Application of ICF conceptual framework in Osteoporosis

Exploring the Validity of Measures of Health-Related Quality of Life in Older Adults at Increased Risk of Falls and/or Fractures in Exercise Clinical Trials

Exercise targeting physical function and body composition may mitigate falls and fracture risk among older adults. This study aimed to identify the most valid instrument(s) to assess quality of life (QoL) in this context by comparing the psychometric properties of the EQ-5D-3L, EQ-5D-5L, CDC Healthy Days measure, Modified Falls Efficacy Scale (MFES), and Work Productivity and Activity Impairment Questionnaire. Data from four exercise trials (n = 210, mean age 64.8 ± 7.4, 79.0% female) were analyzed. Construct validity and responsiveness were compared. There was moderate to strong convergence between the EQ-5D (-3L and -5L) and MFES, and EQ-5D-3L and CDC index (correlation: 0.45-0.61). Only the EQ-5D-3L demonstrated good known-group validity (effect size: 0.98-3.7). Responsiveness was low across all instruments (standardized response mean: -0.33-0.49). The instruments are valid for assessing QoL in older adults at risk of falls and/or fractures. However, variation in their psychometric properties should be considered when selecting instruments for exercise trials.

Examining the factors associated with functional capacity of community-dwelling older adults using the ICF framework: a cross-sectional study from the Frailty in Brazilian Older Adults Study (FIBRA)

BACKGROUND

There are many factors associated with functioning and disability in older adults and these relationships are not clear.

OBJECTIVE

To explore the factors associated with functional capacity of older adults using the framework of the International Classification of Functioning, Disability, and Health (ICF).

METHODS

This is a cross-sectional study with a dataset from a survey of 1 377 community-dwelling older adults (≥ 65 years) in a middle-income country. Three functional outcomes were selected to represent the functioning domains: 1) muscle strength for body function; 2) walking speed for activity; and 3) advanced activities of daily living (ADL) for participation. Demographic, clinical, and social information was selected to represent the domains of health conditions and contextual factors (i.e. personal and environmental factors). Multivariate models tested the impact of these factors on each outcome.

RESULTS

Depressive symptoms, age, and physical activity were associated with the three outcomes. Muscle strength was also associated with urinary incontinence, visual deficits, female sex, and employment. Walking speed was also associated with urinary incontinence, obesity, fractures due to falls, female sex, health professionals' visits, and walking aid devices. Advanced ADL were also associated with stroke, visual deficits, education, employment, health perception, social support, and walking aid devices.

CONCLUSION

Functional capacity of older adults is associated with some non-modifiable factors, such as age and sex. The modifiable factors must be addressed by health professionals and policymakers in the geriatric area, especially depression, obesity, physical inactivity, and social support.

An interpretive descriptive approach of patients with osteoporosis and integrating osteoporosis management advice into their lifestyle

Introduction

Methods

Results

Conclusion

[Topical issues of rehabilitation of patients with osteoporotic vertebral fractures]

The literature review analyzed 20 Russian and 69 foreign publications on the rehabilitation of elderly patients with osteoporotic vertebral fractures. The article deals in detail with the prevalence, medical and social significance of pathological osteoporotic fractures, including vertebral deformities. The data confirming the importance of osteoporosis for physical and rehabilitation medicine specialists are presented. Changes in the quality of life, functional and gate disorders associated with osteoporotic vertebral fractures are described. Based on the available literature data, the principles of rehabilitation of patients with osteoporotic vertebral compression fractures are formulated, including the effectiveness of various methods of physical therapy, mechanotherapy and apparatus physiotherapy. From the standpoint of evidence-based medicine, the role of orthotics in the complex rehabilitation of such patients is described. Based on the analysis of literature data, it was concluded that the problem of osteoporosis is relevant for physicians working in the field of rehabilitation medicine; osteoporotic vertebral fractures are characterized by a high prevalence over the age of 50 years and are associated with a decrease in the quality of life, motor and functional limitations, and an increased risk of death, and well-planned medical rehabilitation programs including physical exercises, physiotherapy and orthotics can significantly improve patient functionality.