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Yoshida Y, Ishizaki T, Masui Y, Hori N, Inagaki H, Ito K, Ogawa M, Yasumoto S, Arai Y, Kamide K, Ikebe K, Gondo Y. Effect of number of medications on the risk of falls among community-dwelling older adults: A 3-year follow-up of the SONIC study. Geriatr Gerontol Int 2024; 24 Suppl 1:306-310. [PMID: 38185808 DOI: 10.1111/ggi.14760] [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: 09/07/2023] [Revised: 10/27/2023] [Accepted: 11/14/2023] [Indexed: 01/09/2024]
Abstract
AIM This study examined the association between the number of prescribed medications and falls among community-dwelling older adults. METHODS We conducted a geriatric comprehensive health-checkup on community-dwelling adults aged 69-91 years who participated in the Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians study. The final analysis of this study included 1,076 participants with complete data. The participants were divided into four groups based on the number of medications at baseline: 0, 1, 2-4, and ≥5. At the 3-year follow-up, the participants were asked whether they had fallen in the past year. Multivariable logistic regression analysis was performed to assess the relationship between the number of medications taken and falls after adjusting for confounding factors. RESULTS The prevalence rates of falls were 10.5%, 18.2%, 18.3%, and 19.8% in the no-medication, one-medication, comedication, and polypharmacy groups, respectively. In the one-medication prescription group, 59% of prescriptions were for fall-risk-increasing drugs (FRID). Multivariable analysis showed a significantly higher incidence of falls in the one-medication group (adjusted odds ratio [OR], 1.91; 95% confidence interval [CI], 1.04-3.54), co-medication (OR, 1.89; 95% CI, 1.09-3.29), and polypharmacy groups (OR, 1.94; 95% CI, 1.09-3.45) than in the no-medication group. CONCLUSIONS The study showed that polypharmacy, as well as just taking one medication, can affect the occurrence of falls. This suggests that in addition to the number of medications and polypharmacy, the type of medication, such as FRID, affects the risk of falls. Therefore, pharmacotherapy should consider the risk of falls in older adults when prescribing medications. Geriatr Gerontol Int 2024; 24: 306-310.
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Affiliation(s)
- Yuko Yoshida
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yukie Masui
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Noriko Hori
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kae Ito
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Uzel AGT, Gosheva M, Neubauer J, Stock L, Bartz-Schmidt KU, Gelisken F. Fall-related ocular trauma in patients over 90 years in tertiary ophthalmic center in Germany: 90-TOSG Report 1. Graefes Arch Clin Exp Ophthalmol 2024; 262:331-336. [PMID: 37589778 PMCID: PMC10805947 DOI: 10.1007/s00417-023-06202-1] [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: 10/09/2022] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE To investigate the clinical characteristics of fall-related ocular trauma in patients over 90 years of age. METHODS Retrospective, medical record reviews. Patients over the age of 90 years treated in a tertiary center with fall-related ocular trauma were included in the study. RESULTS Fifty consecutive patients (fifty eyes) were analyzed. The mean age was 93.6 ± 1.8 years and 41 patients (82%) were female. The most common site of the injuries was orbital fracture (18 patients, 36%), accompanied with open globe rupture (OGR) in three patients, and globe contusion in two patients. Seventeen patients (34%) presented with OGR. Ocular trauma score in those patients was category 1 in 10 patients (58.8%) and category 2 in the others. Conjunctival hemorrhage and/or periocular contusion was seen in 14 patients (28%) and globe contusion in six patients (12%). At the presentation, the mean best corrected visual acuity (BCVA) was 2.82 ± 0.24 logMAR in patients with OGR and 1.98 ± 0.81 logMAR in six patients with globe contusion. Three of the patients with OGR had a final vision of 20/200 or better whereas the remaining patients had hand movements or less. The most common risk factors were female gender (82%) and use of antihypertensive drugs (46%). CONCLUSION Patients with OGR had a poor visual outcome despite the early treatment. It is important to raise public awareness about of the poor prognosis of ocular injuries due to falls in the elderly population in order to establish preventive measures.
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Affiliation(s)
| | - Mariya Gosheva
- Department of Ophthalmology, Eberhard Karls University, Tübingen, Baden-Württemberg, Germany.
| | - Jonas Neubauer
- Department of Ophthalmology, Eberhard Karls University, Tübingen, Baden-Württemberg, Germany
| | - Lydia Stock
- Department of Ophthalmology, Eberhard Karls University, Tübingen, Baden-Württemberg, Germany
| | | | - Faik Gelisken
- Department of Ophthalmology, Eberhard Karls University, Tübingen, Baden-Württemberg, Germany
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Kim GS, Kim N, Won CW, Shim MS, Park MK, Kim M, Lee S. Cross-Lagged Panel Analysis between Physical Frailty, Cognitive Function, and Falls by Sex. J Am Med Dir Assoc 2023; 24:1541-1548.e1. [PMID: 37579927 DOI: 10.1016/j.jamda.2023.07.004] [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: 11/29/2022] [Revised: 06/10/2023] [Accepted: 07/04/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVES This study investigated the reciprocal longitudinal relationships between physical frailty (PF), cognitive function (CF), and falls among community-dwelling older adults, according to sex. The study proposed hypotheses that present PF and CF will affect the occurrence of falls 2 years later. DESIGN Secondary data analysis using the first (T1, 2016-2017) and second (T2, 2018-2019) waves of the Korean Frailty and Aging Cohort Study (KFACS). SETTING AND PARTICIPANTS A total of 2318 community-dwelling older adults aged 70-84 years in South Korea; mean (SD) age: 75.72 (3.83) years; 47.7% men. METHODS PF and CF were measured with the modified version of the Fried Frailty Phenotype and the Korean version of the Mini-Mental State Examination, respectively. The number of falls were assessed. Multigroup cross-lagged panel analysis was used. RESULTS The results showed that relationships between PF, CF, and falls were maintained over time through an autoregressive effect. PF at T1 had a statistically significant longitudinal relationship with fall experience at T2 [standardized regression coefficient (β) = 0.087, 95% CI 0.045-0.129; P < .001], and fall experience at T1 had a significant longitudinal relationship with PF at T2 (β = 0.041, 95% CI 0.006-0.076; P = .020). There was no statistically significant relationship between CF and fall experience. PF and CF had statistically significant reciprocal longitudinal relationships (all P < .001). Based on sex, there was a statistically significant longitudinal relationship between fall experience at T1 and PF at T2 for men only (β = 0.063, 95% CI 0.012-0.114; P = .015). CONCLUSIONS AND IMPLICATIONS Findings highlight that health care providers should plan fall prevention programs through early intervention for PF improvement along with improvement and maintenance of CF. Specifically, even if older men are currently healthy and have a low risk of falls, it is important to prevent future fatal PF through prior interventions, such as risk activities attention and concerns about falls.
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Affiliation(s)
- Gwang Suk Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Namhee Kim
- Wonju College of Nursing, Yonsei University, Wonju, Republic of Korea.
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Mi-So Shim
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Min Kyung Park
- Department of Nursing, Graduate School of Yonsei University, Seoul, Republic of Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, East-West Medical Research Institute, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seoyoon Lee
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul, Republic of Korea
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Chan LLY, Arbona CH, Brodie MA, Lord SR. Prediction of injurious falls in older adults using digital gait biomarkers extracted from large-scale wrist sensor data. Age Ageing 2023; 52:afad179. [PMID: 37738170 DOI: 10.1093/ageing/afad179] [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: 03/09/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVES To determine whether digital gait biomarkers captured by a wrist-worn device can predict injurious falls in older people and to develop a multivariable injurious fall prediction model. DESIGN Population-based longitudinal cohort study. SETTING AND PARTICIPANTS Community-dwelling participants of the UK Biobank study aged 65 and older (n = 32,619) in the United Kingdom. METHODS Participants were assessed at baseline on daily-life walking speed, quality, quantity and distribution using wrist-worn accelerometers for up to 7 days. Univariable and multivariable Cox proportional hazard regression models were used to analyse the associations between these parameters and injurious falls for up to 9 years. RESULTS Five percent of the participants (n = 1,627) experienced at least one fall requiring medical attention over a mean of 7.0 ± 1.1 years. Daily-life walking speed, gait quality, quantity of walking and distribution of daily walking were all significantly associated with the incidence of injurious falls (P < 0.05). After adjusting for sociodemographics, lifestyle factors, comorbidities, handgrip strength and reaction time; running duration, total step counts and usual walking speed were identified as independent and significant predictors of falls (P < 0.01). These associations were consistent in those without a history of previous fall injuries. In contrast, step regularity was the only risk factor for those with a previous fall history after adjusting for covariates. CONCLUSIONS Daily-life gait speed, quantity and quality, derived from wrist-worn sensors, are significant predictors of injurious falls in older people. These digital gait biomarkers could potentially be used to identify fall risk in screening programs and integrated into fall prevention strategies.
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Affiliation(s)
- Lloyd L Y Chan
- Neuroscience Research Australia, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Carmen Herrera Arbona
- Neuroscience Research Australia, Sydney, Australia
- Getafe University Hospital, Madrid, Spain
| | - Matthew A Brodie
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
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Womack JA, Murphy TE, Leo-Summers L, Bates J, Jarad S, Gill TM, Hsieh E, Rodriguez-Barradas MC, Tien PC, Yin MT, Brandt CA, Justice AC. Assessing the contributions of modifiable risk factors to serious falls and fragility fractures among older persons living with HIV. J Am Geriatr Soc 2023; 71:1891-1901. [PMID: 36912153 PMCID: PMC10258163 DOI: 10.1111/jgs.18304] [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: 10/26/2022] [Revised: 01/14/2023] [Accepted: 01/25/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Although 50 years represents middle age among uninfected individuals, studies have shown that persons living with HIV (PWH) begin to demonstrate elevated risk for serious falls and fragility fractures in the sixth decade; the proportions of these outcomes attributable to modifiable factors are unknown. METHODS We analyzed 21,041 older PWH on antiretroviral therapy (ART) from the Veterans Aging Cohort Study from 01/01/2010 through 09/30/2015. Serious falls were identified by Ecodes and a machine-learning algorithm applied to radiology reports. Fragility fractures (hip, vertebral, and upper arm) were identified using ICD9 codes. Predictors for both models included a serious fall within the past 12 months, body mass index, physiologic frailty (VACS Index 2.0), illicit substance and alcohol use disorders, and measures of multimorbidity and polypharmacy. We separately fit multivariable logistic models to each outcome using generalized estimating equations. From these models, the longitudinal extensions of average attributable fraction (LE-AAF) for modifiable risk factors were estimated. RESULTS Key risk factors for both outcomes included physiologic frailty (VACS Index 2.0) (serious falls [15%; 95% CI 14%-15%]; fractures [13%; 95% CI 12%-14%]), a serious fall in the past year (serious falls [7%; 95% CI 7%-7%]; fractures [5%; 95% CI 4%-5%]), polypharmacy (serious falls [5%; 95% CI 4%-5%]; fractures [5%; 95% CI 4%-5%]), an opioid prescription in the past month (serious falls [7%; 95% CI 6%-7%]; fractures [9%; 95% CI 8%-9%]), and diagnosis of alcohol use disorder (serious falls [4%; 95% CI 4%-5%]; fractures [8%; 95% CI 7%-8%]). CONCLUSIONS This study confirms the contributions of risk factors important in the general population to both serious falls and fragility fractures among older PWH. Successful prevention programs for these outcomes should build on existing prevention efforts while including risk factors specific to PWH.
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Affiliation(s)
- Julie A. Womack
- VA Connecticut Healthcare System, West Haven, CT
- Yale School of Nursing, West Haven, CT
| | | | | | - Jonathan Bates
- VA Connecticut Healthcare System, West Haven, CT
- Yale School of Medicine, New Haven, CT
| | | | | | - Evelyn Hsieh
- VA Connecticut Healthcare System, West Haven, CT
- Yale School of Medicine, New Haven, CT
| | - Maria C. Rodriguez-Barradas
- Infectious Diseases Section, Michael E DeBakey VA Medical Center, and Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Phyllis C. Tien
- University of California, San Francisco, and Department of Veterans Affairs, San Francisco, CA
| | | | - Cynthia A. Brandt
- VA Connecticut Healthcare System, West Haven, CT
- Yale School of Medicine, New Haven, CT
| | - Amy C. Justice
- VA Connecticut Healthcare System, West Haven, CT
- Yale School of Medicine, New Haven, CT
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Baba T, Watanabe M, Ogihara H, Handa S, Sasamoto K, Okada S, Okuizumi H, Kimura T. Validity of temporo-spatial characteristics of gait as an index for fall risk screening in community-dwelling older people. J Phys Ther Sci 2023; 35:265-269. [PMID: 36866012 PMCID: PMC9974315 DOI: 10.1589/jpts.35.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/14/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] This study aimed to identify kinematic gait indicators for a fall risk screening test through quantitative comparisons of gait characteristics measured using mobile inertial sensors between faller and non-faller groups in a population of community-dwelling older people. [Participants and Methods] We enrolled 50 people aged ≥65 years who used long-term care prevention services, interviewed them to determine their fall history during the past year, and divided them into faller and non-faller groups. Gait parameters (velocity, cadence, stride length, foot height, heel strike angle, ankle joint angle, knee joint angle, and hip joint angle) were assessed using the mobile inertial sensors. [Results] Gait velocity and left and right heel strike angles were significantly lower and smaller, respectively, in the faller versus non-faller group. Receiver operating characteristic curve analysis revealed areas under the curve of 0.686, 0.722, and 0.691 for gait velocity, left heel strike angle, and right heel strike angle, respectively. [Conclusion] Gait velocity and heel strike angle during gait assessed using mobile inertial sensors may be important kinematic indicators in a fall risk screening test to estimate the likelihood of falls among community-dwelling older people.
