; 2:540930. [PMID: 33367273 PMCID: PMC7750873 DOI: 10.3389/fspor.2020.540930] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 09/10/2020] [Indexed: 12/27/2022] Open
Abstract
Seated postural control is essential for wheelchair users to maintain proper position while performing activities of daily living. Clinical tests are commonly used to measure seated postural control, yet they are subjective and lack sensitivity. Lab-based measures are highly sensitive but are limited in scope and restricted to research settings. Establishing a valid, reliable, and accessible measurement tool of seated postural control is necessary for remote, objective assessments. Therefore, the purpose of this study was to examine the validity, reliability, and sensitivity of smartphone-based postural control assessments in wheelchair users. Eleven participants (age: 35.4 ± 17.9) completed two experimental visits 1-week apart consisting of three clinical tests: Trunk Control Test (TCT), Function in Sitting Test (FIST), and Tee-shirt Test, as well as, standardized instrumented balance tasks that manipulated vision (eyes open and closed), and trunk movement (functional reach and stability boundary). During these tasks, participants held a smartphone instrumented with a research-grade accelerometer to their chest. Maximum and root mean square (RMS) acceleration in the medial-lateral (ML) and anterior-posterior (AP) axes were derived. Participants were grouped into non-impaired and impaired postural groups based on FIST scores. Spearman rank-order correlations were conducted between the two devices' outcome measurements and between these measures and those of the clinical tests. Receiver operating characteristic (ROC) curves and the area under the curves (AUC) were determined to distinguish participants with and without impaired postural control. The reliability of outcome variables was assessed using inter-class correlations. Strong correlations between outputs derived from the smartphone and research-grade accelerometer were seen across balance tasks (ρ = −0.75–1.00; p ≤ 0.01). Numerous significant moderate correlations between clinical test outcomes and smartphone and research-grade RMS ML accelerometry were seen (ρ = −0.62 to 0.83 (p ≤ 0.044)]. On both devices, the AUC for ROC plots were significant for RMS ML sway during the eyes open task and functional stability boundary (p < 0.05). Reliability of smartphone accelerometry was comparable to the research-grade accelerometer and clinical tests. This pilot study illustrated that smartphone-based accelerometry may be able to provide a valid and reliable assessment of seated postural control and have the ability to distinguish between those with and without impaired postural control.
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Affiliation(s)
- Mikaela L Frechette
- Motor Control Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, United States.,Illinois Multiple Sclerosis Research Collaborative, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Libak Abou
- Disability Participation & Quality of Life Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Laura A Rice
- Illinois Multiple Sclerosis Research Collaborative, University of Illinois at Urbana Champaign, Urbana, IL, United States.,Disability Participation & Quality of Life Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Jacob J Sosnoff
- Motor Control Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, United States.,Illinois Multiple Sclerosis Research Collaborative, University of Illinois at Urbana Champaign, Urbana, IL, United States
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Scoping Review of Clinical Practice Guidelines for Fall Risk Screening and Assessment in Older Adults across the Care Continuum. Can J Aging 2020; 40:206-223. [PMID: 32985402 DOI: 10.1017/s0714980820000112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Given the rising numbers of older adults in Canada experiencing falls, evidence-based identification of fall risks and plans for prevention across the continuum of care is a significant priority for health care providers. A scoping review was conducted to synthesize published international clinical practice guidelines (CPGs) and recommendations for fall risk screening and assessment in older adults (defined as 65 years of age and older). Of the 22 CPGs, 6 pertained to multiple settings, 9 pertained to community-dwelling older adults only, 2 each pertained to acute care and long-term care settings only, and 3 did not specify setting. Two criteria, prior fall history and gait and balance abnormalities, were applied either independently or sequentially in 19 CPG fall risk screening algorithms. Fall risk assessment components were more varied across CPGs but commonly included: detailed fall history; detailed evaluation of gait, balance, and/or mobility; medication review; vision; and environmental hazards assessment. Despite these similarities, more work is needed to streamline assessment approaches for heterogeneous and complex older adult populations across the care continuum. Support is also needed for sustainable implementation of CPGs in order to improve health outcomes.
