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Nuic D, van de Weijer S, Cherif S, Skrzatek A, Zeeboer E, Olivier C, Corvol JC, Foulon P, Pastor JZ, Mercier G, Lau B, Bloem BR, De Vries NM, Welter ML. Home-based exergaming to treat gait and balance disorders in patients with Parkinson's disease: A phase II randomized controlled trial. Eur J Neurol 2024; 31:e16055. [PMID: 37691341 DOI: 10.1111/ene.16055] [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: 01/25/2023] [Revised: 07/26/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Exergaming has been proposed to improve gait and balance disorders in Parkinson's disease (PD) patients. We aimed to assess the efficacy of a home-based, tailored, exergaming training system designed for PD patients with dopa-resistant gait and/or balance disorders in a controlled randomized trial. METHODS We recruited PD patients with dopa-resistant gait and/or balance disorders. Patients were randomly assigned (1:1 ratio) to receive 18 training sessions at home by playing a tailored exergame with full-body movements using a motion capture system (Active group), or by playing the same game with the computer's keyboard (Control group). The primary endpoint was the between-group difference in the Stand-Walk-Sit Test (SWST) duration change after training. Secondary outcomes included parkinsonian clinical scales, gait recordings, and safety. RESULTS Fifty PD patients were enrolled and randomized. After training, no significant difference in SWST change was found between groups (mean change SWST duration [SD] -3.71 [18.06] s after Active versus -0.71 [3.41] s after Control training, p = 0.61). Some 32% of patients in the Active and 8% in the Control group were considered responders to the training program (e.g., SWST duration change ≥2 s, p = 0.03). The clinical severity of gait and balance disorders also significantly decreased after Active training, with a between-group difference in favor of the Active training (p = 0.0082). Home-based training induced no serious adverse events. CONCLUSIONS Home-based training using a tailored exergame can be performed safely by PD patients and could improve gait and balance disorders. Future research is needed to investigate the potential of exergaming.
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Affiliation(s)
- Dijana Nuic
- Paris Brain Institute, CNRS UMR 7225, INSERM 1127, Sorbonne University, Paris, France
- LabCom Brain e-Novation, Paris Brain Institute, Paris, France
| | - Sjors van de Weijer
- Donders Institute for Brain, Cognition, and Behavior and Department of Neurology, Center of Expertise for Parkinson and Movement, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Saoussen Cherif
- Paris Brain Institute, CNRS UMR 7225, INSERM 1127, Sorbonne University, Paris, France
- LabCom Brain e-Novation, Paris Brain Institute, Paris, France
| | - Anna Skrzatek
- Paris Brain Institute, CNRS UMR 7225, INSERM 1127, Sorbonne University, Paris, France
| | - Eline Zeeboer
- Donders Institute for Brain, Cognition, and Behavior and Department of Neurology, Center of Expertise for Parkinson and Movement, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Claire Olivier
- Paris Brain Institute, CNRS UMR 7225, INSERM 1127, Sorbonne University, Paris, France
- PANAM core facility, INSERM 1127, Paris Brain Institute, Paris, France
| | - Jean-Christophe Corvol
- Paris Brain Institute, CNRS UMR 7225, INSERM 1127, Sorbonne University, Paris, France
- Clinical Investigation Center, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Pierre Foulon
- LabCom Brain e-Novation, Paris Brain Institute, Paris, France
- GENIOUS Healthcare, Montpellier, France
| | - Jénica Z Pastor
- Biostatistics Department, CHU de Montpellier, Montpellier, France
| | - Gregoire Mercier
- Biostatistics Department, CHU de Montpellier, Montpellier, France
- IDESP UA11, Université de Montpellier, INSERM, Montpellier, France
| | - Brian Lau
- Paris Brain Institute, CNRS UMR 7225, INSERM 1127, Sorbonne University, Paris, France
| | - Bastiaan R Bloem
- Donders Institute for Brain, Cognition, and Behavior and Department of Neurology, Center of Expertise for Parkinson and Movement, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nienke M De Vries
- Donders Institute for Brain, Cognition, and Behavior and Department of Neurology, Center of Expertise for Parkinson and Movement, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marie-Laure Welter