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Affiliation(s)
- Takahiro Baba
- Kakeyu-Misayama Rehabilitation Center Geriatric Health
Services Facility Izumino, Japan
| | | | - Hirofumi Ogihara
- Division of Physical Therapy, Department of Rehabilitation,
Faculty of Health Sciences, Nagano University of Health and Medicine, Japan
| | - Shuichi Handa
- Physical Education and Medicine Research Foundation,
Japan
| | | | - Shinpei Okada
- Physical Education and Medicine Research Foundation,
Japan
| | | | - Teiji Kimura
- School of Health Sciences, Faculty of Medicine, Shinshu
University: 3-1-1 Asahi, Matsumoto City, Nagano 390-8621, Japan,Corresponding author. Teiji Kimura (E-mail: )
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Bruce J, Hossain A, Ji C, Lall R, Arnold S, Padfield E, Underwood M, Lamb SE. Falls and fracture risk screening in primary care: update and validation of a postal screening tool for community dwelling older adults recruited to UK Prevention of Falls Injury Trial (PreFIT). BMC Geriatr 2023; 23:42. [PMID: 36690953 PMCID: PMC9872287 DOI: 10.1186/s12877-022-03649-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/23/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Postal screening has not previously been validated as a method for identifying fall and fracture risk in community-dwelling populations. We examined prognostic performance of a postal risk screener used in the UK Prevention of Falls Injury Trial (PreFIT; ISRCTN71002650), to predict any fall, recurrent falls, and fractures over 12 months. We tested whether adding variables would improve screener performance. METHODS Nine thousand eight hundred and eight community-dwelling participants, aged 70 years and older, and 63 general practices in the UK National Health Service (NHS) were included in a large, pragmatic cluster randomised trial comparing screen and treat fall prevention interventions. The short postal screener was sent to all participants in the trial intervention arms as an A4 sheet to be completed and returned to the GP (n = 6,580). The postal screener items were embedded in the baseline pre-randomisation postal questionnaire for all arms of the trial (n = 9,808). We assessed discrimination and calibration using area under the curve (AUC). We identified additional predictors using data from the control arm and applied these coefficients to internal validation models in the intervention arm participants. We used logistic regression to identify additional predictor variables. FINDINGS A total of 10,743 falls and 307 fractures were reported over 12 months. Over one third of participants 3,349/8,136 (41%) fell at least once over 12 month follow up. Response to the postal screener was high (5,779/6,580; 88%). Prediction models showed similar discriminatory ability in both control and intervention arms, with discrimination values for any fall AUC 0.67 (95% CI 0.65 to 0.68), and recurrent falls (AUC 0.71; 95% CI 0.69, 0.72) but poorer discrimination for fractures (AUC 0.60; 95% CI 0.56, 0.64). Additional predictor variables improved prediction of falls but had modest effect on fracture, where AUC rose to 0.71 (95% CI 0.67 to 0.74). Calibration slopes were very close to 1. CONCLUSION A short fall risk postal screener was acceptable for use in primary care but fall prediction was limited, although consistent with other tools. Fracture and fall prediction were only partially reliant on fall risk although were improved with the additional variables.
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Affiliation(s)
- Julie Bruce
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
- University Hospitals Coventry and Warwickshire, Coventry, CV2 2DX, UK.
| | - Anower Hossain
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Chen Ji
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Ranjit Lall
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Susanne Arnold
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Emma Padfield
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
- University Hospitals Coventry and Warwickshire, Coventry, CV2 2DX, UK
| | - Sarah E Lamb
- South Cloisters, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
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Scurry AN, Szekely B, Murray NG, Jiang F. Older adults with a history of falling exhibit altered cortical oscillatory mechanisms during continuous postural maintenance. J Clin Transl Res 2022; 8:390-402. [PMID: 36518547 PMCID: PMC9741932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/14/2022] [Accepted: 06/14/2022] [Indexed: 02/02/2023] Open
Abstract
Background and Aim The significant risk of falling in older adults 65 years or older presents a substantial problem for these individuals, their caretakers, and the health-care system at large. As the proportion of older adults in the United States is only expected to grow over the next few decades, a better understanding of physiological and cortical changes that make an older adult more susceptible to a fall is crucial. Prior studies have displayed differences in postural dynamics and stability in older adults with a fall history (FH) and those who are non-fallers (NF), suggesting surplus alterations that occur in some older adults (i.e., FH group) in addition to the natural aging process. Methods The present study measured postural dynamics while the FH, NF, and young adult (YA) groups performed continuous postural maintenance. In addition, electroencephalography activity was recorded while participants performed upright postural stance to examine any group differences in cortical areas involved in postural control. Results As expected, older participants (FH and NF) exhibited worse postural stability, as evidenced by increased excursion, compared to the YA group. Further, while NF and YA show increased alpha activity in occipital areas during the most demanding postural task (eyes closed), the FH group did not show any differences in occipital alpha power between postural tasks. Conclusions As alpha activity reflects suppression of bottom-up processing and thus diversion of cognitive resources toward postural centers during more demanding postural maintenance, deficits in this regulatory function in the FH group are a possible impaired cortical mechanism putting these individuals at greater fall risk. Relevance for Patients Impaired inhibitory function in older adults may impact postural control and increase their risk of falling. Interventions that aim at addressing cortical processing deficits may improve postural stability and facilitate independent living in this population.
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Affiliation(s)
- Alexandra N. Scurry
- 1Department of Psychology, University of Nevada, Reno, Nevada 89557, United States
| | - Brian Szekely
- 1Department of Psychology, University of Nevada, Reno, Nevada 89557, United States
| | - Nicholas G. Murray
- 2School of Public Health, University of Nevada, Reno, Nevada 89557, United States
| | - Fang Jiang
- 1Department of Psychology, University of Nevada, Reno, Nevada 89557, United States,Corresponding author: Fang Jiang Department of Psychology, University of Nevada, Reno, Nevada 89557, United States.
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Fast Saccadic Eye Movements Contribute to the Worsened Postural Sway in Older Adults Who Have Experienced Falls. Healthcare (Basel) 2022; 10:healthcare10091708. [PMID: 36141320 PMCID: PMC9498829 DOI: 10.3390/healthcare10091708] [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: 07/19/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to examine changes and between-group differences in postural sway during saccadic eye movement in older adults (n = 152). The participants were stratified into older adults who have experienced a fall (n = 58) (faller group) and those who have not (n = 94) (non-faller group). We measured postural sway during saccadic eye movement. Saccadic eye movement speed was such that the target was displayed at 0.5 Hz, 2 Hz, and 3 Hz. Postural sway was measured based on path length, velocity, and length between the maximal and minimal position of center of pressure in mediolateral and anteroposterior direction. In the faller group, path length, velocity, and mediolateral displacement of the center of pressure increased significantly during 3 Hz saccadic eye movement stimulation. However, in the non-faller group, there was no significant change in the center of pressure parameters during saccadic eye movement stimulation. Mediolateral displacement of the center of pressure increased significantly in both groups during saccadic eye movement, especially at 3 Hz. Therefore, rapid saccadic eye movement stimulation can contribute to the worsened postural sway in older adults who have experienced falls, and rapid external environmental stimuli may contribute to the deterioration of the upright standing stability in older adults.
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10
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Kwon YR, Eom GM, Kim JW. Test-retest reliability of postural sway measures during static standing balance performance in healthy elderly adults. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422400346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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11
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Tsuji T. Rehabilitation for elderly patients with cancer. Jpn J Clin Oncol 2022; 52:1097-1104. [PMID: 35996863 PMCID: PMC9539032 DOI: 10.1093/jjco/hyac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/03/2022] [Indexed: 11/04/2022] Open
Abstract
If physical functions are impaired in patients with cancer owing to the progression of the disease and the treatment processes, their activities of daily living (ADLs) decline; thus, the quality of life is impacted. Elderly patients with cancer constitute a group with diverse basic physical, mental and social skill levels owing to aging. Given that there are potential risks of frailty and sarcopenia, their physical functions and ADL are prone to decline. Furthermore, there are many cases in which patients live alone, isolated from the society or face social problems. Therefore, in the treatment of elderly patients with cancer, geriatric assessment is used to comprehensively assess comorbidity, physical functions and psychophysiological/social/environmental situations and a system that provides supportive care is required. As part of this process, cancer rehabilitation plays an important role in prevention of complications, functional recovery and maintenance and improvement of physical functions and ADL until the time of palliative care. To provide rehabilitation, utmost attention must be paid to issues unique to elderly people, such as frailty, sarcopenia, dementia, delirium, pain management, depression and undernutrition/dysphagia.
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Affiliation(s)
- Tetsuya Tsuji
- For reprints and all correspondence: Tetsuya Tsuji, Department of rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. E-mail:
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Salari N, Darvishi N, Ahmadipanah M, Shohaimi S, Mohammadi M. Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis. J Orthop Surg Res 2022; 17:334. [PMID: 35765037 PMCID: PMC9238111 DOI: 10.1186/s13018-022-03222-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With increasing life expectancy, declining mortality, and birth rates, the world's geriatric population is increasing. Falls in the older people are one of the most common and serious problems. Injuries from falls can be fatal or non-fatal and physical or psychological, leading to a reduction in the ability to perform activities of daily living. The aim of this study was to determine the prevalence of falls in the older people through systematic review and meta-analysis. METHODS In this systematic review and meta-analysis, the data from studies on the prevalence of falls in the older people in the world were extracted in the databases of Scopus, Web of Science (WoS), PubMed and Science Direct, and Google Scholar, Magiran and Scientific Information Database (SID) without any time limit until August 2020. To analyze the eligible studies, the stochastic effects model was used, and the heterogeneity of the studies with the I2 index was investigated. Data analysis was conducted with Comprehensive Meta-Analysis software (Version 2). RESULTS In the review of 104 studies with a total sample size of 36,740,590, the prevalence of falls in the older people of the world was 26.5% (95% CI 23.4-29.8%). The highest rate of prevalence of falls in the older people was related to Oceania with 34.4% (95% CI 29.2-40%) and America with 27.9% (95% CI 22.4-34.2%). The results of meta-regression indicated a decreasing trend in the prevalence of falls in the older people of the world by increasing the sample size and increasing the research year (P < 0.05). CONCLUSION The problem of falls, as a common problem with harmful consequences, needs to be seriously considered by policymakers and health care providers to make appropriate plans for preventive interventions to reduce the rate of falls in the older people.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Niloofar Darvishi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Melika Ahmadipanah
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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13
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A quantitative assessment of the risk of falls in rheumatoid arthritis patients and determination of the risk factors. Turk J Phys Med Rehabil 2022; 68:271-277. [PMID: 35989951 PMCID: PMC9366494 DOI: 10.5606/tftrd.2022.7868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/27/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives
The aim of this study was to compare the risk of falling in patients with rheumatoid arthritis (RA) to the healthy individuals and to identify the factors affecting the risk of falls.
Patients and methods
Between December 2015 and August 2016, a total of 100 consecutive patients with RA (16 males, 84 females; mean age: 49.5±11.1 years; range, 21 to 65 years) and 50 healthy controls (11 males, 39 females; mean age: 34.3±12.7 years; range, 19 to 63 years) were included in this prospective study. The fall risk was evaluated using the Tetrax Portable Balance System. The Health Assessment Questionnaire Disability Index (HAQ-DI), RA disease activity (Disease Activity Score 28 [DAS28], Clinical Disease Activity Index [CDAI], and Simple Disease Activity Index [SDAI]), and Falls Efficacy Scale International (FES-I) were applied to all participants.
Results
The fall risk scores and the FES-I scores were significantly higher in the patients with RA than the control group (p<0.001, p<0.001). A positive significant correlation was found between the Tetrax values of the patients and age, and the scores of the HAQ-DI, FES, DAS28, DAS28-C-reactive protein, CDAI and SDAI.