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Rice LA, Sung JH, Keane K, Peterson E, Sosnoff JJ. A brief fall prevention intervention for manual wheelchair users with spinal cord injuries: A pilot study. J Spinal Cord Med 2020; 43:607-615. [PMID: 31343950 PMCID: PMC7534352 DOI: 10.1080/10790268.2019.1643070] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective: To conduct a pilot study of an intervention to decrease fall incidence and concerns about falling among individuals living with Spinal Cord Injury who use manual wheelchairs full-time. Design: Pre/post. After a baseline assessment, a structured intervention was implemented. The assessment protocol was repeated 12 weeks after the baseline assessment. Setting: Research laboratory and community. Participants: 18 individuals living with SCI who use a manual wheelchair full-time with an average age of 35.78 ± 13.89 years, lived with SCI for 17.06 ± 14.6 years; 61.1% were female. Intervention: A 1:1, 45 minute, in-person intervention focused on factors associated with falls and concerns about falling: transfers skills and seated postural control. Outcome measures: Participants reported fall incidence and completed the Spinal Cord Injury Fall Concerns Scale, Community Participation Indicators and the World Health Organization Quality of Life - short version (WHOQOL-BREF). Transfer quality was assessed with the Transfer Assessment Instrument (TAI) and seated postural control with the Function In Seating Test (FIST). Results: Recruitment, assessment and delivery of the intervention were successfully completed. After exposure to the intervention, fall incidence significantly decreased, (P = 0.047, dz = 0.507) and FIST scores improved (P = 0.035, dz = 0.54). Significant improvements were also found in the WHOQOL-BREF Physical (P = 0.05, dz = 1.566) and Psychological (P = 0.040, dz = 0.760) domains. Conclusion: The feasibility of the structured intervention was established and the intervention has the potential to reduce fall incidence and improve quality of life among individuals living with SCI who use a wheelchair. Appropriately powered randomized controlled trials of the program are warranted.
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Affiliation(s)
- Laura A. Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA,Correspondence to: Laura A. Rice, Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, 906 S. Goodwin Ave., 219 Freer Hall, Urbana, IL61801, USA.
| | - Jong Hun Sung
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Kathleen Keane
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Elizabeth Peterson
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jacob J. Sosnoff
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA,Center on Health, Aging and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: A mixed methods approach using photovoice. PLoS One 2020; 15:e0238116. [PMID: 32857793 PMCID: PMC7454945 DOI: 10.1371/journal.pone.0238116] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/09/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Wheelchair users with spinal cord injury are at a high risk of falls. However, the perspectives of wheelchair users with spinal cord injury on their fall circumstances and their preferences for fall prevention strategies/interventions remain understudied. Therefore, we aimed to: a) describe the circumstances of falls experienced by wheelchair users with spinal cord injury over a six-month period, b) explore their perspectives of why falls occurred in certain situations, and c) explore their perspectives on recommended content/structure of fall prevention strategies/interventions. Methods This sequential explanatory mixed methods study had two phases. Phase I involved tracking of falls experienced by wheelchair users with spinal cord injury over six months, in which participants completed a survey after experiencing a fall to track the number/circumstance of each fall. Data from the surveys were descriptively reported. Phase II involved a photovoice focus group discussion of the survey findings and their preferences for fall prevention strategies/interventions. Data from the focus group discussion were analyzed using a thematic analysis. Results Thirty-two participants completed phase I. More than half of the participants fell at least once in six months. Falls commonly occurred in the afternoon during a transfer, or when participants were wheeling over uneven ground. One-third of the falls caused an injury. Eleven participants that fell during phase I participated in the focus group. Two main themes were identified from the discussion: 1) “circumstances surrounding the falls” (e.g. when falls occurred, the home is a ‘safe space’) and 2) “suggestions and preferences for fall prevention strategies/interventions” (e.g. fall prevention involves all, fall prevention training available as needed). Conclusion Fall prevention strategies/interventions should be an integral component of rehabilitation practices across the lifespan. Participants recommend customizing fall prevention strategies/interventions to their specific needs to guide the structure, content, and delivery of targeted fall prevention programs.
