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Olokunlade T, Benden ME, Han G, Sherman LD, Smith ML. Factors Associated With Incident and Recurrent Falls Among Men Enrolled in Evidence-Based Fall Prevention Programs: An Examination of Race and Ethnicity. J Appl Gerontol 2024:7334648241251735. [PMID: 38741336 DOI: 10.1177/07334648241251735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
We examined factors associated with incident (one) and recurrent (2+) falls among 7207 non-Hispanic White (NHW) (89.7%), non-Hispanic Black (NHB) (5.0%), and Hispanic (5.3%) men ages ≥60 years with ≥1 chronic conditions, enrolled in an evidence-based fall program. Multinomial and binary regression analyses were used to assess factors associated with incident and recurrent falls. Relative to zero falls, NHB and Hispanic men were less likely to report incident (OR = 0.55, p < .001 and OR = 0.70, p = .015, respectively) and recurrent (OR = 0.41, p < .001 and OR = 0.58, p < .001, respectively) falls. Men who reported fear of falling and restricting activities were more likely to report incident (OR = 1.16, p < .001 and OR = 1.32, p < .001, respectively) recurrent and (OR = 1.46, p < .001 and OR = 1.71, p < .001, respectively) falls. Men with more comorbidities were more likely to report recurrent falls (OR = 1.10, p < .001). Compared to those who experienced one fall, men who reported fear of falling (OR = 1.28, p < .001) and restricting activities (OR = 1.31, p < .001) were more likely to report recurrent falls. Findings highlight the importance of multi-component interventions to prevent falls.
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Affiliation(s)
- Temitope Olokunlade
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Mark E Benden
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Gang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Ledric D Sherman
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Community Health and Aging, School of Public Health, Texas A&M University, College Station, TX, USA
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Hu Y, Wang K, Gu J, Huang Z, Li M. Effect of combined physical and cognitive intervention on fear of falling in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 117:105173. [PMID: 37713935 DOI: 10.1016/j.archger.2023.105173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE Fear of falling (FOF) is common among older adults. Currently, physical exercise, cognitive intervention, and combined physical and cognitive intervention have been proven to be effective interventions. However, whether combined interventions can provide additional benefits than single interventions remains unclear. Thus, the systematic and meta-analysis was conducted to explore the immediate and retention effects of combined physical and cognitive interventions, in comparison with a single intervention. MATERIALS AND METHODS Randomized controlled trials of combined interventions on FOF in older adults were searched using Web of Science, PubMed, Cochrane Library, EMBASE, SCOPUS, CINAHL, and PsycINFO from inception to March 20, 2023. The risk of bias in included studies was evaluated using the Cochrane Collaboration Risk of Bias tool. Two independent researchers extracted the data using predetermined criteria. RESULTS 31 studies were included in the systematic review and meta-analysis. For the immediate post-intervention effect, the combined intervention was more effective than the blank/placebo/conventional intervention and the single cognitive intervention, while no additional effect was observed compared with the single physical intervention. Moreover, no additional follow-up retention effects were found when comparing the combined intervention with the single intervention. CONCLUSIONS Combined interventions had positive immediate effects on FOF in older adults, compared with single cognitive intervention, while combined interventions had a similar effect as a single physical intervention. More well-designed studies are required to explore the additional benefits of combined interventions compared with a single intervention and to investigate the follow-up effects of combined interventions.
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Affiliation(s)
- Yue Hu
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Kun Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Jiaxin Gu
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Zhixuan Huang
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Ming Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China.