Conclusion
Our study results showed higher fall risk scores in patients with RA than healthy individuals an objective computerized technique, and this higher fall risk appeared to be affected by older age, disease activity, and disability.
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Lo PY, Su BL, You YL, Yen CW, Wang ST, Guo LY. Measuring the Reliability of Postural Sway Measurements for a Static Standing Task: The Effect of Age. Front Physiol 2022; 13:850707. [PMID: 35634138 PMCID: PMC9138610 DOI: 10.3389/fphys.2022.850707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background: A force plate is used to determine the ability to balance ability. However, only some medical centers or laboratories are equipped with force plates because they are costly so a low-cost force plate is required for home care or health care institutes. Few studies compare the reliability of postural sway measurements in terms of age. This study proposes a low-cost force plate to select reliable parameters to evaluate postural sway.Objectives: To determine the intra-rater reliability of a novel force plate and the effect of age difference on the intra-rater test-retest reliability for the center of pressure (COP).Methods: Forty participants were enrolled for this study: 20 youths and 20 older adults. Participants stood on a custom-made and low-cost force plate with eyes opened and eyes closed to measure COP-related parameters. The within-day test-retest reliability was measured at two sessions on the same day and the between-days reliability was measured on two different days. The COP-related parameters include the average velocity of COP, the average velocity in the antero-posterior and medio-lateral directions, the mean distance of COP and the mean distance in the antero-posterior and medio-lateral directions. An intra-class correlation coefficient test with one-way random model was performed to determine the reliability of different variables within-days and between-days. The results were presented in single measurement of intraclass correlation coefficient (ICC), the standard error of measurements, and the minimal detectable changes of each COP-related parameters.Results: The novel low-cost force plate demonstrates excellent reliability in terms of the COP velocity related parameters for within- and between-day measurements. The ICC of COP distance related parameters were good to excellent reliability for between-day measurements (range: 0.43–0.84). Older adults demonstrated excellent reliability in terms of the mean distance for antero-posterior and the results were better than those for younger participants for the eyes-opened and eyes-closed conditions. The reliability in terms of the mean distance for medio-lateral was poor to good for older adults (range: 0.38–0.55), and excellent for younger participants.Conclusion: The novel and low-cost force plate reliably measured balance and age affects the reliability of different COP variables, so the results of this study were pertinent to the selection of COP measures.
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Affiliation(s)
- Pei-Yi Lo
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Bo-Lin Su
- Department of Mechanical and Electro-mechanical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yu-Lin You
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Wen Yen
- Department of Mechanical and Electro-mechanical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Shih-Ting Wang
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Lan-Yuen Guo
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Humanities and Social Sciences, National Pingtung University of Science and Technology, Pintung, Taiwan
- *Correspondence: Lan-Yuen Guo,
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15
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Koppelmans V, Mulavara AP, Seidler RD, De Dios YE, Bloomberg JJ, Wood SJ. Cortical thickness of primary motor and vestibular brain regions predicts recovery from fall and balance directly after spaceflight. Brain Struct Funct 2022; 227:2073-2086. [PMID: 35469104 DOI: 10.1007/s00429-022-02492-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/30/2022] [Indexed: 01/02/2023]
Abstract
Motor adaptations to the microgravity environment during spaceflight allow astronauts to perform adequately in this unique environment. Upon return to Earth, this adaptation is no longer appropriate and can be disruptive for mission critical tasks. Here, we measured if metrics derived from MRI scans collected from astronauts can predict motor performance post-flight. Structural and diffusion MRI scans from 14 astronauts collected before launch, and motor measures (balance performance, speed of recovery from fall, and tandem walk step accuracy) collected pre-flight and post-flight were analyzed. Regional measures of gray matter volume (motor cortex, paracentral lobule, cerebellum), myelin density (motor cortex, paracentral lobule, corticospinal tract), and white matter microstructure (corticospinal tract) were derived as a-priori predictors. Additional whole-brain analyses of cortical thickness, cerebellar gray matter, and cortical myelin were also tested for associations with post-flight and pre-to-post-flight motor performance. The pre-selected regional measures were not significantly associated with motor behavior. However, whole-brain analyses showed that paracentral and precentral gyri thickness significantly predicted recovery from fall post-spaceflight. Thickness of vestibular and sensorimotor regions, including the posterior insula and the superior temporal gyrus, predicted balance performance post-flight and pre-to-post-flight decrements. Greater cortical thickness pre-flight predicted better performance post-flight. Regional thickness of somatosensory, motor, and vestibular brain regions has some predictive value for post-flight motor performance in astronauts, which may be used for the identification of training and countermeasure strategies targeted for maintaining operational task performance.
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Affiliation(s)
| | | | - Rachael D Seidler
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | | | - Jacob J Bloomberg
- National Aeronautics and Space Administration Johnson Space Center, Houston, TX, USA
| | - Scott J Wood
- National Aeronautics and Space Administration Johnson Space Center, Houston, TX, USA
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16
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Relationship between Associated Neuropsychological Factors and Fall Risk Factors in Community-Dwelling Elderly. Healthcare (Basel) 2022; 10:healthcare10040728. [PMID: 35455905 PMCID: PMC9025626 DOI: 10.3390/healthcare10040728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/07/2022] [Accepted: 04/10/2022] [Indexed: 12/10/2022] Open
Abstract
This study examined whether neuropsychological factors could affect fall risk factors in the community-dwelling elderly via correlation analysis. A total of 393 older adults (76.69 ± 6.01) participated in this study. Cognitive function, depression, fall efficacy, balance confidence, balance, gait, and muscle strength were evaluated, and the correlation between psychological factors and fall risk factors was analyzed. Additionally, a multiple regression analysis was conducted to determine whether or not there was a significant effect between psychological factors and fall risk factors. Analysis showed that the psychological factors examined were all significantly correlated with the fall risk factors. A correlation analysis between cognitive function and fall risk factors showed that the correlation coefficient of the 6-Meter Walk Test was highest; for depression and fall risk factors, the correlation coefficient of gait speed was highest; for fall efficacy and fall risk factors, the correlation coefficient of the 6-Meter Walk Test was highest; and for confidence in balancing and fall risk factors, the correlation coefficient of the 6-Meter Walk Test was highest. This study suggests that psychological factors affect fall risk factors in the community-dwelling elderly, and a multifaceted approach that includes psychological factors would be helpful in providing interventions for falls.
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17
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SHIN CHOL, WOO KYUNGHWA, LEE DASOL, Kwon YR, EOM GWANGMOON, KIM REGINAEY, KIM JIWON. AGE-RELATED DIFFERENCES IN STATIC POSTURAL BALANCE IN KOREAN ELDERLY ADULTS. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422400103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Poor postural balance has been related to falls in older people. Although fall rates increase with age, age-related declines in postural balance of older people are still unclear. The goal of this study was to investigate age-related changes in the static postural balance ability of Korean elderly adults. Three hundred and eighty-nine normal elderly adults with ages ranging from 57 years to 87 years participated in this study. All elderly adults were instructed to stand in their preferred natural stance on a self-developed force platform. As postural sway variables, peak frequency, mean frequency, mean velocity, and mean distance were calculated from the center of pressure (COP) trajectories in both the medio-lateral (ML) and antero-posterior (AP) directions. The mean velocity in the older-elderly was significantly faster compared to those of the other age groups particularly in the AP direction ([Formula: see text]). In both the ML and AP directions, the older-elderly group showed a greater mean distance compared to the other age groups ([Formula: see text]). Conversely, no significant age group differences were found in mean frequency and peak frequency ([Formula: see text]). Our results mean that the older-elderly group showed postural balance with faster AP sway speed and overall sway size. The results of our study help in the understanding of age-related declines in postural balance for the prevention of falls and the development of a regression model for normative postural balance ability in Korean elderly adults.
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Affiliation(s)
- CHOL SHIN
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University, Ansan Hospital, Ansan-si, Gyeonggi-do, Republic of Korea
| | - KYUNG HWA WOO
- Department of Biomedical Engineering, Konkuk University, Chungju-si, Chungcheongbuk-do, Republic of Korea
| | - DA SOL LEE
- Department of Biomedical Engineering, Konkuk University, Chungju-si, Chungcheongbuk-do, Republic of Korea
| | - Yu-Ri Kwon
- Department of Biomedical Engineering, Konkuk University, Chungju-si, Chungcheongbuk-do, Republic of Korea
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Chungju-si, Chungcheongbuk-do, Republic of Korea
| | - GWANG-MOON EOM
- Department of Biomedical Engineering, Konkuk University, Chungju-si, Chungcheongbuk-do, Republic of Korea
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Chungju-si, Chungcheongbuk-do, Republic of Korea
| | - REGINA EY KIM
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - JI-WON KIM
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Chungju-si, Chungcheongbuk-do, Republic of Korea
- Department of Biomedical Engineering, Konkuk University Chungju-si, Chungcheongbuk-do, Republic of Korea
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18
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Moriyama Y, Yamada T, Shimamura R, Ohmi T, Hirosawa M, Yamauchi T, Tazawa T, Kato J. Movement patterns of the functional reach test do not reflect physical function in healthy young and older participants. PLoS One 2022; 17:e0266195. [PMID: 35358272 PMCID: PMC8970498 DOI: 10.1371/journal.pone.0266195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/15/2022] [Indexed: 11/18/2022] Open
Abstract
The relationship of the Functional Reach Test (FRT) value with the Center of Pressure Excursion (COPE) and physical function remains unclear, and would be influenced by different population characteristics and movement patterns used in the FRT. Therefore, we explored the relationship between the FRT value and the COPE and physical function in healthy young and older individuals classified according to movement patterns. In 21 healthy young participants (42 sides) and 20 older participants (40 sides), three-dimensional motion analysis was performed during the FRT and physical function assessments. The participants were assigned to two clusters after performing a motion analysis during the FRT. Kinematic and kinetic parameters during the FRT and physical function assessment results were compared between the clusters for both groups. Correlation analysis was performed to investigate the relationships of the FRT value with COPE and physical function parameters in each cluster, in young and older individuals separately. The results showed that the hip strategies could be divided into two groups according to the degree of use (Small Hip Strategy, SHS Group; Large Hip Strategy, LHS Group). In the older SHS group, the FRT values were significantly correlated with the COPE (r = 0.75), toe grip strength (r = 0.62), and the five-times sit-to-stand test time (r = -0.52). In the older LHS group and in both groups of young individuals, there were no significant correlations of the FRT value with any parameters. The FRT value reflects the COPE and physical function only in older individuals using the SHS. This could explain previous discrepant results. As there is no simple relationship between the FRT value and physical function, it is important to include movement strategy assessment when using the FRT in clinical evaluations.
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Affiliation(s)
- Yoshinao Moriyama
- Division of Physical Therapy, Department of Rehabilitation, Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan
- * E-mail:
| | - Takumi Yamada
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Ryota Shimamura
- Division of Physical Therapy, Department of Rehabilitation, Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan
| | - Takehiro Ohmi
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaki Hirosawa
- Division of Physical Therapy, Department of Rehabilitation, Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan
| | - Tomoyuki Yamauchi
- Department of Rehabilitation, Nihon University Hospital, Tokyo, Japan
| | - Tomohiro Tazawa
- Department of Rehabilitation, Sonodakai Joint Replacement Center Hospital, Tokyo, Japan
| | - Junpei Kato
- Karadacare Business Development Office, NEC Livex, Ltd., Tokyo, Japan
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19
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Sedaghati P, Goudarzian M, Ahmadabadi S, Tabatabai-Asl SM. The impact of a multicomponent-functional training with postural correction on functional balance in the elderly with a history of falling. J Exp Orthop 2022; 9:23. [PMID: 35233709 PMCID: PMC8888785 DOI: 10.1186/s40634-022-00459-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/16/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose Good posture plays a significant role for the elderly in achieving optimal quality of life. This study aimed to evaluate the impact of multicomponent functional training with postural correction on functional balance in the elderly with a history of falling. Methods This study was a randomized controlled, single-blind study. Subjects (n = 28, mean age = 70 years) with a history of falling were selected and randomly allocated to either a multicomponent functional training (n = 14) or a control group (n = 14). The experimental group exercised for 8 weeks, three days per week for 60 min per day. The training program with strength, endurance, and balance parts was conducted in the multi-task conditions to stimulate the physical and cognitive abilities focusing on the attentional-correct posture. The control group received conventional care. The Berg balance and short physical performance battery tests were used in the pre-test and post-test. The adjusted post-test means of experimental and control groups were analyzed using the ANCOVA test to eliminate any pretest effects. Results This study found a significant effect of training on Berg balance test (P = 0.001), Timed Up and Go with D-T (P = 0.01), Timed Up and Go (P = 0.002), and Short Physical Performance Battery (P = 0.001). Conclusions Eight weeks of multicomponent exercise training has beneficial effects on balance and physical function and results in improved equilibrium and a decreasing probability of falling. Therefore, practitioners can use this 8-week training program for older adults.