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Moran RN, Broglio SP, Francioni KK, Sosnoff JJ. Exploring Baseline Concussion-Assessment Performance in Adapted Wheelchair Sport Athletes. J Athl Train 2020; 55:856-862. [PMID: 32607535 DOI: 10.4085/1062-6050-294-19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT With growing awareness of and advocacy for including individuals with disabilities in sport, implementation of concussion-assessment and -management strategies is warranted. Limited research is available on concussion assessment in adapted wheelchair sport athletes. OBJECTIVE To examine baseline symptom reporting, computerized neurocognitive testing, and a modified balance scoring system in adapted athletes. A secondary objective was to provide preliminary normative data for this population. DESIGN Cross-sectional study. SETTING University athletic training room and computer laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-one athletes (age = 22.1 ± 3.0 years) from 1 institution's collegiate adapted athletics program. MAIN OUTCOME MEASURE(S) Athletes completed baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and the Wheelchair Error Scoring System (WESS) before the start of their respective seasons. Symptom reporting variables consisted of total symptoms, symptom severity scores, and baseline symptom factors (eg, vestibular-somatic, sleep arousal, cognitive-sensory, and affective). We analyzed ImPACT composite scores of verbal memory, visual memory, visual motor processing speed, and reaction time and impulse control to determine neurocognitive function. Balance performance was quantified using the WESS condition and overall errors. RESULTS Compared with normative reference values, 17 (81%) of adapted athletes reported greater symptoms and 20 (95%) performed at or below average on at least 1 neurocognitive composite score. Mean errors on the WESS were 3.14 ± 2.9, with 81% committing ≥1 error. Sex differences were not present for symptoms, neurocognitive testing, or balance measures. CONCLUSIONS Our findings provide context for baseline performance in adapted athletes and help to further develop the WESS as an assessment of balance in these athletes.
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Affiliation(s)
- Ryan N Moran
- Athletic Training Research Laboratory, The University of Alabama, Tuscaloosa
| | - Steven P Broglio
- NeuroTrauma Research Laboratory, University of Michigan, Ann Arbor
| | | | - Jacob J Sosnoff
- Motor Control Research Laboratory, University of Illinois at Urbana-Champaign
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Veronese N, Soysal P, Stubbs B, Maggi S, Jackson SE, Demurtas J, Celotto S, Koyanagi A, Bolzetta F, Smith L. Dietary Protein Intake and Falls in Older People: Longitudinal Analyses From the Osteoarthritis Initiative. J Am Med Dir Assoc 2019; 20:1623-1627. [DOI: 10.1016/j.jamda.2019.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/05/2019] [Accepted: 03/16/2019] [Indexed: 02/05/2023]
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Lo L, Hebert D, Colquhoun H. Measuring practice gaps in the delivery of evidence-based seating assessments: a retrospective chart review. Disabil Rehabil Assist Technol 2019; 16:255-261. [DOI: 10.1080/17483107.2019.1672814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Lorna Lo
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Debbie Hebert
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Rocket Family Upper Extremity Clinic, Toronto Rehab, Toronto, Ontario, Canada
| | - Heather Colquhoun
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
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30
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Rice LA, Peters J, Sung J, Bartlo WD, Sosnoff JJ. Perceptions of Fall Circumstances, Recovery Methods, and Community Participation in Manual Wheelchair Users. Am J Phys Med Rehabil 2019; 98:649-656. [PMID: 31318744 DOI: 10.1097/phm.0000000000001161] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to examine the circumstances surrounding the worst fall experienced by full-time manual wheelchair users in the past 12 mos, the recovery process, and influence on community participation. DESIGN A mixed-method research study was conducted. Semistructured interviews were conducted to understand the circumstances of the worst fall experienced and the recovery process. A quantitative fear of falling assessment and the community participation indicators were used to further evaluate the influence of the fall. RESULTS There were 20 manual wheelchair users (mean ± SD, 47 ± 13 yrs, 55% male). Falls most commonly occurred outside during wheelchair propulsion. Falls were attributed to both intrinsic and extrinsic factors. Seventy percent of participants reported a fear of falling and 80% required assistance to recovery. No significant correlations were found between fall frequency and community participation indicator scores. Participants who needed assistance to recover (56.70 ± 17.66) had lower community participation indicator importance scores compared with participants able to recover independently (88.93 ± 22.13), P = 0.05. CONCLUSIONS Falls are complex and most manual wheelchair users need assistance to recover. Comprehensive programs including education on prevention and postfall management are needed. Results may increase understanding of the circumstances associated with falls and inform the development of evidenced-based clinical practice guidelines.