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Kim J, Foucher K. Fall experiences from the perspectives of people with osteoarthritis: in their own words. Disabil Rehabil 2024; 46:77-85. [PMID: 36519505 DOI: 10.1080/09638288.2022.2156629] [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: 10/20/2021] [Accepted: 11/23/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE To explore real-life experiences of people with osteoarthritis (OA) to increase understanding of how they perceive contributing factors to falls, circumstances at time of falls, and consequences of falls. MATERIALS AND METHODS Four focus groups of 3-7 people with OA from the Chicago, IL, USA, and neighboring areas were conducted remotely via web-based videoconferencing. Inclusion criteria included history of falls in previous 12 months and hip and/or knee OA. Focus group transcripts were coded and analyzed using a modified grounded theory approach to identify themes. RESULTS Focus group participants (n = 17) described experiences associated with fall-related events that resulted in the identification of four themes: (1) perception of falls and fall risks can be influenced by OA symptoms, (2) ability to remember circumstances of falls are influenced by consequences, (3) behaviors and attitudes that address OA symptoms and avoidance of falls are similar and (4) OA symptoms and falls have common psychological impacts on lives. CONCLUSION Our study highlights how people with OA define falls, perceive contributing factors to falls, and describe general and OA-related factors that contributed to their fall experiences. The shared experiences contributed to the creation of themes that represented various aspects of the circumstances and impact of falls. Consideration for the identified themes may enhance recording and reporting of falls, contribute to development of improved fall risk assessment tools, and prioritize research into the biopsychosocial effects of falls in people with OA.IMPLICATIONS FOR REHABILITATIONInformation about circumstances of a fall such as location, activity, and symptoms of osteoarthritis may be beneficial in creating tailored fall prevention training and education.Falls are a common problem for people with lower limb osteoarthritis that can lead to negative changes in activity and quality of life.The psychological impact of osteoarthritis symptoms may be contributing to fear of falling and decrease participation in daily activities.Awareness of the perceptions people with osteoarthritis have about their symptoms may provide educational and training opportunities to address the benefits of different therapeutic treatments.Awareness of perceptions people with osteoarthritis have about their risk of falling may provide educational and training opportunities to address the benefits of different therapeutic treatments.
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Affiliation(s)
- Janis Kim
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Kharma Foucher
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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Sinatti P, Sánchez Romero EA, Martínez-Pozas O, Villafañe JH. Effects of Patient Education on Pain and Function and Its Impact on Conservative Treatment in Elderly Patients with Pain Related to Hip and Knee Osteoarthritis: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6194. [PMID: 35627729 PMCID: PMC9140798 DOI: 10.3390/ijerph19106194] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/05/2022] [Accepted: 05/16/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: Patient education (PE), exercise therapy, and weight management are recommended as first-line interventions for hip and knee osteoarthritis (OA). Evidence supporting the effectiveness of exercise therapy and weight management in people with lower-limb OA has been synthesized in recent studies. However, according to the Osteoarthritis Research Society International, PE is often considered a standard of care and the inclusion of this as a first-line intervention for people with knee OA in clinical practice guidelines is often supported by limited evidence. The aim of this review is to evaluate the effects of PE on pain and function and how it impacts on conservative treatment. (2) Methods: This is a literature review of studies investigating the effect of patient education on pain and function and its impact on conservative treatment in elderly patients with pain related to hip and knee OA. PRISMA guidelines were followed during the design, search, and reporting stages of this review. The search was carried out in the PubMed database. (3) Results: A total of 1732 studies were detected and analyzed by performing the proposed searches in the detailed database. After removing duplicates and analyzing the titles and abstracts of the remaining articles, 20 studies were ultimately selected for this review. Nineteen of these twenty articles showed positive results in pain or function in patients with pain related to hip and knee OA. (4) Conclusions: PE seems to be effective in reducing pain and improving function in patients with pain related to hip and knee OA. Furthermore patient education seems to positively impact the conservative treatment with which it can be associated.
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Affiliation(s)
- Pierluigi Sinatti
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
| | - Eleuterio A. Sánchez Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 La Orotava, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Tenerife, Spain
| | - Oliver Martínez-Pozas
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Tenerife, Spain
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
| | - Jorge H. Villafañe
- IRCCS Fondazione Don Carlo Gnocchi, Piazzale Morandi 6, 20148 Milan, Italy
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Cerilo PC, Siegmund LA. Pilot testing of nurse led multimodal intervention for falls prevention. Geriatr Nurs 2021; 43:242-248. [PMID: 34952307 DOI: 10.1016/j.gerinurse.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
Patient fall-risk awareness, self-efficacy, and engagement in fall-prevention activities are important aspects of fall-prevention. The current pilot study examined the effect of a nurse-led multimodal intervention on hospitalized adults' levels of fall risk awareness, self-efficacy, and engagement in fall prevention. Sixty hospitalized older adults in an acute care setting in Florida participated in the study. There were significant differences [pre-test (M = 19.02, SD=1.152) and post-test (M = 21.71, SD=0.527); t (17.355) = 58, p≤.001] on level of fall risk awareness in fall prevention. There were no significant findings for fall self-efficacy and engagement. Study findings suggested that the higher the fall self-efficacy, the higher the engagement. Future research is needed to examine self-efficacy and engagement for fall prevention in larger diverse cohorts of hospitalized older adults.