- Paris Brain Institute, CNRS UMR 7225, INSERM 1127, Sorbonne University, Paris, France
- LabCom Brain e-Novation, Paris Brain Institute, Paris, France
- PANAM core facility, INSERM 1127, Paris Brain Institute, Paris, France
- CHU Rouen, Neurophysiology Department, Rouen University, Rouen, France
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Bouchahda N, Jarraya M, Kallala Y, Sassi G, Boussaada M, Bader M, Mahjoub M, Haj H, Zemni I, Betbout F, Gamra H, Hassine M, Messaoud MB. Reproducibility of transthoracic 3D echocardiography in the assessment of mitral valve area in patients with rheumatic mitral stenosis: real time versus ECG-gated 3D echocardiography. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:2419-2426. [PMID: 37658988 DOI: 10.1007/s10554-023-02939-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE To assess reproducibility of Real time 3D echocardiography (RT3D) and ECG-gated 3D echocardiography (EG3D) when measuring the mitral valve area (MVA) in rheumatic mitral stenosis (MS). METHODS MVA was assessed by three operators in 68 MS patients using RT3D and EG3D. Reproducibility of each technique was determined by calculating the standard error of measurements (SEM). RESULTS SEM was similar between RT3D and EG3D. MVA variability was of 0.4 cm² or 30% of any RT3D or EG3D measured MVA. The minimal change in MVA above which two measurements should be considered to differ significantly for the same operator was of 0.4 cm² for RT3D and 0.5 cm² for EG3D. For two different operators making successive measurements, the minimum significant change was of 0.5 cm² for RT3D and 0.6 cm² for EG3D. The minimum significant difference when switching from RT3D to EG3D or vice versa is of 0.6 cm². Low temporal resolution of 6 Hz has the least variability when using RT3D (0.19 cm² vs. 0.26 cm², p = 0.009) but significantly underestimated MVA (1.3 ± 0.4 cm² vs. 1.4 ± 0.4 cm², p < 10- 3) when compared to EG3D. MVA variability was significantly higher in mild MS when compared to severe MS whether it is RT3D (0.23 cm² vs. 0.18 cm², p = 0.02) or EG3D (0.27 cm² vs. 0.16 cm², p < 0.001). CONCLUSION RT3D and EG3D are equally reproducible in the assessment of MVA in patients with MS. Further measurements standardization is required to have a clinically acceptable estimations of the true 3D MVA and minimal detectable differences.
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Affiliation(s)
- Nidhal Bouchahda
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia.
| | - Marwa Jarraya
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Yessine Kallala
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Ghada Sassi
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Mehdi Boussaada
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Mouna Bader
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Marwen Mahjoub
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Hassen Haj
- Cardiology Department, TAHER SFAR University Hospital, 5100, Mahdia, Tunisia
| | - Imen Zemni
- Department of preventive Medicine, Faculty of Medicine, University of Monastir, Rue. Avicenne, 5019, Monastir, Tunisia
| | - Fethi Betbout
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Habib Gamra
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Majed Hassine
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
| | - Mejdi Ben Messaoud
- Cardiology A Department, Research Laboratory LR12 SP 16 Fattouma, University of Monastir, Bourguiba University Hospital, Rue du 1er juin 1955, 5000, Monastir, Tunisia
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Honvo G, Sabico S, Veronese N, Bruyère O, Rizzoli R, Amuthavalli Thiyagarajan J, Mikton C, Diaz T, Cooper C, Reginster JY. Measures of attributes of locomotor capacity in older people: a systematic literature review following the COSMIN methodology. Age Ageing 2023; 52:iv44-iv66. [PMID: 37902521 PMCID: PMC10615073 DOI: 10.1093/ageing/afad139] [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: 02/28/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Locomotor capacity (LC) is an important domain of intrinsic capacity and key determinant of functional ability and well-being in older age. The United Nations Decade of Healthy Ageing (2021-2030) calls for strengthening data and research on healthy ageing, including the measurement of older persons' LC. To advance the measurement and monitoring of LC, there is pressing need to identify valid and reliable