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Affiliation(s)
- Laura A Rice
- From the Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois (LAR, JP, JHS, JJS); and Center on Health, Aging, and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois (WDB, JJS)
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Li J, Jiang J, Zhang Y, Liu B, Zhang L. Impairment of Vestibular Function and Balance Control in Patients with Type 2 Diabetes. Audiol Neurootol 2019; 24:154-160. [PMID: 31326970 DOI: 10.1159/000501291] [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: 10/05/2018] [Accepted: 06/03/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Recent evidence suggests that falls are a major complication of diabetes in elderly patients, leading to disability and preventable death. However, the potential risk factors leading to falls in patients with type 2 diabetes are not fully understood. This study was designed to explore the characteristics of vestibular dysfunction and balance control in patients with type 2 diabetes and to analyse the risk factors associated with falls. METHODS The study recruited 51 patients with type 2 diabetes and 43 controls who underwent vestibular function tests and balance control capability tests between January 2013 and December 2015. Vestibular function and balance control capability assessment was based on slow-phase velocity, canal paresis, Sensory Organisation Test (SOT) score, Limits of Stability Test (LOS) score, and Motor Control Test (MCT) score. RESULTS In all, 56.7% of the diabetic patients had vestibular dysfunction, compared with 27.9% of the controls (p = 0.005). Vestibular dysfunction was dependent on the duration of the disease and serum HbA1c levels. There were no significant differences between the two groups with respect to the balance test results for SOT score, somatosensory subtest score, vestibular subtest score, or LOS score. However, the visual system and MCT scores were significantly lower in the diabetic patients than in the controls (p = 0.032 and p = 0.018, respectively). CONCLUSIONS Patients with type 2 diabetes have a higher incidence of vestibular dysfunction. Vestibular dysfunction, visual system impairment, and a decline in motion control may be the risk factors that can lead to falls, and thus need to be managed accordingly in diabetic patients.