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Affiliation(s)
- Parisa Sedaghati
- Department of Sports Injuries and Corrective Exercise, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, IR, Iran.
| | - Maryam Goudarzian
- Iranian Research Center On Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, IR, Iran.
| | - Somayeh Ahmadabadi
- Department of Physical Education and Sports Sciences, Farhangian University, Tehran, IR, Iran
| | - Seyed Mojtaba Tabatabai-Asl
- Department of Sports Injuries and Corrective Exercise, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, IR, Iran
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20
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Lieberz D, Borgeson H, Dobson S, Ewings L, Johnson K, Klaysmat K, Schultz A, Tasson R, Borstad AL. A Physical Therapy Mobility Checkup for Older Adults: Feasibility and Participant Preferences From a Discrete Choice Experiment. J Patient Cent Res Rev 2022; 9:24-34. [PMID: 35111880 PMCID: PMC8772607 DOI: 10.17294/2330-0698.1874] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024] Open
Abstract
PURPOSE Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment. METHODS Adults over 55 years of age were recruited from the community. In the study's first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the second phase, a new sample of older adults (>55 years old) were educated about the Mobility Checkup and then completed a discrete choice experiment to determine their preferences regarding 4 attributes of this care model: cost, visit duration, desired education topic, and style of educational graphic. RESULTS Each study phase was completed by 31 participants. Of the 6 feasibility criteria, 5 were met. Visit duration exceeded the 60-minute criteria for 13 of the 31 participants. Still, 91% of participants were very satisfied with the Mobility Checkup. Ability to transition positions identified preclinical mobility disability most frequently. A 30-minute visit with no out-of-pocket cost was deemed preferred. CONCLUSIONS Older adults value knowing what physical performance measurements predict about their general health. Transitions should be evaluated as part of a Mobility Checkup for older adults. Clearly conveyed cost of health care service is important to older adult consumers.
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Affiliation(s)
- Dalerie Lieberz
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
| | | | | | - Lindsey Ewings
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
| | | | - Kori Klaysmat
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
| | - Abby Schultz
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
| | - Rachel Tasson
- Department of Physical Therapy, The College of St. Scholastica, Duluth, MN
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21
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Blodgett JM, Ventre JP, Mills R, Hardy R, Cooper R. A systematic review of one-legged balance performance and falls risk in community-dwelling adults. Ageing Res Rev 2022; 73:101501. [PMID: 34748974 DOI: 10.1016/j.arr.2021.101501] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/20/2021] [Accepted: 10/20/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this systematic review was to synthesise all published evidence on associations between one-legged balance performance and falls. METHODS Medline, EMBASE, CINAHL and Web of Science were systematically searched (to January 2021) to identify peer-reviewed, English language journal articles examining the association between one-legged balance performance and falls in community-dwelling adults. RESULTS Of 4310 records screened, 55 papers were included (n = 36954 participants). There was considerable heterogeneity between studies including differences in study characteristics, ascertainment of balance and falls, and analytical approaches. A meta-analysis of the time that individuals could maintain the one-legged balance position indicated that fallers had worse balance times than non-fallers (standardised mean difference: -0.29 (95%CI:-0.38,-0.20) in cross-sectional analyses; -0.19 (-0.28, -0.09) in longitudinal analyses), although there was no difference in the pooled median difference. Due to between-study heterogeneity, regression estimates between balance and fall outcomes could not be synthesised. Where assessed, prognostic accuracy indicators suggested that one-legged balance was a poor discriminator of fall risk; for example, 5 of 7 studies demonstrated poor prognostic accuracy (Area Under the Curve <0.6), with most studies demonstrating poor sensitivity. CONCLUSIONS This systematic review identified 55 papers that examined associations between balance and fall risk, the majority in older aged adults. However, the evidence was commonly of low quality and results were inconsistent. This contradicts previous perceptions of one-legged balance as a useful fall risk tool and highlights crucial gaps that must be addressed in order to translate such assessments to clinical settings.
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Affiliation(s)
- Joanna M Blodgett
- Institute of Sport, Exercise & Health, Division of Surgery & Interventional Science, University College London, 170 Tottenham Court Road, W1T 7HA, London, UK.
| | - Jodi P Ventre
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Oxford Road, M15 6BH, Manchester, UK; Department of Psychology, Health, Psychology and Communities Research Centre, Manchester Metropolitan University, Bonsall Street, M15 6GX, Manchester, UK
| | - Richard Mills
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Oxford Road, M15 6BH, Manchester, UK
| | - Rebecca Hardy
- CLOSER, Social Research Institute, University College London, 55-59 Gordon Square, WC1H 0NU, London, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Oxford Road, M15 6BH, Manchester, UK
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22
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Womack JA, Murphy TE, Ramsey C, Bathulapalli H, Leo-Summers L, Smith AC, Bates J, Jarad S, Gill TM, Hsieh E, Rodriguez-Barradas MC, Tien PC, Yin MT, Brandt C, Justice AC. Brief Report: Are Serious Falls Associated With Subsequent Fragility Fractures Among Veterans Living With HIV? J Acquir Immune Defic Syndr 2021; 88:192-196. [PMID: 34506360 PMCID: PMC8513792 DOI: 10.1097/qai.0000000000002752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/09/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The extensive research on falls and fragility fractures among persons living with HIV (PWH) has not explored the association between serious falls and subsequent fragility fracture. We explored this association. SETTING Veterans Aging Cohort Study. METHODS This analysis included 304,951 6-month person- intervals over a 15-year period (2001-2015) contributed by 26,373 PWH who were 50+ years of age (mean age 55 years) and taking antiretroviral therapy (ART). Serious falls (those falls significant enough to result in a visit to a health care provider) were identified by the external cause of injury codes and a machine learning algorithm applied to radiology reports. Fragility fractures were identified using ICD9 codes and included hip fracture, vertebral fractures, and upper arm fracture and were modeled with multivariable logistic regression with generalized estimating equations. RESULTS After adjustment, serious falls in the previous year were associated with increased risk of fragility fracture [odds ratio (OR) 2.10; 95% confidence interval (CI): 1.83 to 2.41]. The use of integrase inhibitors was the only ART risk factor (OR 1.17; 95% CI: 1.03 to 1.33). Other risk factors included the diagnosis of alcohol use disorder (OR 1.49; 95% CI: 1.31 to 1.70) and having a prescription for an opioid in the previous 6 months (OR 1.40; 95% CI: 1.27 to 1.53). CONCLUSIONS Serious falls within the past year are strongly associated with fragility fractures among PWH on ART-largely a middle-aged population-much as they are among older adults in the general population.
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Affiliation(s)
- Julie A Womack
- VA Connecticut Healthcare System and Yale School of Nursing, West Haven, CT
| | | | - Christine Ramsey
- Yale School of Medicine, New Haven, CT
- VA Connecticut Healthcare System, West Haven, CT
| | - Harini Bathulapalli
- Yale School of Medicine, New Haven, CT
- VA Connecticut Healthcare System, West Haven, CT
| | | | | | - Jonathan Bates
- Yale School of Medicine, New Haven, CT
- VA Connecticut Healthcare System, West Haven, CT
| | | | | | - Evelyn Hsieh
- Yale School of Medicine, New Haven, CT
- VA Connecticut Healthcare System, West Haven, CT
| | - Maria C Rodriguez-Barradas
- Michael E DeBakey VA Medical Center, Infectious Diseases Section, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Phyllis C Tien
- Department of Veterans Affairs, University of California, San Francisco, San Francisco, CA
| | - Michael T Yin
- Columbia University Medical Center, New York, NY; and
| | - Cynthia Brandt
- VA Connecticut Healthcare System, West Haven, CT
- Yale University Schools of Medicine and Public Health, New Haven, CT
| | - Amy C Justice
- VA Connecticut Healthcare System, West Haven, CT
- Yale University Schools of Medicine and Public Health, New Haven, CT
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Chang WK, Kim WS, Sohn MK, Jee S, Shin YI, Ko SH, Ock M, Kim HJ, Paik NJ. Korean Model for Post-acute Comprehensive rehabilitation (KOMPACT): The Study Protocol for a Pragmatic Multicenter Randomized Controlled Study on Early Supported Discharge. Front Neurol 2021; 12:710640. [PMID: 34566853 PMCID: PMC8455937 DOI: 10.3389/fneur.2021.710640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/09/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction: Early supported discharge (ESD) is a transitional care model aimed at facilitating post-acute stroke patients' discharge to home. Previous studies have demonstrated that ESD provides equivalent patient and caregiver outcomes with superior cost-effectiveness compared to conventional rehabilitation (CR). This study intends to examine the feasibility of ESD in Korea. Methods and Analysis: This study is designed as a multicenter assessor-blinded, randomized controlled trial. Ninety post-acute stroke patients with mild to moderate disability (modified Rankin Scale 1–3) will be recruited from three university hospitals (30 patients per hospital) in Korea and allocated to either the ESD group or the CR group in a 1:1 ratio. Patients in the ESD group will receive individualized discharge planning and goal setting, a 4-week home-based rehabilitation program, and liaison service to community-based resources by a multidisciplinary team. Patients in the CR group will receive rehabilitation practices according to their current hospital policy. Outcomes: The primary outcome is the Korean version of the modified Barthel Index, and the primary endpoint was post-onset 3 months. Clinical outcomes, patient/caregiver reported outcomes, and socioeconomic outcomes will be measured at baseline, 1 month after discharge, 2 months after discharge, and 3 months after onset. Discussion: The efficacy and cost-effectiveness of ESD can vary according to the healthcare system and sociocultural aspects. To establish ESD as an alternative transitional care model for post-acute stroke patients in Korea, its feasibility needs to be examined in prior. This study will add evidence on the applicability of ESD in Korea. Ethical Considerations: The study protocol was reviewed and approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB number B-2012/654-308). The study protocol was registered at ClinicalTrials.gov (Identifier NCT04720820). Disseminations will include submission to peer-reviewed journals and presentations at conferences.
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Affiliation(s)
- Won Kee Chang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Min Kyun Sohn
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Chugnam National University Hospital, Daejeon, South Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Chugnam National University Hospital, Daejeon, South Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Pusan, South Korea
| | - Sung-Hwa Ko
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Pusan, South Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Hyun Joo Kim
- Department of Nursing Science, Shinsung University, Dangjin, South Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
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KO JUNGHYUK, KWON DOYOUNG, CHAE SUUNG, KWON YURI, EOM GWANGMOON, KIM JIWON. TEST–RETEST RELIABILITY OF STATIC POSTURAL BALANCE VARIABLES IN NATURAL AND FEET-TOGETHER STANCE CONDITIONS. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421400339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
It is important to confirm the reliability of postural balance variables because the results of balance tests would be different with different balance test protocols, i.e., stance conditions such as natural and feet-together stances. The aim of this study was to investigate the test–retest reliability of postural balance variables during the natural and feet-together stance conditions. Sixteen young healthy adults were instructed to sustain their center of body mass as stably as possible on the force plate. As balance standing conditions, natural (a comfortable self-selected stance width) and feet-together stances (placing the feet [Formula: see text] apart) were selected. The mean distance, mean velocity, mean frequency, and 95% confidence ellipse area were derived from the center of pressure (COP) time series in the overall, anteroposterior (AP), and mediolateral (ML) directions. To evaluate the test–retest reliability of the postural balance variables, Cronbach’s alpha coefficient was calculated in each stance condition. Mean velocity was the most reliable variable particularly in three repeated balances within both the natural and feet together stances ([Formula: see text]–0.921). The reliability of all variables of the three balance test was greater than that of the two balance tests, mainly in the natural stance. In contrast, the mean ML distance of the feet-together stance had poor reliability despite three balance tests ([Formula: see text]). These results suggest that the balance test protocol should consider the appropriate stance conditions as well as the number of balance trials to select the reliable postural balance variables.