measures. OBJECTIVE To identify all the available tools that were validated for measurement of LC or of its specific attributes in older people and to assess the methodological quality of the studies and measurement properties of the tools. DESIGN Systematic review. SETTING Anywhere (Community-dwelling; long-term care facility; etc.). SUBJECTS Older people. METHODS We used highly sensitive search strategies to search the following databases: Medline, Embase, Scopus, CINAHL and PsycINFO. The study was conducted following the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology for systematic review of outcome measurement instruments. RESULTS A total of 125 studies were included, which assessed tools for balance (n = 84), muscle power (n = 12), muscle strength (n = 32, including four studies about tools for balance and muscle power) and endurance (n = 1). No studies on tools for muscle function, joint function, or locomotor capacity overall, were retrieved. We identified 69 clinician-report or objective assessment tools for balance, 30 for muscle strength, 12 for muscle power and 1 endurance assessment tool. The GRADE assessment of quality of evidence showed that only a few tools have high quality evidence for both sufficient validity and reliability: The Balance Evaluation Systems Test (BESTest), the Mini-Balance Evaluation Systems Test (Mini-BESTest), the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test. CONCLUSIONS A few tools with high quality evidence for sufficient validity and reliability are currently available for balance assessment in older people that may be recommended for use in clinical and research settings. Further validation studies are required for muscle strength, muscle power and endurance assessment tools.
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Affiliation(s)
- Germain Honvo
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Nicola Veronese
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Olivier Bruyère
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - René Rizzoli
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Christopher Mikton
- Demographic Change and Healthy Aging Unit, Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Theresa Diaz
- Epidemiology, Monitoring and Evaluation Unit, Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Cyrus Cooper
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Jean-Yves Reginster
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Janssen NP, Oude Voshaar RC, Wassink-Vossen S, Hendriks GJ. Functional improvement by behavioural activation for depressed older adults. Eur Psychiatry 2023; 66:e62. [PMID: 37496446 PMCID: PMC10594265 DOI: 10.1192/j.eurpsy.2023.2433] [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: 06/11/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Recovery in mental health care comprises more than symptomatic improvement, but preliminary evidence suggests that only collaborative care may improve functioning of depressed older adults. This study therefore evaluates the effectiveness of behavioural activation (BA) on functional limitations in depressed older adults in primary care. METHODS This study uses data from a multicentre cluster randomised controlled trial in which 59 primary care centres (PCCs) were randomised to BA and treatment as usual (TAU), and 161 consenting older (≥65 years) adults with clinically relevant symptoms of depression participated. Interventions were an eight-week individual BA programme by a mental health nurse (MHN) and unrestricted TAU. The outcome was self-reported functional limitations (WHODAS 2.0) at post-treatment (9 weeks) and at 12-month follow-up. RESULTS At the end of treatment, the BA participants reported significantly fewer functional limitations than TAU participants (WHODAS 2.0 difference -3.62, p = 0.01, between-group effect size = 0.39; 95% CI = 0.09-0.69). This medium effect size decreases during follow-up resulting in a small and non-significant effect at the 12-month follow-up (WHODAS 2.0 difference = -2.22, p = 0.14, between-group effect size = 0.24; 95% CI = -0.08-0.56). MoCA score moderated these results, indicating that the between-group differences were merely driven by those with no cognitive impairment. CONCLUSIONS Compared to TAU, BA leads to a faster improvement of functional limitations in depressed older adults with no signs of cognitive decline. Replication of these findings in confirmatory research is needed.