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Affiliation(s)
- Jin Li
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Jana Jiang
- University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Yi Zhang
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Bo Liu
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China, .,Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China,
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Sung J, Trace Y, Peterson EW, Sosnoff JJ, Rice LA. Falls among full-time wheelchair users with spinal cord injury and multiple sclerosis: a comparison of characteristics of fallers and circumstances of falls. Disabil Rehabil 2019; 41:389-395. [PMID: 29069956 DOI: 10.1080/09638288.2017.1393111] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this study is to (1) explore and (2) compare circumstances of falls among full-time wheelchair users with spinal cord injury (SCI) and multiple sclerosis (MS). METHODS A mixed method approach was used to explore and compare the circumstances of falls of 41 full-time wheelchair users with SCI (n = 23) and MS (n = 18). In addition to collecting participants' demographic information (age, gender, type of wheelchair used, duration of wheelchair use, and duration of disability), self-reported fall frequency in the past 6 months, self-reported restriction in activity due to fear of falling and the Spinal Cord Injury-Fall Concerns Scale (SCI-FCS) was collected. Qualitative data in the form of participants' responses to an open-ended question yielding information regarding the circumstances of the most recent fall were also collected. To examine differences in survey outcomes and demographic characteristics between participants with SCI and MS, independent t-tests and Pearson's Chi-square tests were used. Qualitative data were analyzed with a thematic analysis. RESULTS Statistical analysis revealed that individuals with MS (mean =3.3) had significantly higher average SCI-FCS than individuals with SCI (mean =2.4). The analysis of the participants' descriptions of the circumstances of their most recent falls resulted in three main categories: action-related fall contributors (e.g., transfer), (2) location of falls (e.g., bathroom), and (3) fall attributions (e.g., surface condition). CONCLUSIONS The results from this study helped to understand fall circumstances among full-time wheelchair users with MS and SCI. Findings from this study can inform the development of evidenced-based interventions to improve the effectiveness of clinically based treatment protocols. Implications for rehabilitation Falls are a common health concern in full-time wheelchair users living with multiple sclerosis and spinal cord injury. The circumstances surrounding falls reported by full-time wheelchair users living with multiple sclerosis and spinal cord injuries were found to be multifactorial. The complex nature of falls must be taken into consideration in the development of fall prevention programs. Findings from this study can inform the development of comprehensive evidence-based, population-specific interventions to manage falls among full-time wheelchair users living with multiple sclerosis and spinal cord injury.
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Affiliation(s)
- JongHun Sung
- a Department of Kinesiology and Community Health , University of Illinois at Urbana , Urbana, IL , USA
| | - Yarden Trace
- a Department of Kinesiology and Community Health , University of Illinois at Urbana , Urbana, IL , USA
| | - Elizabeth W Peterson
- b Department of Occupational Therapy , University of Illinois at Chicago , Chicago , IL , USA
| | - Jacob J Sosnoff
- a Department of Kinesiology and Community Health , University of Illinois at Urbana , Urbana, IL , USA
| | - Laura A Rice
- a Department of Kinesiology and Community Health , University of Illinois at Urbana , Urbana, IL , USA
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Sandoval-Insausti H, Pérez-Tasigchana RF, López-García E, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. Protein Intake and Risk of Falls: A Prospective Analysis in Older Adults. J Am Geriatr Soc 2018; 67:329-335. [DOI: 10.1111/jgs.15681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- Service of Preventive Medicine; Hospital Universitario de La Princesa; Madrid Spain
| | - Raúl F. Pérez-Tasigchana
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- School of Medicine, Universidad San Francisco de Quito; Quito Ecuador
| | - Esther López-García
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid Spain
| | - José R. Banegas
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid Spain
- Welch Center for Prevention; Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health; Baltimore Maryland
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Hsieh KL, Fanning JT, Rogers WA, Wood TA, Sosnoff JJ. A Fall Risk mHealth App for Older Adults: Development and Usability Study. JMIR Aging 2018; 1:e11569. [PMID: 31518234 PMCID: PMC6716481 DOI: 10.2196/11569] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/21/2018] [Accepted: 10/14/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Falls are the leading cause of injury-related death in older adults. Due to various constraints, objective fall risk screening is seldom performed in clinical settings. Smartphones offer a high potential to provide fall risk screening for older adults in home settings. However, there is limited understanding of whether smartphone technology for falls screening is usable by older adults who present age-related changes in perceptual, cognitive, and motor capabilities. OBJECTIVE The aims of this study were to develop a fall risk mobile health (mHealth) app and to determine the usability of the fall risk app in healthy, older adults. METHODS A fall risk app was developed that consists of a health history questionnaire and 5 progressively challenging mobility tasks to measure individual fall risk. An iterative design-evaluation process of semistructured interviews was performed to determine the usability of the app on a smartphone and tablet. Participants also completed a Systematic Usability Scale (SUS). In the first round of interviews, 6 older adults participated, and in the second round, 5 older adults participated. Interviews were videotaped and transcribed, and the data were coded to create themes. Average SUS scores were calculated for the smartphone and tablet. RESULTS There were 2 themes identified from the first round of interviews, related to perceived ease of use and perceived usefulness. While instructions for the balance tasks were difficult to understand, participants found it beneficial to learn about their risk for falls, found the app easy to follow, and reported confidence in using the app on their own. Modifications were made to the app, and following the second round of interviews, participants reported high ease of use and usefulness in learning about their risk of falling. Few differences were reported between using a smartphone or tablet. Average SUS scores ranged from 79 to 84. CONCLUSIONS Our fall risk app was found to be highly usable by older adults as reported from interviews and high scores on the SUS. When designing a mHealth app for older adults, developers should include clear and simple instructions and preventative strategies to improve health. Furthermore, if the design accommodates for age-related sensory changes, smartphones can be as effective as tablets. A mobile app to assess fall risk has the potential to be used in home settings by older adults.