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Affiliation(s)
- Perlita C Cerilo
- Nursing Operations Manager, Cleveland Clinic, Weston, Florida 33331, USA.
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Chua CHM, Jiang Y, Lim DS, Wu VX, Wang W. Effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling among community‐dwelling older adults: A systematic review and meta‐analysis. J Adv Nurs 2019; 75:3299-3315. [DOI: 10.1111/jan.14150] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/10/2019] [Accepted: 07/02/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Claris Hui Min Chua
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Der Shin Lim
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
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Bidonde J, Busch AJ, van der Spuy I, Tupper S, Kim SY, Boden C. Whole body vibration exercise training for fibromyalgia. Cochrane Database Syst Rev 2017; 9:CD011755. [PMID: 28950401 PMCID: PMC6483692 DOI: 10.1002/14651858.cd011755.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Exercise training is commonly recommended for adults with fibromyalgia. We defined whole body vibration (WBV) exercise as use of a vertical or rotary oscillating platform as an exercise stimulus while the individual engages in sustained static positioning or dynamic movements. The individual stands on the platform, and oscillations result in vibrations transmitted to the subject through the legs. This review is one of a series of reviews that replaces the first review published in 2002. OBJECTIVES To evaluate benefits and harms of WBV exercise training in adults with fibromyalgia. SEARCH METHODS We searched the Cochrane Library, MEDLINE, Embase, CINAHL, PEDro, Thesis and Dissertation Abstracts, AMED, WHO ICTRP, and ClinicalTrials.gov up to December 2016, unrestricted by language, to identify potentially relevant trials. SELECTION CRITERIA We included randomized controlled trials (RCTs) in adults with the diagnosis of fibromyalgia based on published criteria including a WBV intervention versus control or another intervention. Major outcomes were health-related quality of life (HRQL), pain intensity, stiffness, fatigue, physical function, withdrawals, and adverse events. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, extracted data, performed risk of bias assessments, and assessed the quality of evidence for major outcomes using the GRADE approach. We used a 15% threshold for calculation of clinically relevant differences. MAIN RESULTS We included four studies involving 150 middle-aged female participants from one country. Two studies had two treatment arms (71 participants) that compared WBV plus mixed exercise plus relaxation versus mixed exercise plus relaxation and placebo WBV versus control, and WBV plus mixed exercise versus mixed exercise and control; two studies had three treatment arms (79 participants) that compared WBV plus mixed exercise versus control and mixed relaxation placebo WBV. We judged the overall risk of bias as low for selection (random sequence generation), detection (objectively measured outcomes), attrition, and other biases; as unclear for selection bias (allocation concealment); and as high for performance, detection (self-report outcomes), and selective reporting biases.The WBV versus control comparison reported on three major outcomes assessed at 12 weeks post intervention based on the Fibromyalgia Impact Questionnaire (FIQ) (0 to 100 scale, lower score is better). Results for HRQL in the control group at end of treatment (59.13) showed a mean difference (MD) of -3.73 (95% confidence interval [CI] -10.81 to 3.35) for absolute HRQL, or improvement of 4% (11% better to 3% worse) and relative improvement of 6.7% (19.6% better to 6.1% worse). Results for withdrawals indicate that 14 per 100 and 10 per 100 in the intervention and control groups, respectively, withdrew from the intervention (RR 1.43, 95% CI 0.27 to 7.67; absolute change 4%, 95% CI 16% fewer to 24% more; relative change 43% more, 95% CI 73% fewer to 667% more). The only adverse event reported was acute pain in the legs, for which one participant dropped out of the program. We judged the quality of evidence for all outcomes as very low. This study did not measure pain intensity, fatigue, stiffness, or physical function. No outcomes in this comparison met the 15% threshold for clinical relevance.The WBV plus mixed exercise (aerobic, strength, flexibility, and relaxation) versus control study (N = 21) evaluated symptoms at six weeks post intervention