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Affiliation(s)
- JUNGHYUK KO
- Division of Mechanical Engineering, College of Engineering, Korea Maritime and Ocean University, Busan, Korea
| | - DO-YOUNG KWON
- Department of Neurology, Korea University College of Medicine, Ansan Hospital, Ansan-City, Republic of Korea
| | - SU-UNG CHAE
- Department of Biomedical Engineering, Konkuk University, Chungju, Republic of Korea
| | - YU-RI KWON
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Chungju, Republic of Korea
| | - GWANG-MOON EOM
- Department of Biomedical Engineering, Konkuk University, Chungju, Republic of Korea
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Republic of Korea
| | - JI-WON KIM
- Department of Biomedical Engineering, Konkuk University, Chungju, Republic of Korea
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Republic of Korea
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Sápi M, Fehér-Kiss A, Csernák K, Domján A, Pintér S. The Effects of Exergaming on Sensory Reweighting and Mediolateral Stability of Women Aged Over 60: Usability Study. JMIR Serious Games 2021; 9:e27884. [PMID: 34287215 PMCID: PMC8339979 DOI: 10.2196/27884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/30/2021] [Accepted: 05/29/2021] [Indexed: 12/19/2022] Open
Abstract
Background Older adults tend to experience difficulties in switching quickly between various reliable sensory inputs, which ultimately may contribute to an increased risk of falls and injuries. Sideward falls are the most frequent cause of hip fractures among older adults. Recently, exergame programs have been confirmed as beneficial tools for enhancing postural control, which can reduce the risk of falls. However, studies to explore more precisely which mechanism of exergaming directly influences older women’s ability to balance are still needed. Objective Our aim was to evaluate, in a single-group pretest/posttest/follow-up usability study, whether Kinect exergame balance training might have a beneficial impact on the sensory reweighting in women aged over 60. Methods A total of 14 healthy women (mean age 69.57 [SD 4.66] years, mean body mass index 26.21 [SD 2.6] kg/m2) participated in the study. The volunteers trained with the commercially available games of Kinect for Xbox 360 console 3 times (30 minutes/session) a week over a 6-week period (total of 18 visits). Participants’ postural sway in both the anteroposterior (AP) and mediolateral (ML) directions was recorded with NeuroCom Balance Master 6.0. To assess and measure postural sensory reweighting, the Modified Clinical Test of Sensory Interaction in Balance was used, where volunteers were exposed to various changes in visual (eyes open or eyes closed) and surface conditions (firm or foam surface). Results In the ML direction, the Kinect exergame training caused a significant decrease in the sway path on the firm surface with the eyes open (P<.001) and eyes closed (P=.001), and on the foam surface with the eyes open (P=.001) and eyes closed (P<.001) conditions compared with baseline data. The follow-up measurements when compared with the baseline data showed a significant change in the sway path on the firm surface with the eyes open (P<.001) and eyes closed (P<.001) conditions, as well as on the foam surface with the eyes open (P=.003) and eyes closed (P<.001) conditions. Besides, on the firm surface, there were no significant differences in sway path values in the AP direction between the baseline and the posttraining measurements (eyes open: P=.49; eyes closed: P=.18). Likewise, on the foam surface, there were no significant differences in sway path values in the AP direction under both eyes open (P=.24) and eyes closed (P=.84) conditions. Conclusions The improved posturography measurements of the sway path in the ML direction might suggest that the Kinect exergame balance training may have effects on sensory reweighting, and thus on the balance of women aged over 60. Based on these results, Kinect exergaming may provide a safe and potentially useful tool for improving postural stability in the crucial ML direction, and thus it may help reduce the risk of falling.
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Affiliation(s)
- Mariann Sápi
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Anna Fehér-Kiss
- Physiotherapy Center, Albert Szent-Györgyi Health Center, University of Szeged, Szeged, Hungary
| | - Krisztina Csernák
- Department of Psychiatry and Psychiatric Clinic, Bács-Kiskun County Hospital Kecskemét, Kecskemét, Hungary
| | - Andrea Domján
- Department of Physiotherapy, Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Sándor Pintér
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
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Abstract
OBJECTIVES The motivation for this research is to determine whether a listening-while-balancing task would be sensitive to quantifying listening effort in middle age. The premise behind this exploratory work is that a decrease in postural control would be demonstrated in challenging acoustic conditions, more so in middle-aged than in younger adults. DESIGN A dual-task paradigm was employed with speech understanding as one task and postural control as the other. For the speech perception task, participants listened to and repeated back sentences in the presence of other sentences or steady-state noise. Targets and maskers were presented in both spatially-coincident and spatially-separated conditions. The postural control task required participants to stand on a force platform either in normal stance (with feet approximately shoulder-width apart) or in tandem stance (with one foot behind the other). Participants also rated their subjective listening effort at the end of each block of trials. RESULTS Postural control was poorer for both groups of participants when the listening task was completed at a more adverse (vs. less adverse) signal-to-noise ratio. When participants were standing normally, postural control in dual-task conditions was negatively associated with degree of high-frequency hearing loss, with individuals who had higher pure-tone thresholds exhibiting poorer balance. Correlation analyses also indicated that reduced speech recognition ability was associated with poorer postural control in both single- and dual-task conditions. Middle-aged participants exhibited larger dual-task costs when the masker was speech, as compared to when it was noise. Individuals who reported expending greater effort on the listening task exhibited larger dual-task costs when in normal stance. CONCLUSIONS Listening under challenging acoustic conditions can have a negative impact on postural control, more so in middle-aged than in younger adults. One explanation for this finding is that the increased effort required to successfully listen in adverse environments leaves fewer resources for maintaining balance, particularly as people age. These results provide preliminary support for using this type of ecologically-valid dual-task paradigm to quantify the costs associated with understanding speech in adverse acoustic environments.
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Collins CE, Schultz K, Mathew P, Chandra A, Nguyen B, Chen T, Renshaw S, Rose KM, Santry HP. A personalized approach empowering successful aging: Patient perspective on fall prevention education. PM R 2021; 14:786-792. [PMID: 34181824 DOI: 10.1002/pmrj.12663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 04/28/2021] [Accepted: 06/07/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Falls are the leading cause of fatal injury, and the most common cause of nonfatal trauma, among older adults. However, patient perspectives on preferences for obtaining fall education are not well reported. OBJECTIVE To identify components of successful fall prevention education. DESIGN Prospective qualitative study. SETTING Tertiary care center; institutional. PARTICIPANTS Adults aged 65 years or older with a history of falls who received services from inpatient trauma or outpatient geriatric services. INTERVENTIONS One-hour face-to-face semistructured interview. MAIN OUTCOME MEASURE Semistructured interviews sought to determine participants' history of fall education and perceived strengths and weaknesses of various formats of fall education. RESULTS Nearly all participants (9/10) indicated they had not received fall prevention education of any kind. Many participants (6/10) reported that, despite not receiving any formal education about falls, they had either given or received information about falls from other older adults in their communities. Participants indicated that framing fall education as a part of healthy aging would be more desirable and mentioned involving participants' families as part of the education. The majority of participants (7/10) suggested fall education be delivered through in-person discussion with providers, and most (9/10) indicated this would provide a personalized approach with opportunity for questions. Participants specified fall education should consist of both environmental modifications (5/10) and awareness of one's surroundings (4/10). CONCLUSIONS Despite histories of falls, nearly all participants reported they had not received formal fall education. However, many indicated they received fall information informally through their communities. Participants agreed successful fall prevention education would be delivered in an empowering way by a trusted member of the care team.
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Affiliation(s)
- Courtney E Collins
- Department of Surgery, Ohio State University, Columbus, Ohio, USA.,Center for Surgical Health Assessment, Research & Policy, Ohio State University, Columbus, Ohio, USA
| | - Kurt Schultz
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Pawan Mathew
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Arnav Chandra
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Bryan Nguyen
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Tiffany Chen
- Department of Family Medicine, Sutter Health, Sacramento, California, USA
| | - Savannah Renshaw
- Department of Surgery, Ohio State University, Columbus, Ohio, USA.,Center for Surgical Health Assessment, Research & Policy, Ohio State University, Columbus, Ohio, USA
| | - Karen M Rose
- College of Nursing, Ohio State University, Columbus, Ohio, USA.,Center for Healthy Aging, Self-Management and Complex Care, Ohio State University, Columbus, Ohio, USA
| | - Heena P Santry
- Department of Surgery, Ohio State University, Columbus, Ohio, USA.,Center for Surgical Health Assessment, Research & Policy, Ohio State University, Columbus, Ohio, USA
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Seo Y, Kim K, Kim JS. Trends of Nursing Research on Accidental Falls: A Topic Modeling Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3963. [PMID: 33918730 PMCID: PMC8068873 DOI: 10.3390/ijerph18083963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022]
Abstract
This descriptive study analyzed 1849 international and 212 Korean studies to explore the main topics of nursing research on accidental falls. We extracted only nouns from each abstract, and four topics were identified through topic modeling, which were divided into aspects of fall prevention and its consequences. "Fall prevention program and scale" is popular among studies on the validity of fall risk assessment tools and the development of exercise and education programs. "Nursing strategy for fall prevention" is common in studies on nurse education programs and practice guidelines to improve the quality of patient safety care. "Hospitalization by fall injury" is used in studies about delayed discharge, increased costs, and deaths of subjects with fall risk factors hospitalized at medical institutions due to fall-related injuries. "Long-term care facility falls" is popular in studies about interventions to prevent fall injuries that occur in conjunction with dementia in long-term care facilities. It is necessary to establish a system and policy for fall prevention in Korean medical institutions. This study confirms the trends in domestic and international fall-related research, suggesting the need for studies to address insufficient fall-related policies and systems and translational research to be applied in clinical trials.
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Affiliation(s)
| | | | - Ji-Su Kim
- Department of Nursing, Chung-Ang University, 84 Heukseok-Ro Dongjak-Gu, Seoul 06974, Korea; (Y.S.); (K.K.)
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Hirata K, Suzuki M, Iso N, Okabe T, Goto H, Cho K, Shimizu J. Using machine learning to investigate the relationship between domains of functioning and functional mobility in older adults. PLoS One 2021; 16:e0246397. [PMID: 33571239 PMCID: PMC7877571 DOI: 10.1371/journal.pone.0246397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/19/2021] [Indexed: 11/18/2022] Open
Abstract
Previous studies have shown that functional mobility, along with other physical functions, decreases with advanced age. However, it is still unclear which domains of functioning (body structures, body functions, and activities) are most closely related to functional mobility. This study used machine learning classification to predict the rankings of Timed Up and Go tests based on the results of four assessments (soft lean mass, FEV1/FVC, knee extension torque, and one-leg standing time). We tested whether assessment results for each level could predict functional mobility assessments in older adults. Using support vector machines for machine learning classification, we verified that the four assessments of each level could classify functional mobility. Knee extension torque (from the body function domain) was the most closely related assessment. Naturally, the classification accuracy rate increased with a larger number of assessments as explanatory variables. However, knee extension torque remained the highest of all assessments. This extended to all combinations (of 2-3 assessments) that included knee extension torque. This suggests that resistance training may help protect individuals suffering from age-related declines in functional mobility.
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Affiliation(s)
- Keisuke Hirata
- Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
- * E-mail:
| | - Makoto Suzuki
- Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
| | - Naoki Iso
- Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
| | - Takuhiro Okabe
- Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
| | - Hiroshi Goto
- Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
| | - Kilchoon Cho
- Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
| | - Junichi Shimizu
- Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
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Wagner AR, Akinsola O, Chaudhari AMW, Bigelow KE, Merfeld DM. Measuring Vestibular Contributions to Age-Related Balance Impairment: A Review. Front Neurol 2021; 12:635305. [PMID: 33633678 PMCID: PMC7900546 DOI: 10.3389/fneur.2021.635305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/18/2021] [Indexed: 12/16/2022] Open
Abstract
Aging is associated with progressive declines in both the vestibular and human balance systems. While vestibular lesions certainly contribute to imbalance, the specific contributions of age-related vestibular declines to age-related balance impairment is poorly understood. This gap in knowledge results from the absence of a standardized method for measuring age-related changes to the vestibular balance pathways. The purpose of this manuscript is to provide an overview of the existing body of literature as it pertains to the methods currently used to infer vestibular contributions to age-related imbalance.
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Affiliation(s)
- Andrew R. Wagner
- School of Health and Rehabilitation Science, The Ohio State University, Columbus, OH, United States
- Department of Otolaryngology—Head and Neck Surgery, The Ohio State University, Columbus, OH, United States
| | - Olaoluwa Akinsola
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, United States
| | - Ajit M. W. Chaudhari
- School of Health and Rehabilitation Science, The Ohio State University, Columbus, OH, United States
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, United States
| | - Kimberly E. Bigelow
- Department of Mechanical and Aerospace Engineering, University of Dayton, Dayton, OH, United States
| | - Daniel M. Merfeld
- School of Health and Rehabilitation Science, The Ohio State University, Columbus, OH, United States
- Department of Otolaryngology—Head and Neck Surgery, The Ohio State University, Columbus, OH, United States
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States
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Shaw J, Bastawrous M, Burns S, McKay S. System Issues Leading to "Found-on-Floor" Incidents: A Multi-Incident Analysis. J Patient Saf 2021; 17:30-35. [PMID: 27811588 DOI: 10.1097/pts.0000000000000294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although attention to patient safety issues in the home care setting is growing, few studies have highlighted health system-level concerns that contribute to patient safety incidents in the home. Found-on-floor (FOF) incidents are a key patient safety issue that is unique to the home care setting and highlights a number of opportunities for system-level improvements to drive enhanced patient safety. METHODS We completed a multi-incident analysis of FOF incidents documented in the electronic record system of a home health care agency in Toronto, Canada, for the course of 1 year between January 2012 and February 2013. RESULTS Length of stay (LOS) was identified as the cross-cutting theme, illustrating the following 3 key issues: (1) in the short LOS group, a lack of information continuity led to missed fall risk information by home care professionals; (2) in the medium LOS group, a lack of personal support worker/carer training in fall prevention led to inadequate fall prevention activity; and (3) in the long LOS group, a lack of accountability policy at a system level led to a lack of fall risk assessment follow-up. CONCLUSIONS Our study suggests that considering LOS in the home care sector helps expose key system-level issues enabling safety incidents such as FOF to occur. Our multi-incident analysis identified a number of opportunities for system-level changes that might improve fall prevention practice and reduce the likelihood of FOF incidents in the home. Specifically, investment in electronic health records that are functional across the continuum of care, further research and understanding of the training and skills of personal support workers, and enhanced incentives or more punitive approaches (depending on the circumstances) to ensure accountability in home safety will strengthen the home care sector and help prevent FOF incidents among older people.