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Affiliation(s)
- Katherine L Hsieh
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Jason T Fanning
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Wendy A Rogers
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Tyler A Wood
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Jacob J Sosnoff
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, United States
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Rice LA, Sung J, Peters J, Bartlo WD, Sosnoff JJ. Perceptions of fall circumstances, injuries and recovery techniques among power wheelchair users: a qualitative study. Clin Rehabil 2018; 32:985-993. [PMID: 29627995 DOI: 10.1177/0269215518768385] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To understand the circumstances surrounding the worst fall experienced by power wheelchair users in the past year and to examine injuries sustained and recovery methods. DESIGN A qualitative study using a semi-structured interview. SETTING Community. PARTICIPANTS A self-selected volunteer sample of 19 power wheelchair users who utilize their device for at least 75% of mobility. The most common disability represented was cerebral palsy ( n = 8). The mean (SD) age of participants was 41.9 (7.6) years, who lived with their disability for a mean (SD) of 20.5 (8.62) years and used their current device for a mean (SD) of 3.9 (1.9) years. INTERVENTION None. MAIN OUTCOME MEASURES A semi-structured interview examined the circumstances surrounding the worst fall experienced in the past year, injuries sustained and recovery techniques used. RESULTS Upon examination of the circumstances of the worst fall, four main themes emerged: (1) action-related fall contributors, (2) location of falls, (3) fall attributions and (4) time of fall. Each fall described was found to involve multiple factors. As a result of the fall, participants also reported the occurrence of physical injuries and a fear of falling. Physical injuries ranged from skin abrasion and bruises to fractures and head injuries. Participants also reported that fear of falling diminished their desire to participation in activities they enjoyed doing. Finally, most participants reported the need for physical assistance to recover from a fall. CONCLUSION Participant descriptions provide an in-depth description of the circumstances and aftermath of falls experienced by power wheelchair users.
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Affiliation(s)
- Laura A Rice
- 1 Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - JongHun Sung
- 1 Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Joseph Peters
- 1 Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Wendy D Bartlo
- 2 The Center on Health, Aging, and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Jacob J Sosnoff
- 1 Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Kim D, Yang PS, Kim TH, Uhm JS, Park J, Pak HN, Lee MH, Joung B. Effect of Atrial Fibrillation on the Incidence and Outcome of Osteoporotic Fracture - A Nationwide Population-Based Study. Circ J 2018; 82:1999-2006. [PMID: 29794400 DOI: 10.1253/circj.cj-17-1179] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Both atrial fibrillation (AF) and osteoporosis are common in older adults. The purpose of this study was to investigate whether comorbid AF in patients with osteoporosis is associated with fracture incidence, or death after fracture.Methods and Results:From the National Health Insurance Service database of Korea, we selected 31,778 patients with osteoporosis. During a median follow-up of 48 months, the incidence of bone fractures was higher in AF patients than in non-AF patients (3.20 vs. 2.18 per 100 person-years), respectively. In the multivariate Cox regression analysis, AF was associated with fracture independently of other risk factors with an adjusted hazard ratio (HR) of 1.21 (95% confidence interval [CI], 1.02-1.41; P=0.031). The mortality rate after fracture was significantly higher in AF patients than it was in non-AF patients (adjusted HR, 1.92; 95% CI, 1.35-3.27; P=0.016). After propensity score-matching, AF was consistently associated with a higher risk of osteoporotic fracture and subsequent death after fracture. In AF patients, older age, female sex, being underweight (body mass index <18.5 kg/m2), decreased physical activity (exercise <3 times/week), history of stroke or transient ischemic attack, thiazide use, sedative use, and higher CHADS2(≥2 points) or CHA2DS2-VASc (≥2 points) scores were associated with the incidence of fractures. CONCLUSIONS Comorbid AF in patients with osteoporosis was associated with an increased risk of bone fracture and death after fracture.