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Affiliation(s)
- Noortje P. Janssen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Department of Primary and Community Care, Research Institute of Health Sciences, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
- Institute for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands
| | - Richard C. Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sanne Wassink-Vossen
- Department of Old Age Psychiatry, GGNet Mental Health, Warnsveld, The Netherlands
| | - Gert-Jan Hendriks
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Institute for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands
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Heleno E, Andias R, Neto M, Silva AG. A Feasibility Study of Pain Neuroscience Education and Exercise for Community-Dwelling Older Adults With Chronic Pain. J Geriatr Phys Ther 2023; 46:26-35. [PMID: 34417415 DOI: 10.1519/jpt.0000000000000327] [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: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Pain prevalence in older adults is high and greatly impacts their functioning. The primary aim of this study was to determine the feasibility of an intervention consisting of pain neuroscience education (PNE) plus exercise for community-dwelling older adults attending primary care, by assessing recruitment rates (inclusion, refusal, and exclusion rates), adverse events, and acceptability of the intervention. Secondary aims were to establish suitable procedures for delivering the intervention and assess the feasibility of data collection for psychosocial and physical functioning. METHODS A mixed-methods feasibility study with 2 groups was conducted. One group received 8 weekly 75-minute sessions of PNE plus exercise (PNE+E) and the other received usual care (UC), which consisted of appointments with the general practitioner. Inclusion, refusal, exclusion, and retention rates, dropouts, and adverse events were assessed. The Brief Pain Inventory, the Pain Catastrophizing Scale, the Tampa Scale, the Geriatric Depression Scale, the World Health Organization Disability Assessment Schedule, the 4-meter walk gait speed test and the 5 times sit-to-stand tests were used for assessment. A focus group interview was conducted with participants from the PNE+E group. Descriptive statistics were used for quantitative data and thematic analysis for qualitative data. RESULTS AND DISCUSSION Of 61 participants recruited, 33 (PNE+E = 22; UC = 11) entered the study, and 24 completed the intervention (PNE+E = 15; UC = 9). The inclusion rate was 54%, the refusal rate was 21%, the exclusion rate was 35%, the dropout rate was 32% in the PNE+E and 18% in the UC, and the retention rate was 68% in the PNE+E group and 82% in the UC group. No adverse events were reported and the intervention was well accepted by participants. Data collection for the clinical outcomes was feasible and results suggested higher improvements in the PNE+E group than in the UC group. CONCLUSION PNE+E is possible to implement, safe, and well accepted by community-dwelling older adults independent of their education level. This study informs future studies on practical and methodological strategies that should be considered when designing a PNE+E intervention for older adults, such as adapting the language of the PNE to participants, using relatable metaphors, and encouraging written and exercise homework.
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Affiliation(s)
- Emanuel Heleno
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Rosa Andias
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal
| | | | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal
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Reliability and validity of Foot Posture Index (FPI-6) for evaluating foot posture in participants with low back pain. Sci Rep 2022; 12:21168. [PMID: 36477012 PMCID: PMC9729570 DOI: 10.1038/s41598-022-22220-1] [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: 03/18/2022] [Accepted: 10/11/2022] [Indexed: 12/12/2022] Open
Abstract
Previous studies have demonstrated that Foot Posture Index (FPI-6) is a valid and moderately reliable tool to evaluate foot posture. However, data about reliability and validity of FPI-6 in the assessment of foot posture in people with low back pain (LBP) is lacking. To investigate reliability and validity of FPI-6 in the assessment of foot posture in people with LBP. Thirty volunteers with LBP, aged 20-64 years, were recruited for the research and assessed by two raters. The data measured by different raters on the same day were used to calculate the inter-rater reliability. The data measured by the same rater on different dates were used to calculate the test-retest reliability. The reliability of FPI-6 was tested with intraclass correlation coefficient (ICC), and absolute reliability with standard error of measurement (SEM), minimal detectable change (MDC) and Bland-Altman analysis. The validity of FPI-6 was tested with Exploratory Factor Analysis (EFA) and Spearman's correlation coefficients. The FPI-6 indicated excellent inter-rater and test-retest reliability in the evaluation of foot posture in people with LBP (ICC = 0.97 and 0.95). The agreement for inter-rater and test-retest was excellent based on the SEM (SEM = 0.12) and MDC value (MDC = 0.33). Bland-Altman plots showed that there was no significant systematic bias for the agreement on the ground of low mean difference (< 1). The EFA suggested that the fit indices were considered acceptable according to the Kaiser-Meyer-Olkin (KMO) value (KMO = 0.620) and Bartlett's sphericity test (P < 0.01). There was a statistically significant positive correlation between each item and total score of FPI-6 because the Spearman's correlation coefficient of six items were all > 0.3 (P < 0.01). The inter-rater and test-retest reliability and validity of FPI-6 on people with LBP were proved reliable. It might be considered a reliable and valid adjunctive tool to detect possible changes of foot posture after interventions in patients with LBP.