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Affiliation(s)
- James Shaw
- From the Institute for Health System Solutions and Virtual Care, Women's College Hospital
| | | | - Susan Burns
- VHA Home Health Care, Toronto, Ontario, Canada
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Zhao X, Huang H, Gu Y. Age score for assessing motor function in Chinese community-dwelling older women. J Women Aging 2020; 34:170-180. [PMID: 33319638 DOI: 10.1080/08952841.2020.1859936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study aimed to develop a physical fitness age score to assess motor function in community-dwelling elderly women and verify its validity. Principal component analysis was employed to build a physical fitness age score based on motor function variables. Validation test showed that the physical fitness age in the exercised older women was significantly lower than their chronological age, while no significant difference was observed between the physical fitness age and the chronological age in the normal elderly. The findings suggest that physical fitness age score is a valid approach to evaluate motor function in Chinese community-dwelling elderly women.
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Affiliation(s)
- Xiaoguang Zhao
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Huiming Huang
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Yaodong Gu
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
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Choi HG, Lee JK, Lee MJ, Park B, Sim S, Lee SM. Blindness increases the risk for hip fracture and vertebral fracture but not the risk for distal radius fracture: a longitudinal follow-up study using a national sample cohort. Osteoporos Int 2020; 31:2345-2354. [PMID: 32632509 DOI: 10.1007/s00198-020-05475-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/21/2020] [Indexed: 12/14/2022]
Abstract
UNLABELLED The risks for hip fracture and vertebral fracture, but not the risk for distal radius fracture, were significantly higher in the blindness group than in the control group with a maximum 12-year follow-up. PURPOSE To evaluate the influence of visual impairment on the risk for osteoporotic fractures at common sites: hip, thoracic/lumbar vertebra, and distal radius. METHODS This longitudinal follow-up study used a database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. Of a total of 1,125,691 subjects, 3918 patients with visual impairment and age ≥ 50 years were enrolled in a 1:4 ratio; 15,672 control participants were matched for age, sex, income, and region of residence. Stratified Cox proportional-hazards models were used to evaluate the crude and adjusted (for steroid medication, rheumatoid arthritis, depression, osteoporosis, diabetes mellitus, and stroke history) hazard ratios (HRs) for each fracture site. Fracture diagnoses were based on the ICD-10 codes: hip fracture (S720, S721, S722), vertebral fracture (S220, S320), and distal radius fracture (S525). RESULTS The HRs for hip and vertebral fracture were significantly higher in the blindness group (adjusted HR = 2.46, p < 0.001 for hip fracture; adjusted HR = 1.42, p = 0.020 for thoracic/lumbar vertebral fracture) than in the matched control group. However, the HR for distal radius fracture was not higher in the blindness group. The HRs for all three fracture sites were not significantly higher in the non-blindness visual impairment group after adjustment. CONCLUSION The risks for hip fracture and vertebral fracture were significantly higher in the blindness group. However, the risk for distal radius fracture was not related to visual impairment including blindness.
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Affiliation(s)
- H G Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - J K Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - M J Lee
- Department of Ophthalmology, Hallym University College of Medicine, Anyang, Republic of Korea
| | - B Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - S Sim
- Department of Statistics and Institute of Statistics, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si, Gangwon-do, 24252, Republic of Korea.
| | - S-M Lee
- Department of Cornea, External Disease & Refractive Surgery, HanGil Eye Hospital, Catholic Kwandong University College of Medicine, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, Republic of Korea.
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Choi HS, Baek YS. Effects of the degree of freedom and assistance characteristics of powered ankle-foot orthoses on gait stability. PLoS One 2020; 15:e0242000. [PMID: 33170866 PMCID: PMC7654833 DOI: 10.1371/journal.pone.0242000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 10/26/2020] [Indexed: 11/21/2022] Open
Abstract
We studied the use of powered ankle-foot orthoses (PAFOs) and walking stability of the wearers, focusing on the ankle joint, which is known to play a critical role in gait stability. Recognizing that the subtalar joint is an important modulator of walking stability, we conducted the walking experiment on a treadmill by applying varying assistance techniques to the 2-degree-of-freedom (DOF) PAFO, which has the subtalar joint as the rotating axis, and the commonly used 1-DOF PAFO. The participants were 8 healthy men (mean±SD: height, 174.8±7.1 cm; weight, 69.8±6.5 kg; and age, 29.1±4.8 years) with no history of gait abnormality. Center of pressure (COP) was measured with an in-shoe pressure sensor, and stability was estimated on the basis of the angular acceleration measured with the inertial measurement unit attached to the trunk. The experimental results of the 2-DOF PAFO, with or without assistance, showed a significantly higher stability than those of the 1-DOF PAFO (up to 23.78%, p<0.0326). With the 1-DOF PAFO, the stability deteriorated with the increase in the degree of assistance provided. With the 2-DOF PAFO, this tendency was not observed. Thus, the importance of the subtalar joint was proven using PAFOs. The mean position analysis of the COP during the stance phase confirmed that the COP highly correlated with stability (Pearson correlation coefficient: −0.6607). Thus, we conclude that only the 2-DOF PAFO can maintain walking stability, regardless of the assistance characteristics, by preserving the COP in the medial position through eversion. Awareness regarding the role of the subtalar joint is necessary during the manufacture or use of PAFOs, as lack of awareness could lead to the degradation of the wearer’s gait stability, regardless of effective assistance, and deteriorate the fundamental functionality of PAFO.
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Affiliation(s)
- Ho Seon Choi
- School of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea
| | - Yoon Su Baek
- School of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea
- * E-mail:
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Ryan AS, Roy A, Oursler KK. Gait and Balance Biomechanics in Older Adults With and Without Human Immunodeficiency Virus. AIDS Res Hum Retroviruses 2020; 35:1089-1094. [PMID: 31547668 DOI: 10.1089/aid.2019.0102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Balance deficits impose limitations and can impede safe walking contributing to falls and falls-related complications. The objective of this study was to perform an in-depth balance assessment and compare domains of limitations in older men with and without HIV infection. Fifteen sedentary African American men either with HIV (n = 6) or without HIV (n = 9 controls) participated. Standing balance was assessed under quiet stance on dual synchronized force plates during three 30 s trials with eyes open. Participants also completed standardized clinical instruments of balance, including the Berg Balance Scale (BBS) and Dynamic Gait Index (DGI). Older participants with HIV have lower BBS and DGI scores than controls (both p < .05). Adults with HIV have nearly twice the magnitude greater center of pressure (COP) sway variability than controls (1.42 ± 1.20 cm2 vs. 0.71 ± 0.1 cm2, p < .05). These data demonstrating differences in COP sway area between groups may further support evidence of potential fall risk and contribute to frailty in older adults with HIV.
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Affiliation(s)
- Alice S. Ryan
- VA Maryland Health Care System, Baltimore VA Medical Center, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
- Baltimore VA Medical Center, Geriatric Research, Education and Clinical Center (GRECC), VA Maryland Health Care System, Baltimore, Maryland
- Division of Infectious Disease, Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
- Salem Veterans Affairs Medical Center, Salem, Virginia
| | - Anindo Roy
- VA Maryland Health Care System, Baltimore VA Medical Center, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
- Baltimore VA Medical Center, Geriatric Research, Education and Clinical Center (GRECC), VA Maryland Health Care System, Baltimore, Maryland
- Division of Infectious Disease, Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
- Salem Veterans Affairs Medical Center, Salem, Virginia
| | - Krisann K. Oursler
- VA Maryland Health Care System, Baltimore VA Medical Center, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
- Baltimore VA Medical Center, Geriatric Research, Education and Clinical Center (GRECC), VA Maryland Health Care System, Baltimore, Maryland
- Division of Infectious Disease, Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
- Salem Veterans Affairs Medical Center, Salem, Virginia
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Cattuzzo MT, de Santana FS, Safons MP, Ré AHN, Nesbitt DR, Santos ABD, Feitoza AHP, Stodden DF. Assessment in the Supine-To-Stand Task and Functional Health from Youth to Old Age: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165794. [PMID: 32785195 PMCID: PMC7460168 DOI: 10.3390/ijerph17165794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/17/2020] [Accepted: 07/27/2020] [Indexed: 11/18/2022]
Abstract
Performance in the supine-to-stand (STS) task is an important functional and health marker throughout life, but the evaluation methods and some correlates can impact it. This article aims to examine the studies that assessed the performance of the STS task of young people, adults and the elderly. Evidence of the association between the STS task and body weight status, musculoskeletal fitness and physical activity was investigated, and a general protocol was proposed. MEDLINE/Pubmed and Web of Science databases were accessed for searching studies measuring the STS task directly; identification, objective, design, sample, protocols and results data were extracted; the risk of bias was assessed (PROSPERO CRD42017055693). From 13,155 studies, 37 were included, and all demonstrated a low to moderate risk of bias. The STS task was applied in all world, but the protocols varied across studies, and they lacked detail; robust evidence demonstrating the association between STS task and musculoskeletal fitness was found; there was limited research examining body weight status, physical activity and the STS task performance. In conclusion, the STS task seems to be a universal tool to track motor functional competence and musculoskeletal fitness throughout life for clinical or research purposes.
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Affiliation(s)
- Maria Teresa Cattuzzo
- Higher School of Physical Education, University of Pernambuco, Recife 50100-130, PE, Brazil; (A.B.D.S.); (A.H.P.F.)
- Correspondence: ; Tel.: +55-81-99998-6506
| | | | - Marisete Peralta Safons
- Faculty of Physical Education, University of Brasília, Brasília 70910-900, DF, Brazil; (F.S.d.S.); (M.P.S.)
| | | | - Danielle Rene Nesbitt
- Department of Health, Physical and Secondary Education, Fayetteville State University, Fayetteville, NC 28301, USA;
| | - Ariane Brito Diniz Santos
- Higher School of Physical Education, University of Pernambuco, Recife 50100-130, PE, Brazil; (A.B.D.S.); (A.H.P.F.)
| | | | - David Franklin Stodden
- Department of Physical Education, College of Education, University of South Carolina, Columbia, SC 29208, USA;
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Kera T, Kawai H, Takahashi J, Hirano H, Watanabe Y, Fujiwara Y, Ihara K, Kim H, Obuchi S. Association between ground reaction force in sit-to-stand motion and falls in community-dwelling older Japanese individuals. Arch Gerontol Geriatr 2020; 91:104221. [PMID: 32810735 DOI: 10.1016/j.archger.2020.104221] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Ground reaction force (GRF) during sit-to-stand motion is associated with lower extremity strength and balance function. The relationship between GRF and experience of falls has been reported; however, there are no reports on whether GRF can predict the incidence of future falls. We aimed to evaluate the ability of GRF to predict falls and compare GRF with existing predictors. METHODS This prospective observational cohort study enrolled 456 community-dwelling older adults living in Itabashi ward who participated in health check-ups in 2016 and 2017. Participants' physical and cognitive functions were assessed, and the maximum GRF (F), F/weight (F/W), rate of force development (RFD), RFD/W (RFD/weight), and time taken to stand up were evaluated. The following year, participants were asked to report the number of falls during the year. Cox proportional hazards regression was conducted to analyze the relationship between the lowest quintile of each GRF parameter as a predictive factor for falling and assess the annual incidence of falls. RESULTS Twenty-three participants reported having two or more falls in the previous year. Of all GRF parameters evaluated, only F/W was lower in the fallers than in the non-fallers. After adjusting for sex, age, lifestyle, and comorbidities, F/W was associated with falls in 1 year, and the lowest F/W group had higher risks of falls than the highest F/W group (hazard ratio 2.72, 95 % confidence interval 1.11-6.68). Other measures were not associated with falls. CONCLUSIONS GRF during the sit-to-stand motion might predict the incidence of future falls.