using the FIQ. Results for HRQL at end of treatment (59.64) showed an MD of -16.02 (95% CI -31.57 to -0.47) for absolute HRQL, with improvement of 16% (0.5% to 32%) and relative change in HRQL of 24% (0.7% to 47%). Data showed a pain intensity MD of -28.22 (95% CI -43.26 to -13.18) for an absolute difference of 28% (13% to 43%) and a relative change of 39% improvement (18% to 60%); as well as a fatigue MD of -33 (95% CI -49 to -16) for an absolute difference of 33% (16% to 49%) and relative difference of 47% (95% CI 23% to 60%); and a stiffness MD of -26.27 (95% CI -42.96 to -9.58) for an absolute difference of 26% (10% to 43%) and a relative difference of 36.5% (23% to 60%). All-cause withdrawals occurred in 8 per 100 and 33 per 100 withdrawals in the intervention and control groups, respectively (two studies, N = 46; RR 0.25, 95% CI 0.06 to 1.12) for an absolute risk difference of 24% (3% to 51%). One participant exhibited a mild anxiety attack at the first session of WBV. No studies in this comparison reported on physical function. Several outcomes (based on the findings of one study) in this comparison met the 15% threshold for clinical relevance: HRQL, pain intensity, fatigue, and stiffness, which improved by 16%, 39%, 46%, and 36%, respectively. We found evidence of very low quality for all outcomes.The WBV plus mixed exercise versus other exercise provided very low quality evidence for all outcomes. Investigators evaluated outcomes on a 0 to 100 scale (lower score is better) for pain intensity (one study, N = 23; MD -16.36, 95% CI -29.49 to -3.23), HRQL (two studies, N = 49; MD -6.67, 95% CI -14.65 to 1.31), fatigue (one study, N = 23; MD -14.41, 95% CI -29.47 to 0.65), stiffness (one study, N = 23; MD -12.72, 95% CI -26.90 to 1.46), and all-cause withdrawal (three studies, N = 77; RR 0.72, 95% CI -0.17 to 3.11). Adverse events reported for the three studies included one anxiety attack at the first session of WBV and one dropout from the comparison group ("other exercise group") due to an injury that was not related to the program. No studies reported on physical function. AUTHORS' CONCLUSIONS Whether WBV or WBV in addition to mixed exercise is superior to control or another intervention for women with fibromyalgia remains uncertain. The quality of evidence is very low owing to imprecision (few study participants and wide confidence intervals) and issues related to risk of bias. These trials did not measure major outcomes such as pain intensity, stiffness, fatigue, and physical function. Overall, studies were few and were very small, which prevented meaningful estimates of harms and definitive conclusions about WBV safety.
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Affiliation(s)
- Julia Bidonde
- Norwegian Institute of Public HealthPO Box 4404 NydalenOsloNorway0403
| | - Angela J Busch
- University of SaskatchewanSchool of Physical Therapy104 Clinic PlaceSaskatoonCanadaS7N 2Z4
| | - Ina van der Spuy
- University of SaskatchewanSchool of Physical Therapy104 Clinic PlaceSaskatoonCanadaS7N 2Z4
| | | | - Soo Y Kim
- University of SaskatchewanSchool of Physical Therapy104 Clinic PlaceSaskatoonCanadaS7N 2Z4
| | - Catherine Boden
- University of SaskatchewanLeslie and Irene Dube Health Sciences Library, University LibraryRm 1400 Health Sciences Building 104 Clinic PlaceSaskatoonCanadaS7N 5E5
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Verlinden VJA, de Kruijf M, Bierma-Zeinstra SMA, Hofman A, Uitterlinden AG, Ikram MA, van Meurs JBJ, van der Geest JN. Asymptomatic radiographic hip osteoarthritis is associated with gait differences, especially in women: A population-based study. Gait Posture 2017; 54:248-254. [PMID: 28359929 DOI: 10.1016/j.gaitpost.2017.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 01/12/2017] [Accepted: 03/06/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hip and knee osteoarthritis (OA) are debilitating diseases that impair gait at severe stages. Although associations between OA and gait are established for normal walking, little is known about its relation with turning and tandem (heel-to-toe) walking. Furthermore, it is unknown how asymptomatic OA associates with gait, and whether associations differ by sex. We investigated how symptomatic and asymptomatic hip and knee OA associate with gait in community-dwelling individuals. METHODS In 2706 participants of a population-based cohort study, gait was assessed by electronic walkway and summarised into seven gait domains. Hip and knee radiographs were graded for radiographic OA (ROA) using the Kellgren and Lawrence (K&L) score. Linear regression was used to investigate associations between ROA and gait. Analyses were repeated including only participants with asymptomatic ROA, defined as a K&L-score of 2 without pain. RESULTS In total, 177 participants (6.5%) had hip ROA and 441 (16.3%) knee ROA. We found no associations of knee ROA with gait. Hip ROA associated with Rhythm, Tandem, and Turning. Furthermore, unilateral hip ROA associated with larger gait asymmetry and gait differences in osteoarthritic and non-osteoarthritic leg, when compared to people without hip ROA. Associations between hip ROA and gait were generally stronger for women than men. Associations for hip ROA remained after restricting to asymptomatic ROA. CONCLUSION Hip ROA, but not knee ROA, associates with gait differences in normal walking, turning, and tandem walking in community-dwelling individuals. These associations differ between the sexes, and are already present for asymptomatic ROA.
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Affiliation(s)
- Vincentius J A Verlinden
- Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Marjolein de Kruijf
- Department of Internal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass., USA
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
| | - Joyce B J van Meurs
- Department of Internal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jos N van der Geest
- Department of Neuroscience, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Sousa LMM, Marques-Vieira CMA, Caldevilla MNGND, Henriques CMAD, Severino SSP, Caldeira SMA. Risk for falls among community-dwelling older people: systematic literature review. Rev Gaucha Enferm 2017; 37:e55030. [PMID: 28273251 DOI: 10.1590/1983-1447.2016.04.55030] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/17/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the risk factors for falls of the community-dwelling elderly in order to update the Taxonomy II of NANDA International. METHOD A systematic literature review based on research using the following platforms: EBSCOHost®, CINAHL and MEDLINE, from December 2010 to December 2014. The descriptors used were (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND Nurs* AND Fall Risk Factors. RESULTS The sample comprised 62 studies and 50 risk factors have been identified. Of these risk factors, only 38 are already listed in the classification. CONCLUSIONS Two new categories of risk factors are proposed: psychological and socio-economical. New fall risk factors for the community-dwelling elderly have been identified, which can contribute to the updating of this nursing diagnosis of the Taxonomy II of NANDA International.
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Affiliation(s)
- Luís Manuel Mota Sousa
- Centro Hospital Lisboa Central, Polo Hospital Curry Cabral. Lisboa, Portugal
- Universidade Atlântica, Escola Superior de Saúde Atlântica. Barcarena, Oeiras, Portugal
| | | | | | - Cristina Maria Alves Dias Henriques
- Administração Regional de Saúde de Lisboa e Vale do Tejo, Equipa Coordenadora Regional da Rede Nacional de Cuidados Continuados Integrados. Lisboa, Portugal
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Dorsey J, Bradshaw M. Effectiveness of Occupational Therapy Interventions for Lower-Extremity Musculoskeletal Disorders: A Systematic Review. Am J Occup Ther 2016; 71:7101180030p1-7101180030p11. [PMID: 28027040 DOI: 10.5014/ajot.2017.023028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Lower-extremity (LE) musculoskeletal disorders (MSDs) can have a major impact on the ability to carry out daily activities. The effectiveness of interventions must be examined to enable occupational therapy practitioners to deliver the most appropriate services. This systematic review examined the literature published between 1995 and July 2014 that investigated the effectiveness of occupational therapy interventions for LE MSDs. Forty-three articles met the criteria and were reviewed. Occupational therapy interventions varied on the basis of population subgroup: hip fracture, LE joint replacement, LE amputation or limb loss, and nonsurgical osteoarthritis and pain. The results indicate an overall strong role for occupational therapy in treating clients with LE MSDs. Activity pacing is an effective intervention for nonsurgical LE MSDs, and multidisciplinary rehabilitation is effective for LE joint replacement and amputation. Further research on specific occupational therapy interventions in this important area is needed.