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Galhardas L, Raimundo A, Del Pozo-Cruz J, Marmeleira J. Physical and Motor Fitness Tests for Older Adults Living in Nursing Homes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5058. [PMID: 35564453 PMCID: PMC9105463 DOI: 10.3390/ijerph19095058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/09/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
This systematic review aimed to identify the physical/motor fitness tests for nursing home residents and to examine their psychometric properties. Electronic databases were searched for articles published between January 2005 and October 2021 using MeSh terms and relevant keywords. Of the total of 4196 studies identified, 3914 were excluded based on title, abstracts, or because they were duplicates. The remaining 282 studies were full-text analyzed, and 41 were excluded, resulting in 241 studies included in the review. The most common physical component assessed was muscle strength; 174 (72.2%) studies assessed this component. Balance (138 studies, 57.3%) and agility (102 studies, 42.3%) were the second and third components, respectively, most widely assessed. In this review, we also describe the most used assessment tests for each physical/motor component. Some potentially relevant components such as manual dexterity and proprioception have been little considered. There are few studies assessing the psychometric properties of the tests for nursing home residents, although the data show that, in general, they are reliable. This review provides valuable information to researchers and health-care professionals regarding the physical/motor tests used in nursing home residences, helping them select the screening tools that could most closely fit their study objectives.
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Affiliation(s)
- Luis Galhardas
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Jesús Del Pozo-Cruz
- Department of Physical Education and Sports, University of Seville, 41013 Sevilla, Spain;
- Epidemiology of Physical Activity and Fitness across Lifespan Research Group (EPAFit), University of Seville, 41013 Sevilla, Spain
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
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Ferreira S, Raimundo A, Marmeleira J. Test-retest reliability of the functional reach test and the hand grip strength test in older adults using nursing home services. Ir J Med Sci 2021; 190:1625-1632. [PMID: 33475966 DOI: 10.1007/s11845-020-02492-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/17/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aimed to determine the absolute and relative test-retest reliability of the functional reach test (FRT) and the handgrip strength test (HGST) in older adults using nursing homes. METHODS Participants (≥ 65 years old), living in nursing homes or using their day care services, were distributed into a group without cognitive impairment (GWCI, n = 43) and a group with mild cognitive impairment (GCI; n = 22). A 1-week test-retest was performed for the FRT and the HGST. Relative reliability was measured by the intraclass correlation coefficient (ICC3.1), and absolute reliability by the standard error of measurement (SEM), minimal detectable change (MDC95), and Bland-Altman plots. RESULTS The ICC showed high reliability for the FRT (GWCI, ICC = 0.83; GCI, ICC = 0.87) and the HGST (ICC ≥ 0.95 in both hands and participant groups). The absolute reliability was good: FRT, SEM = 2.96/2.29, MDC95 = 8.20/6.35 for the GWCI and the GCI, respectively; HGST dominant hand SEM = 1.26/0.82, MDC95 = 3.50/2.29, and HGST non-dominant hand SEM = 1.05/0.80, MDC95 = 2.90/2.21, for the GWCI and the GCI, respectively. Bland-Altman showed that there was not a systematic bias for the tests in both groups. DISCUSSION Findings show that the FRT and the HGST are reliable, have acceptable measurement error, and may be used for research and clinical purposes to assess functional balance and strength of the hands in older adults using nursing homes.
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Affiliation(s)
- Soraia Ferreira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Rua de Reguengos de Monsaraz, n° 14, 7005-399, Évora, Portugal. .,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal.