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Affiliation(s)
- Takeshi Kera
- Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan; Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Junta Takahashi
- The Tokyo Metropolitan Support Center for Promotion of Preventive Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan.
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University School of Medicine, Aomori, Japan.
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
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Rotondi NK, Beaton DE, Sujic R, Bogoch E, Inrig T, Linton D, Weldon J, Jain R, Sale JEM. Factors associated with screening positive for high falls risk in fragility fracture patients: a cross-sectional study. BMC Musculoskelet Disord 2020; 21:372. [PMID: 32532279 PMCID: PMC7291444 DOI: 10.1186/s12891-020-03410-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/08/2020] [Indexed: 11/18/2022] Open
Abstract
Background We sought to report the prevalence of fragility fracture patients who were screened at high falls risk using a large provincial database, and to determine the characteristics associated with being screened at high falls risk. Methods The study population included fragility fracture patients 50+ years of age who were screened at 35 hospital fracture clinics in Ontario over a 3.5 year period. The outcome was based on two screening questions measuring the risk of falling, both adapted from the STEADI (Stopping Elderly Accidents, Deaths & Injuries) tool. Multivariable associations of sociodemographic, fracture-related, and health-related characteristics were evaluated using logistic regression. Results Of the sample, 9735 (44.5%) patients were classified as being at high falls risk, and 12,089 (55.3%) were not. In the multivariable logistic regression, being 80+ years of age (vs. 50–64 years of age), non-community dwelling (vs. living with spouse, family member, roommate), having a mental/physical impairment (vs. none), and taking multiple medications, were all strongly associated with being screened at high falls risk. Conclusions Living in a non-community dwelling and taking 4+ medications were the variables most strongly associated with being screened at high falls risk. These are potentially modifiable characteristics that should be considered when assessing falls risk in fragility fracture patients, and particularly when designing interventions for preventing subsequent falls. Ongoing work to address the higher risk of falls in the fragility fracture population is warranted.
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Affiliation(s)
- Nooshin K Rotondi
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe St. North, Oshawa, Ontario, L1H 7K4, Canada. .,Musculoskeletal Health & Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Dorcas E Beaton
- Musculoskeletal Health & Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.,Institute for Work & Health, University of Toronto, Toronto, Ontario, Canada
| | - Rebeka Sujic
- Musculoskeletal Health & Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Earl Bogoch
- Musculoskeletal Health & Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Mobility Program, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Taucha Inrig
- Musculoskeletal Health & Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Denise Linton
- Musculoskeletal Health & Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Ravi Jain
- Osteoporosis Canada, Toronto, Ontario, Canada
| | - Joanna E M Sale
- Musculoskeletal Health & Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
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Piau A, Mattek N, Duncan C, Sharma N, Riley T, Kaye J. The Five W's of Falls: Weekly Online Health Survey of Community-Dwelling Older Adults: Analysis of 4 Years Prospective Follow-up. J Gerontol A Biol Sci Med Sci 2020; 75:946-951. [PMID: 31054258 PMCID: PMC7164523 DOI: 10.1093/gerona/glz114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND An in-depth examination of prospectively collected falls details may facilitate more effective falls prevention. Who was involved? What happened? Where did the fall take place? When did it happen? Why did it occur? This study aimed to provide previously unavailable details about the circumstances surrounding fall events and their consequences. METHOD A retrospective analysis of falls prospectively self-reported by older adults via an online weekly health form over 4 years. RESULTS We collected 371 falls during the 4 year time period from 120 clinically characterized fallers (74% women, mean age 83.3 years). Most of the 371 falls occurred indoors (62%) and in well-lit areas (81%). Bedrooms were the most common places for in-home falls. Commonly observed precipitating factors included loss of balance, slipping or tripping. Almost one-third (31%) of falls were defined as injurious whereas 22% resulted in a change in the walking ability of which 26% led to the use of a cane or walker. Among falls that did not give rise to any formal health care intervention, 8% resulted in a modification of walking ability. CONCLUSIONS A relatively high rate of fall-related injuries compared to the existing literature was observed. Online weekly surveys and the richness of details provided through these data capture method allowed us to identify falls that did not result in health care utilization but did result in decreased mobility. This finding suggests why some falls classified in the literature as noninjurious may nevertheless increase the risk of loss of autonomy and undesired outcomes.
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Affiliation(s)
- Antoine Piau
- Internal Medicine and Gerontology, University Hospital of Toulouse, UPS, Toulouse, France
- Department of Neurology, Oregon Center for Aging and Technology (ORCATECH), Oregon Health and Science University, Portland
| | - Nora Mattek
- Department of Neurology, Oregon Center for Aging and Technology (ORCATECH), Oregon Health and Science University, Portland
| | - Colette Duncan
- Department of Neurology, Oregon Center for Aging and Technology (ORCATECH), Oregon Health and Science University, Portland
| | - Nicole Sharma
- Department of Neurology, Oregon Center for Aging and Technology (ORCATECH), Oregon Health and Science University, Portland
| | - Thomas Riley
- Department of Neurology, Oregon Center for Aging and Technology (ORCATECH), Oregon Health and Science University, Portland
| | - Jeffrey Kaye
- Department of Neurology, Oregon Center for Aging and Technology (ORCATECH), Oregon Health and Science University, Portland
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Hong Z, Xu L, Zhou J, Sun L, Li J, Zhang J, Hu F, Gao Z. The Relationship between Self-Rated Economic Status and Falls among the Elderly in Shandong Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062150. [PMID: 32213856 PMCID: PMC7143219 DOI: 10.3390/ijerph17062150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 01/24/2023]
Abstract
(1) Background: Older people are more vulnerable and likely to have falls and the consequences of these falls place a heavy burden on individuals, families and society. Many factors directly or indirectly affect the prevalence of falls. The aims of this study were to understand the prevalence and risk factors of falls among the elderly in Shandong, China; the relationship between economic level and falls was also preliminary explored. (2) Methods: Using a multi-stage stratified sampling method, 7070 elderly people aged 60 and over were selected in Shandong Province, China. General characteristics and a self-rated economic status were collected through face to face interviews. Chi-square tests, rank sum tests and two logistic regression models were performed as the main statistical methods. (3) Results: 8.59% of participants reported that they had experienced at least one fall in the past half year. There was a significant difference in experienced falls regarding gender, residence, marital status, educational level, smoking, drinking, hypertension, diabetes, coronary disease, and self-reported hearing. The worse the self-rated economic status, the higher the risk of falling, (poor and worried about livelihood, OR = 3.60, 95%; CI = 1.76–7.35). (4) Conclusions: Women, hypertension, diabetes and self-reported hearing loss were identified as the risk factors of falls in the elderly. The difference of economic level affects the falls of the elderly in rural and urban areas. More fall prevention measures should be provided for the elderly in poverty.
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Affiliation(s)
- Zhuang Hong
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Lingzhong Xu
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
- Correspondence:
| | - Jinling Zhou
- School of Medicine and Health Management, Shandong University, Jinan 250012, China;
| | - Long Sun
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Jiajia Li
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Jiao Zhang
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Fangfang Hu
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Zhaorong Gao
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
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Bend Don't Break: Stretching Improves Scores on a Battery of Fall Assessment Tools in Older Adults. J Sport Rehabil 2020; 30:78-84. [PMID: 32087599 DOI: 10.1123/jsr.2019-0246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/27/2019] [Accepted: 01/02/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Falls and loss of autonomy are often attributed in large part to musculoskeletal impairments in later adulthood. Age-related declines in flexibility contribute to late adulthood musculoskeletal impairment. The novel sitting-rising test has been proposed to be a quick, effective screening of musculoskeletal fitness, fall risk, and all-cause mortality in older adults. The timed up and go and 5 times sit-to-stand tests are two of the 3 most evidence-supported performance measures to assess fall risk. OBJECTIVE This study aimed to determine if 5 weeks of flexibility training could increase sitting-rising test, timed up and go, and 5 times sit-to-stand scores in community-dwelling older adults. PARTICIPANTS Forty-seven adults aged 60 years and older (mean age = 66.7 y, SD = 4.1) participated in this study. Participants completed a static stretching protocol consisting of 3 weekly 1-hour stretching sessions. RESULTS The protocol improved flexibility as seen in sit-and-reach scores and improved scores on all outcome variables. Specifically, there was a significant increase in sitting-rising test scores from preintervention (M = 7.45, SD = 1.45) to postintervention (M = 8.04, SD = 1.36), t(42) = -5.21, P < .001. Timed up and go scores demonstrated a significant decrease from preintervention (M = 8.85, SD = 1.32) to postintervention (M = 8.20, SD = 1.35), t(46) = 5.10, P < .001. Five times sit-to-stand scores demonstrated a significant decrease from preintervention (M = 12.57, SD = 2.68) to postintervention (M = 10.46, SD = 2.06), t(46) = 6.62, P < .001. Finally, significant increases in sit-and-reach scores were associated with improved functional performance (r = -.308, P = .03). CONCLUSION Findings suggest that flexibility training can be an effective mode of low-level exercise to improve functional outcomes. Static stretching may help to improve musculoskeletal health, promote autonomy, and decrease mortality in community-dwelling older adults.
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Burt LA, Gabel L, Billington EO, Hanley DA, Boyd SK. Postural Balance Effects Associated with 400, 4000 or 10,000 IU Vitamin D 3 Daily for Three Years: A Secondary Analysis of a Randomized Clinical Trial. Nutrients 2020; 12:nu12020527. [PMID: 32092887 PMCID: PMC7071365 DOI: 10.3390/nu12020527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 12/22/2022] Open
Abstract
Vitamin D supplementation is proposed as a fall prevention strategy, as it may improve neuromuscular function. We examined whether three years of vitamin D supplementation (400, 4000 or 10,000 IU daily) affects postural sway in older adults. Three hundred and seventy-three non-osteoporotic, vitamin D-sufficient, community-dwelling healthy adults, aged 55–70 years, were randomized to 400 (n = 124), 4000 (n = 125) or 10,000 (n = 124) IU daily vitamin D3 for three years. Sway index was assessed at baseline, 12-, 24- and 36-months using the Biosway machine. We tested participants under four conditions: eyes open or eyes closed with firm (EOFI, ECFI) or foam (EOFO, ECFO) surfaces. Secondary assessments examined sway in the anterior-posterior (AP) and medio-lateral (ML) directions. Linear mixed effects models compared sway between supplementation groups across time. Postural sway under EOFO and ECFO conditions significantly improved in all supplementation groups over time. Postural sway did not differ between supplementation groups at any time under any testing conditions in normal, AP or ML directions (p > 0.05 for all). Our findings suggest that high dose (4000 or 10,000 IU) vitamin D supplementation neither benefit nor impair balance compared with 400 IU daily in non-osteoporotic, vitamin D-sufficient, healthy older adults.
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Phelan EA, Rillamas-Sun E, Johnson L, LaMonte MJ, Buchner DM, LaCroix AZ, Anderson GL. Determinants, circumstances and consequences of injurious falls among older women living in the community. Inj Prev 2020; 27:34-41. [PMID: 31941756 DOI: 10.1136/injuryprev-2019-043499] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To identify the risk factors of women who fell with injury relative to women who did not fall or fell without injury and to describe the circumstances and consequences of injurious and non-injurious falls. METHODS We analysed 5074 older women from the Objective Physical Activity and Cardiovascular Health Study who prospectively tracked their falls using a 13-month calendar. Women with a reported fall were phone interviewed about fall-related details, including injuries. Risk factors were identified from surveys and clinical home visits. Logistic regression models were used to calculate adjusted ORs and 95% CIs for injurious falls relative to not falling or falling without injury. Circumstances of injurious and non-injurious falls were compared. RESULTS At least one fall was experienced by 1481 (29%) participants. Of these, 1043 were phone interviewed, of whom 430 (41%) reported at least one injurious fall. Relative to not falling, the risk factor most strongly associated with experiencing an injurious fall was having fallen ≥2 times (OR 4.0, CI 2.7 to 5.8) in the past year. Being black was protective for fall-related injury (OR 0.6, CI 0.4 to 0.9). No strong associations in risk factors were observed for injurious relative to non-injurious falls. Injurious falls were more likely to occur away from and outside of the home (p<0.05). Over half of those who injured self-managed their injury. CONCLUSION Falling repeatedly is a powerful risk factor for injurious falls. Those who have fallen more than once should be prioritised for interventions to mitigate the risk of an injurious fall.