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Affiliation(s)
- Julie Dorsey
- Julie Dorsey, OTD, OTR/L, CEAS, is Associate Professor, Department of Occupational Therapy, Ithaca College, Ithaca, NY;
| | - Michelle Bradshaw
- Michelle Bradshaw, DC, OTR/L, is Assistant Professor, Department of Occupational Therapy, Ithaca College, Ithaca, NY
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Laubenstein S, Beissner K. Exercise and Movement-based Therapies in Geriatric Pain Management. Clin Geriatr Med 2016; 32:737-762. [PMID: 27741967 DOI: 10.1016/j.cger.2016.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Exercise is often recommended for older adults with pain, but pain itself is often a barrier to increased activity. This article reviews the evidence on the impact of various forms of exercise and related movement therapies on older adults with pain problems. The literature is reviewed with respect to published guidelines. When prescribing exercise, it is important to consider appropriate intensity, type, and duration of exercise as well as incorporating a plan for progression. Strategies to ensure adherence to exercise programs are also important.
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Affiliation(s)
| | - Katherine Beissner
- Department of Physical Therapy Education, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA.
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Howard BS, Beitman CL, Walker BA, Moore ES. Cross-cultural Educational Intervention and Fall Risk Awareness. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2016. [DOI: 10.3109/02703181.2015.1105344] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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French MA, Moore MF, Pohlig R, Reisman D. Self-efficacy Mediates the Relationship between Balance/Walking Performance, Activity, and Participation after Stroke. Top Stroke Rehabil 2015; 23:77-83. [PMID: 26653764 DOI: 10.1080/10749357.2015.1110306] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Many outcome measures (OM) that assess individuals' ability or beliefs in their ability to perform tasks exist to evaluate activity and participation after stroke; however, the relationship between various OM and activity/participation is unclear. OBJECTIVE The purpose of this study was to explore the relationships between different OM and activity and participation in people after stroke. METHODS Fifty-nine subjects post stroke participated in an assessment including self-selected walking speed, 6 minute walk test, Timed "Up and Go" test, Berg Balance Scale, Functional Gait Assessment, Walk 12, and Activity-specific Balance Confidence Scale. Step Watch Activity Monitoring (SAM) was used as a measure of activity and Stroke Impact Scale-Participation (SIS-P) as a measure of participation. Exploratory Factor Analysis was performed including all measures except SAM and SIS-P. Two factors were extracted and termed performance based (PB) and self-efficacy (SE). A path analysis assessed the role of SE as a mediator in the relationships of PB and SAM/SIS-P. RESULTS In the path analysis, PB significantly predicts SE (p < 0.001, b = 0.44), but not SAM or SIS-P (p > 0.05, b = 0.25, and b = 0.11, respectively). SE significantly predicts both SAM and SIS-P (p < 0.001, b = 0.46, and b = 0.59, respectively). The indirect effects of PB on SAM and SIS-P were significant (p < 0.001; b = 0.20, and b = 0.26, respectively). CONCLUSION These results suggest that SE mediates the relationship between PB and activity and participation after stroke, reinforcing that improving activity and participation is more complicated than only targeting performance. Clinicians should administer SE and PB measures to determine the most accurate view of patients after stroke and seek to improve SE through interventions.