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Affiliation(s)
- Daehoon Kim
- Division of Cardiology, Yonsei University College of Medicine
| | - Pil-Sung Yang
- Division of Cardiology, Yonsei University College of Medicine.,Department of Cardiology, CHA Bundang Medical Center, CHA University
| | - Tae-Hoon Kim
- Division of Cardiology, Yonsei University College of Medicine
| | - Jae-Sun Uhm
- Division of Cardiology, Yonsei University College of Medicine
| | - Junbeom Park
- Department of Cardiology, School of Medicine, Ewha Womans University
| | - Hui-Nam Pak
- Division of Cardiology, Yonsei University College of Medicine
| | - Moon-Hyoung Lee
- Division of Cardiology, Yonsei University College of Medicine
| | - Boyoung Joung
- Division of Cardiology, Yonsei University College of Medicine
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Rice LA, Isaacs Z, Ousley C, Sosnoff J. Investigation of the Feasibility of an Intervention to Manage Fall Risk in Wheeled Mobility Device Users with Multiple Sclerosis. Int J MS Care 2018; 20:121-128. [PMID: 29896048 DOI: 10.7224/1537-2073.2016-097] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Falls are a common concern for wheeled mobility device users with multiple sclerosis (MS); however, no evidence-based fall prevention programs have been developed to meet the specific needs of the population. We examine the preliminary feasibility of a fall management intervention in wheeled mobility device users with MS. Methods Study participants were exposed to an intervention program targeting risk factors for falls, including transfer skills and seated postural control. The feasibility of the program was evaluated by assessing participant perspectives, cost, recruitment rates, study adherence, participant retention, safety, and the ability to collect primary and secondary outcomes, including fall frequency, concerns about falling, transfer quality, and seated postural control. Results 16 wheeled mobility device users completed the program, which was found to be feasible and was positively evaluated by participants. No adverse events were experienced. After exposure to the intervention, fall frequency significantly decreased (P < .001) and transfer quality (P = .001) and seated postural control (P = .002) significantly improved. No significant differences were found regarding concerns about falling (P = .728). Conclusions This study examined the feasibility of an intervention program to manage fall risk in wheeled mobility device users with MS. The program was found to be feasible, and preliminary results showed the intervention to be effective in decreasing fall frequency. Additional testing is needed to further examine the efficacy and long-term impact of the intervention.
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Rice L, Kalron A, Berkowitz SH, Backus D, Sosnoff JJ. Fall prevalence in people with multiple sclerosis who use wheelchairs and scooters. Medicine (Baltimore) 2017; 96:e7860. [PMID: 28858096 PMCID: PMC5585490 DOI: 10.1097/md.0000000000007860] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 07/05/2017] [Accepted: 07/18/2017] [Indexed: 12/02/2022] Open
Abstract
Falls are a serious health concern for persons with multiple sclerosis (PwMS) who use wheelchairs or scooters as their primary mode of mobility. Unfortunately, little is known about the fall prevalence and characteristics of this large segment of the multiple sclerosis (MS) community. The purpose of this study is to determine the prevalence and circumstances of falls in wheelchair and scooter users living with MS. Forty-four PwMS were recruited from research and medical centers in the United States and Asia. Participants completed a survey focusing on prevalence of falls, frequency of injurious falls, circumstances of the fall, and various quality of life indicators. A total of 44 individuals (32 females/11 males/1 not reported) aged 27 to 82 years (mean = 58 yrs) completed the survey. Seventy-five percent (n = 33) reported falling at least once in 6 months and 48% (n = 12) of those that fell sustained an injury. The majority (87.5%) of the falls occurred inside the home. Most individuals (76.7%; n = 33) reported concerns about falling and 65.9% (n = 29) limited their activities because of their concern of falling. Falls are prevalent in wheelchair and scooter users with MS. The observations highlight the need for interventions targeting this segment of the MS community.