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Affiliation(s)
- Elizabeth A Phelan
- Division of Gerontology and Geriatric Medicine and Department of Health Services, University of Washington, Seattle, Washington, USA
| | - Eileen Rillamas-Sun
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Lisa Johnson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo - The State University of New York, Buffalo, New York, USA
| | - David M Buchner
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Andrea Z LaCroix
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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de Amorim JSC, Torres KCL, Carvalho AT, Martins-Filho OA, Lima-Costa MF, Peixoto SV. Inflammatory markers associated with fall recurrence and severity: The Bambuí Cohort Study of Aging. Exp Gerontol 2020; 132:110837. [PMID: 31935439 DOI: 10.1016/j.exger.2020.110837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/21/2019] [Accepted: 01/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to analyze the association between inflammatory markers and recurrent and severe falls in 1304 community-dwelling older adults from the Bambuí Cohort Study of Aging. METHODS Information about falls in the previous 12 months was collected, and classified based on recurrence (two or more falls) and severity (requirement of medical attention). The screened biomarkers included interleukins (IL-1β, IL-6, IL-10, and IL-12, TNF), chemokines (CXCL8, CXCL9, CXCL10, CCL2, and CCL5), and high-sensitive C-reactive protein (hs-PCR). Potential confounders included sociodemographic, behavioral, and health indicators. Associations were evaluated through logistic regression, using odds ratios (OR) and 95% confidence intervals (95% CI), with Stata 13.1. RESULTS The prevalence of recurrent and severe falls was 10.7% and 9.0%, respectively. After adjustments, elevated levels of IL-12 (OR: 1.92; 95% CI: 1.09-3.37) and CXCL9 (OR: 1.67; 95% CI: 1.05-2.66) were found to be associated with recurrent falls, while elevated levels of TNF (OR: 1.58; 95% CI: 1.01-2.50), IL-12 (OR: 2.04; 95% CI: 1.13-3.70), CXCL10 (OR: 1.75; 95% CI: 1.04-2.92), and CCL5 (OR: 1.90; 95% CI: 1.18-3.07) were associated with severe falls. CONCLUSIONS The results highlight a wide range of biomarkers not yet explored in the literature and suggest that inflammation may be an important component of recurrent and severe falls.
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Affiliation(s)
- Juleimar Soares Coelho de Amorim
- Postgraduate Program in Public Health, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil.
| | - Karen Cecília Lima Torres
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil; Faculty of Medicine, University José do Rosário Vellano, UNIFENAS, Belo Horizonte, Brazil
| | - Andréa Teixeira Carvalho
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil
| | - Olindo Assis Martins-Filho
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil
| | - Maria Fernanda Lima-Costa
- Center of Studies in Public Health and Aging, René Rachou René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil
| | - Sérgio Viana Peixoto
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil; Federal University of Minas Gerais, Nursing School, Belo Horizonte, Brazil
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Ye J, Simpson MW, Liu Y, Lin W, Zhong W, Cai S, Zou L. The Effects of Baduanjin Qigong on Postural Stability, Proprioception, and Symptoms of Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Front Med (Lausanne) 2020; 6:307. [PMID: 31998728 PMCID: PMC6966958 DOI: 10.3389/fmed.2019.00307] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 12/05/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Knee osteoarthritis is a common disease affecting a large number of old individuals worldwide. This study aimed to explore the effects of Baduanjin Qigong in patients with knee osteoarthritis. Methods: Fifty participants with knee osteoarthritis were randomly assigned to either an experimental group (n = 25) or a control group (n = 25). Participants in the experimental group received Baduanjin Qigong training for 12 weeks, with three sessions per week lasting 40 min per session. Participants in the control group did not receive any additional physical training. All of participants completed outcome (proprioception, postural stability, and functional ability) assessments at three time points (baseline, Week 8, 12). Results: Proprioception and Western Ontario and McMaster Universities Osteoarthritis Index function were statistically improved at eighth and 12th week of the intervention in the Baduanjin Qigong group (p < 0.05), while the control group did not have any significant changes. For postural stability at the anterior-posterior direction with eyes closed, Baduanjin Qigong group showed significant improvement compared to controls after the 12 weeks of intervention (p < 0.05). Conclusions: Regular Baduanjin Qigong practice helped the improvement of knee joint proprioception and postural stability, and reduction of pain, stiffness, and functional impairments of old adults with knee osteoarthritis. Well-designed randomized controlled trials with long-term assessment are needed. The trial was registered in Chinese Clinical Trial Registry (ChiCTR-IOR-16010042). URL: http://www.chictr.org.cn/hvshowproject.aspx?id=10550.
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Affiliation(s)
- Jiajia Ye
- Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Michael William Simpson
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yang Liu
- Department of Kinesiology and Program in Neuroscience, Indiana University Bloomington, Bloomington, IN, United States
| | - Wei Lin
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Weihong Zhong
- Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shuhe Cai
- Department of Orthopaedic Rehabilitation, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China
| | - Liye Zou
- Exercise and Mental Health Laboratory, Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China
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Palmer TB, Farrow AC, Palmer BM. Relationships between hamstring morphological characteristics and postural balance in elderly men. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2020; 20:88-93. [PMID: 32131372 PMCID: PMC7104577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The link between hamstring morphology and postural balance performance in older adults is not well understood. This study aimed to examine the relationships between hamstring morphological characteristics of muscle size (cross-sectional area [CSA]) and quality (echo intensity [EI]) and postural balance with the eyes open and closed in elderly men. METHODS Nineteen healthy elderly men (age= 73±4 years) participated in this study. Muscle CSA and EI were determined from ultrasound scans of the hamstrings. Postural balance was assessed with the eyes open and closed using a commercially designed balance testing device, which provides a measurement of static stability based on the sway index. RESULTS The sway index with eyes closed was significantly related to muscle EI (r=0.474; P=0.040) but not CSA (r=0.021; P=0.932). The sway index with eyes open was not related to muscle CSA (r= -0.036; P=0.883) or EI (r=-0.079; P=0.747). CONCLUSIONS The significant relationship observed between the sway index with eyes closed and muscle EI suggests that hamstring muscle quality may be a characteristic relevant to postural balance in the absence of visual feedback. These findings may provide important insight regarding the morphological mechanisms involved in maintaining balance and in the development of proper training programs aimed at improving postural stability in older individuals.
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Affiliation(s)
- Ty B. Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX,Corresponding author: Ty B. Palmer, PhD, Assistant Professor, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409 E-mail:
| | - Ahalee C. Farrow
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
| | - Bailey M. Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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Monteiro AM, Forte P, Carvalho J, Barbosa TM, Morais JE. Relationship between fear of falling and balance factors in healthy elderly women: A confirmatory analysis. J Women Aging 2019; 33:57-69. [PMID: 31813340 DOI: 10.1080/08952841.2019.1681244] [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] [Indexed: 10/25/2022]
Abstract
The aim of this study was to develop a confirmatory model, using structural equation modeling, to describe and explain the fear of falling in elderly women. Forty-one participants (67.69 ± 5.30 years) were selected to test a theoretical model. The final model revealed that the fear of falling is related to impaired balance (dynamic and static). Strength has a positive effect on both dynamic and static balance. Strength depends on bone mineral density. In conclusion, more strength and bone mineral density and better body balance tend to decrease the fear of falling.
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Affiliation(s)
- António M Monteiro
- Department of Sport Sciences, Instituto Politécnico de Bragança , Bragança, Portugal
| | - Pedro Forte
- Department of Sport Sciences, Instituto Politécnico de Bragança , Bragança, Portugal.,Research Centre in Sports, Health and Human Development (CIDESD), University of Trás-os-Montes and Alto Douro , Vila Real, Portugal.,Department of Sport Sciences and Physical Education, Higher Institute of Educational Sciences of the Douro , Penafiel, Portugal
| | - Joana Carvalho
- Research Center in Physical Activity, Health and Leisure, University of Porto , Porto, Portugal
| | - Tiago M Barbosa
- Department of Sport Sciences, Instituto Politécnico de Bragança , Bragança, Portugal.,Research Centre in Sports, Health and Human Development (CIDESD), University of Trás-os-Montes and Alto Douro , Vila Real, Portugal.,National Institute of Education, Nanyang Technological University , Singapore
| | - Jorge E Morais
- Department of Sport Sciences, Instituto Politécnico de Bragança , Bragança, Portugal.,Research Centre in Sports, Health and Human Development (CIDESD), University of Trás-os-Montes and Alto Douro , Vila Real, Portugal
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Golubić A, Šarabon N, Marković G. Association between trunk muscle strength and static balance in older women. J Women Aging 2019; 33:288-297. [PMID: 31739776 DOI: 10.1080/08952841.2019.1692628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study was to determine the relationship between trunk muscle strength and balance ability in both simple and dual-task conditions in older women. Sixty-seven older women (age: 67.2 ± 1.1 years) volunteered in this study. Each participant performed isometric trunk muscle strength testing in standing position (extension, flexion, and lateral flexion) and balance testing in semitandem stance for 30 seconds in two conditions: with and without an additional cognitive task (counting down by 3 from 300). Balance was quantified via force plate as a mean velocity of center of pressure (CoP) displacement over 30 seconds. We found a statistically significant correlation between the trunk extensor strength and mean velocity of CoP displacement, both without (r = 0.5, p < .05) and with an additional cognitive task (r = 0.4, p < .05). There were no statistically significant correlations between trunk flexor and lateral flexors strength and balance measures (r < 0.2; p > .05). These results indicate that trunk extensor muscle strength is related to balance ability of healthy older women. Although additional studies are needed, our findings suggest that trunk strength training could be of importance in prevention of falls and fall-related injuries in seniors.
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Affiliation(s)
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Koper, Slovenia
| | - Goran Marković
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia.,Research Unit, Motus Melior Ltd., Zagreb, Croatia
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Welsh TJ, Gordon AL, Gladman JR. Treatment of Hypertension in People With Dementia: A Multicenter Prospective Observational Cohort Study. J Am Med Dir Assoc 2019; 20:1111-1115. [DOI: 10.1016/j.jamda.2019.03.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/26/2019] [Accepted: 03/30/2019] [Indexed: 10/26/2022]
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Mulavara AP, Peters BT, Miller CA, Kofman IS, Reschke MF, Taylor LC, Lawrence EL, Wood SJ, Laurie SS, Lee SMC, Buxton RE, May-Phillips TR, Stenger MB, Ploutz-Snyder LL, Ryder JW, Feiveson AH, Bloomberg JJ. Physiological and Functional Alterations after Spaceflight and Bed Rest. Med Sci Sports Exerc 2019; 50:1961-1980. [PMID: 29620686 PMCID: PMC6133205 DOI: 10.1249/mss.0000000000001615] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Supplemental digital content is available in the text. Introduction Exposure to microgravity causes alterations in multiple physiological systems, potentially impacting the ability of astronauts to perform critical mission tasks. The goal of this study was to determine the effects of spaceflight on functional task performance and to identify the key physiological factors contributing to their deficits. Methods A test battery comprised of seven functional tests and 15 physiological measures was used to investigate the sensorimotor, cardiovascular, and neuromuscular adaptations to spaceflight. Astronauts were tested before and after 6-month spaceflights. Subjects were also tested before and after 70 d of 6° head-down bed rest, a spaceflight analog, to examine the role of axial body unloading on the spaceflight results. These subjects included control and exercise groups to examine the effects of exercise during bed rest. Results Spaceflight subjects showed the greatest decrement in performance during functional tasks that required the greatest demand for dynamic control of postural equilibrium which was paralleled by similar decrements in sensorimotor tests that assessed postural and dynamic gait control. Other changes included reduced lower limb muscle performance and increased HR to maintain blood pressure. Exercise performed during bed rest prevented detrimental change in neuromuscular and cardiovascular function; however, both bed rest groups experienced functional and balance deficits similar to spaceflight subjects. Conclusion Bed rest data indicate that body support unloading experienced during spaceflight contributes to postflight postural control dysfunction. Further, the bed rest results in the exercise group of subjects confirm that resistance and aerobic exercises performed during spaceflight can play an integral role in maintaining neuromuscular and cardiovascular functions, which can help in reducing decrements in functional performance. These results indicate that a countermeasure to mitigate postflight postural control dysfunction is required to maintain functional performance.
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Affiliation(s)
| | | | | | | | | | | | | | - Scott J Wood
- Neurosciences Laboratory, NASA-Johnson Space Center, Houston, TX
| | | | - Stuart M C Lee
- Cardiovascular and Vision Laboratory, KBRwyle, Houston, TX
| | - Roxanne E Buxton
- Exercise Physiology and Countermeasures Laboratory, KBRwyle, Houston, TX
| | | | - Michael B Stenger
- Cardiovascular and Vision Laboratory, NASA-Johnson Space Center, Houston, TX
| | | | - Jeffrey W Ryder
- Exercise Physiology and Countermeasures Laboratory, KBRwyle, Houston, TX
| | - Alan H Feiveson
- Biostatistics Laboratory, NASA-Johnson Space Center, Houston, TX
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