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Affiliation(s)
- Margaret A French
- a Department of Physical Medicine and Rehabilitation , The Johns Hopkins Hospital , Baltimore , MD , USA.,b Department of Physical Therapy , University of Delaware , Newark , DE , USA
| | - Meghan F Moore
- a Department of Physical Medicine and Rehabilitation , The Johns Hopkins Hospital , Baltimore , MD , USA.,b Department of Physical Therapy , University of Delaware , Newark , DE , USA
| | - Ryan Pohlig
- c Biostatistics Core Facility , University of Delaware , Newark , DE , USA
| | - Darcy Reisman
- b Department of Physical Therapy , University of Delaware , Newark , DE , USA.,d Biomechanics and Movement Science , University of Delaware , Newark , DE , USA
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Laroche D, Kubicki A, Stapley PJ, Gremeaux V, Mazalovic K, Maillefert JF, Ornetti P. Test-retest reliability and responsiveness of centre of pressure measurements in patients with hip osteoarthritis. Osteoarthritis Cartilage 2015; 23:1357-66. [PMID: 25827970 DOI: 10.1016/j.joca.2015.03.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 02/18/2015] [Accepted: 03/20/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to determine a set of measures for the evaluation of balance in patients suffering from hip osteoarthritis (OA) that were both reliable and responsive to change. DESIGN Three groups of subjects; Healthy, hip OA patients without surgery, and hip OA with surgery (pre and post-surgery) were included in this study. Subjects had to perform balance tests in two positions: standard and narrowed stance. CoP-based measures test-retest reliability was assessed in hip OA without surgery group, responsiveness were assessed between all groups and between pre and post-surgery. RESULTS Intraclass Correlation Coefficient (ICC) values from hip OA without surgery ranged from -0.03 to 0.9 for only five parameters (CoP path length, SD velocity, mean velocity, and antero-posterior Root Mean Square (RMS(AP)) having values over 0.7. SD velocity and RMS(AP) showed significant differences between healthy and surgery group in standard stance whereas narrowed stance revealed most differences between all groups. RMS(AP) showed the best responsiveness (Standardized Response Mean ∼0.5) between pre vs post-surgery in both conditions. RMS(AP) was also capable of discriminating between hip OA with surgery vs without surgery groups with good sensitivity and specificity. CONCLUSIONS Our results showed there to be reliability and responsiveness of five postural parameters in hip OA patients in two conditions of standing balance. More parameters were significantly different in narrowed stance whereas sensitivity was better in standard stance. SD velocity and RMS(AP) discriminate between degrees of OA severity and highlight potential balance deficits even after arthroplasty. Selected parameters during standing balance could be assessed to complete the set of quantitative measures to quantify hip OA patient deficiencies.
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Affiliation(s)
- D Laroche
- CIC INSERM 1432, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon, France; INSERM U1093, University of Burgundy, Dijon, France.
| | - A Kubicki
- INSERM U1093, University of Burgundy, Dijon, France
| | - P J Stapley
- Neural Control of Movement Laboratory, School of Medicine, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - V Gremeaux
- CIC INSERM 1432, Plateforme d'Investigation Technologique, Dijon University Hospital, Dijon, France; INSERM U1093, University of Burgundy, Dijon, France; Department of Physical Medicine and Rehabilitation, Dijon University Hospital, Dijon, France
| | - K Mazalovic
- Department of General Medicine, Faculty of Medicine, University of Burgundy, Dijon, France
| | - J-F Maillefert
- INSERM U1093, University of Burgundy, Dijon, France; Department of Rheumatology, Dijon University Hospital, Dijon, France
| | - P Ornetti
- INSERM U1093, University of Burgundy, Dijon, France; Department of Rheumatology, Dijon University Hospital, Dijon, France
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Chopra S, Moerenhout K, Crevoisier X. Characterization of gait in female patients with moderate to severe hallux valgus deformity. Clin Biomech (Bristol, Avon) 2015; 30:629-35. [PMID: 25841314 DOI: 10.1016/j.clinbiomech.2015.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 03/19/2015] [Accepted: 03/21/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hallux valgus is one of the most common forefoot problems in females. Studies have looked at gait alterations due to hallux valgus deformity, assessing temporal, kinematic or plantar pressure parameters individually. The present study, however, aims to assess all listed parameters at once and to isolate the most clinically relevant gait parameters for moderate to severe hallux valgus deformity with the intent of improving post-operative patient prognosis and rehabilitation. METHODS The study included 26 feet with moderate to severe hallux valgus deformity and 30 feet with no sign of hallux valgus in female participants. Initially, weight bearing radiographs and foot and ankle clinical scores were assessed. Gait assessment was then performed utilizing pressure insoles (PEDAR) and inertial sensors (Physilog) and the two groups were compared using a non-parametric statistical hypothesis test (Wilcoxon rank sum, P<0.05). Furthermore, forward stepwise regression was used to reduce the number of gait parameters to the most clinically relevant and correlation of these parameters was assessed with the clinical score. FINDINGS Overall, the results showed clear deterioration in several gait parameters in the hallux valgus group compared to controls and 9 gait parameters (effect size between 1.03 and 1.76) were successfully isolated to best describe the altered gait in hallux valgus deformity (r(2)=0.71) as well as showed good correlation with clinical scores. INTERPRETATION Our results, and nine listed parameters, could serve as benchmark for characterization of hallux valgus and objective evaluation of treatment efficacy.