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Rua de Reguengos de Monsaraz, n° 14, 7005-399, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Rua de Reguengos de Monsaraz, n° 14, 7005-399, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
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Katajapuu N, Heinonen A, Saltychev M. Minimal clinically important difference and minimal detectable change of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) amongst patients with chronic musculoskeletal pain. Clin Rehabil 2020; 34:1506-1511. [PMID: 32718186 PMCID: PMC7649960 DOI: 10.1177/0269215520942573] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aim of this study is to estimate a minimal clinically important difference (MCID) and a minimal detectable change (MDC) of the 12-item WHODAS 2.0 amongst patients with chronic musculoskeletal pain. DESIGN Cross-sectional cohort study. SETTING Outpatient Physical and Rehabilitation Medicine clinic. SUBJECTS A total of 1988 consecutive patients with musculoskeletal pain. INTERVENTIONS A distribution-based approach was employed to estimate a minimal clinically important difference, a minimal detectable change, and a minimal detectable percent change (MDC%). RESULTS The mean age of the patients was 48 years, and 65% were women. The average intensity of pain was 6,3 (2.0) points (0-10 numeric rating scale) and the mean WHODAS 2.0 total score was 13 (9) points out of 48. The minimal clinically important difference ranged between 3.1 and 4.7 points. The minimal detectable change was 8.6 points and minimal detectable % change was unacceptably high 66%. CONCLUSIONS Amongst patients with chronic musculoskeletal pain, the 12-item WHODAS 2.0 demonstrated a high minimal detectable change of almost nine points. As the minimal detectable change exceeded the level of minimal clinically important difference, nine points were considered to be the amount of change perceived by a respondent as clinically significant.
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Affiliation(s)
- Niina Katajapuu
- Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Faculty of Health and Wellbeing, Turku University of Applied Sciences, Turku, Finland
| | - Ari Heinonen
- Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
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Simões P, Andias R, Simões D, Silva AG. Group pain neuroscience education and dance in institutionalized older adults with chronic pain: a case series study. Physiother Theory Pract 2020; 38:164-172. [DOI: 10.1080/09593985.2020.1728794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Patrícia Simões
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Rosa Andias
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal
| | - Diana Simões
- Association of Assistance to Children and Elderly of Fermentelos, Idade, Aveiro, Portugal
| | - Anabela G. Silva
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal
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Mateus A, Rebelo J, Silva AG. Effects of a Multimodal Exercise Program Plus Neural Gliding on Postural Control, Pain, and Flexibility of Institutionalized Older Adults: A Randomized, Parallel, and Double-Blind Study. J Geriatr Phys Ther 2019; 43:3-11. [PMID: 31569173 DOI: 10.1519/jpt.0000000000000249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The effect of adding neural mobilization to a multimodal program of exercises has not been investigated, despite its potential positive effects. The aim of this study was to compare the acute effects of a multimodal exercise program and neural gliding against a multimodal exercise program only, on pain intensity, gait speed, Timed Up and Go (TUG) test, lower limb flexibility, and static balance of institutionalized older adults. METHODS Older adults who were institutionalized (n = 26) were randomized to receive a multimodal exercise program plus neural gliding or a multimodal exercise program only. Both interventions were delivered twice a week for 8 weeks. Participants were assessed for pain, gait velocity, balance, flexibility, and TUG at baseline and postintervention. RESULTS A significant main effect of time for pain intensity (F1,24 = 8.95, P = .006), balance (F1,24 = 10.29, P = .004), and gait velocity (F1,24 = 5.51, P = .028) was observed, indicating a positive impact of both interventions. No other significant effects were found (TUG and flexibility; P > .05). DISCUSSION A 45-minute multimodal exercise program, twice a week for 8 weeks, has a positive impact on pain intensity, balance, and gait velocity, but neural gliding has no additional benefit. It is unclear whether dose and type of neural mobilization may have had an impact on results. Considering the structural and physiological changes that tend to occur with age, future studies could explore the effects of neural tensioning or of higher doses of neural mobilization. CONCLUSIONS This study suggests that adding neural gliding to a multimodal exercise program has no additional benefit.
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Affiliation(s)
- Ana Mateus
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Portugal
| | - Jessica Rebelo
- Lar Santa Catarina do Reboleiro, Avenida da Ribeirinha, Trancoso, Portugal
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Portugal.,CINTESIS.UA, University of Aveiro, Campus Universitário de Santiago, Portugal
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