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Affiliation(s)
- Laura Rice
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Alon Kalron
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University
| | | | - Deborah Backus
- Crawford Research Institute, Shepherd Center, Atlanta, GA
| | - Jacob J. Sosnoff
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
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Reliability and validity of the function in sitting test in nonambulatory individuals with multiple sclerosis. Int J Rehabil Res 2016; 39:308-312. [DOI: 10.1097/mrr.0000000000000188] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Steffel J, Giugliano RP, Braunwald E, Murphy SA, Mercuri M, Choi Y, Aylward P, White H, Zamorano JL, Antman EM, Ruff CT. Edoxaban Versus Warfarin in Atrial Fibrillation Patients at Risk of Falling. J Am Coll Cardiol 2016; 68:1169-1178. [DOI: 10.1016/j.jacc.2016.06.034] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/02/2016] [Accepted: 06/08/2016] [Indexed: 10/21/2022]
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Moody L, Evans J, Fielden S, Heelis M, Dryer P, Shapcott N, Magee P, Stefanov D. Establishing user needs for a stability assessment tool to guide wheelchair prescription. Disabil Rehabil Assist Technol 2015; 12:47-55. [PMID: 26138221 DOI: 10.3109/17483107.2015.1063019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The WheelSense project aims to develop a system for assessing the stability and performance of wheelchairs through a user-centred design process. This study sought to capture user needs and define the specification for the system. METHOD A mixed methods approach was adopted. An online survey was completed by 98 participants working in wheelchair provision. The results were built upon through 10 semi-structured interviews and one focus group (n = 5) with professionals working in wheelchair provision in three NHS Trusts in the UK. RESULTS The results provided a picture of the current UK practice in stability testing. Issues with the reliability and usefulness of the existing methods used to assess the stability and performance of wheelchairs were highlighted. Requirements for a new system were ascertained. These included improved accuracy of tipping angles, features to support record keeping, improved client/carer education support and ability to model or predict client-wheelchair system performance in different configurations. CONCLUSIONS The paper concludes that there is a need for improved tools to determine the stability of the client-wheelchair system and support the prescription process, to ensure client safety and optimum equipment performance. A list of requirements has been produced to guide the future development of WheelSense. Implications for Rehabilitation The results of this survey and interview-based study present a picture of wheelchair stability testing practices in the UK, and highlight the need for new, more informative methods for guiding wheelchair prescription. The requirements for the design of a new system, or further development of existing tools to support the stability testing and prescription of wheelchairs have been established.
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Affiliation(s)
- Louise Moody
- a Department of Industrial Design , Coventry University , Coventry , UK
| | - Jill Evans
- b Health Design & Technology Institute, Coventry University , Coventry , UK
| | - Simon Fielden
- b Health Design & Technology Institute, Coventry University , Coventry , UK
| | - Mike Heelis
- c West Midlands Rehabilitation Centre , Birmingham , UK
| | - Paul Dryer
- d Kings College Hospital NHS Foundation , London , UK , and
| | | | - Paul Magee
- b Health Design & Technology Institute, Coventry University , Coventry , UK
| | - Dimitar Stefanov
- b Health Design & Technology Institute, Coventry University , Coventry , UK
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