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Affiliation(s)
- S Chopra
- Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Department of Orthopaedic Surgery and Traumatology, Pierre-Decker 4, CH-1011 Lausanne, Switzerland.
| | - K Moerenhout
- Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Department of Orthopaedic Surgery and Traumatology, Pierre-Decker 4, CH-1011 Lausanne, Switzerland.
| | - X Crevoisier
- Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Department of Orthopaedic Surgery and Traumatology, Pierre-Decker 4, CH-1011 Lausanne, Switzerland.
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Kim O, Kim JH. Falls and Use of Assistive Devices in Stroke Patients with Hemiparesis: Association with Balance Ability and Fall Efficacy. Rehabil Nurs 2014; 40:267-74. [PMID: 25042606 DOI: 10.1002/rnj.173] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2014] [Indexed: 02/01/2023]
Abstract
PURPOSE This study investigates balance ability and the fall efficacy with regard to the experiences of stroke patients with hemiparesis. METHODS The experience of falling, the use of assistive devices, and each disease-related characteristic were assessed using face-to-face interviews and a self-reported questionnaire. The Berg Balance Scale and Fall Efficacy Scale were used to measure balance ability and confidence. RESULTS The fall efficacy was significantly lower in participants who had experienced falls than those who had not. The participants who used assistive devices exhibited low balance ability and fall efficacy compared to those who did not use assistive devices. CONCLUSIONS Stroke patients with fall experience and walking aids might be considered at increased risk of falling. CLINICAL RELEVANCE Preventive measures for individuals using walking aids may be beneficial in reducing the fall rate of community-dwelling stroke patients.
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Affiliation(s)
- Oksoo Kim
- Division of Nursing, College of Health Sciences, Ewha Womans University, Seoul, Korea
| | - Jung-Hee Kim
- Department of Nursing, College of Health Sciences, Dankook University, Cheonan, Korea
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Arnold CM, Gyurcsik NC. Risk factors for falls in older adults with lower extremity arthritis: a conceptual framework of current knowledge and future directions. Physiother Can 2013; 64:302-14. [PMID: 23729967 DOI: 10.3138/ptc.2011-12bh] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE As the numbers of Canadians aged 65 years and over increases over the next 20 years, the prevalence of chronic conditions, including arthritis, will rise as will the number of falls. Although known fall-risk factors are associated with hip and knee osteoarthritis (OA), minimal research has evaluated fall and fracture risk and/or rates in this population. Thus, the purpose was to summarize research on fall and fracture risk in older adults with hip or knee OA and to develop a conceptual framework of fall-risk screening and assessment. METHOD The International Classification of Functioning, Disability and Health, clinical practice guidelines for fall-risk screening, and a selected literature review were used. RESULTS Gaps exist in our knowledge of fall and fracture risk for this population. Muscle performance, balance, and mobility impairments have been identified, but little is known about whether personal and environmental contextual factors impact fall and fracture risk. Physical activity may help to prevent falls, but non-adherence is a problem. CONCLUSION A need exists to assess fall risk in older adults with hip and knee OA. Promoting regular physical activity by focusing on disease- and activity-specific personal contextual factors may help direct treatment planning.
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Bladh S, Nilsson MH, Carlsson G, Lexell J. Content Analysis of 4 Fear of Falling Rating Scales by Linking to the International Classification of Functioning, Disability and Health. PM R 2013; 5:573-582.e1. [DOI: 10.1016/j.pmrj.2013.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 01/04/2013] [Accepted: 01/06/2013] [Indexed: 11/30/2022]
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Muir SW. Clinician's Commentary on Arnold et al.(1). Physiother Can 2012; 63:421-2. [PMID: 22942518 DOI: 10.3138/ptc.2010-29-cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Susan W Muir
- Department of Geriatric Medicine, University of Western Ontario; Parkwood Hospital, A2-101, 801 Commissioners Road East, London, Ontario.
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