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Vega-Díaz M, González-García H, De Labra C. Parenting profiles: motivation toward health-oriented physical activity and intention to be physically active. BMC Psychol 2023; 11:205. [PMID: 37438804 DOI: 10.1186/s40359-023-01239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Parents influence their sons' and daughters' interest in practicing and maintaining physical activity through parenting patterns. OBJECTIVE To identify perceived parenting style profiles and examine whether the participants differed in their motivation toward health-oriented physical activity and the intention to be physically active. METHOD A sample of 296 participants completed a series of self-report measures and a latent profile analysis (LPA) was performed. RESULTS Two profiles emerged as the most suitable: profile (a) with average scores in parenting variables, and profile (b) with high scores in parenting variables. The results revealed significant differences in integrated regulation and in amotivation, reporting higher scores for profile (b) in the parenting variables love/affection, hostility/aggression, and indifference/neglect, and average in undifferentiated/rejection and control. CONCLUSION The combination of perceived parenting style variables in the profiles seems to influence people's motivation toward health-oriented physical activity. As such, it is crucial to understand parenting from a multivariate approach, mostly in interventions to adjust parenting styles to the most suitable combination.
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Affiliation(s)
- Marta Vega-Díaz
- Faculty of Nursing and Podiatry, University of A Coruña (UDC), A Coruña Galicia, Spain.
| | - Higinio González-García
- TECNODEF Research Group, Faculty of Education, Universidad Internacional de La Rioja (UNIR), Logroño (La Rioja), Spain
| | - Carmen De Labra
- NEUROcom, Centro de Investigaciones Científicas Avanzadas (CICA), Instituto de Investigación Biomédica de A Coruña (INIBIC), Faculty of Nursing and Podiatry, University of A Coruña, A Coruña Galicia, Spain
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Cremer S, Vluggen S, Man-Van-Ginkel JMD, Metzelthin SF, Zwakhalen SM, Bleijlevens MHC. Effective nursing interventions in ADL care affecting independence and comfort - a systematic review. Geriatr Nurs 2023; 52:73-90. [PMID: 37269607 DOI: 10.1016/j.gerinurse.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 06/05/2023]
Abstract
Despite its frequent provision, evidence of nursing interventions in Activities of Daily Living (ADL) remains unclear. Hence, we addressed the research question: What are the effects of ADL nursing interventions on independence and comfort in adults across all care settings? We conducted a systematic review of randomized controlled trials and quasi-experimental studies described in systematic reviews. In three databases, we searched for systematic reviews that we used as a portal to select (quasi) experimental studies. After narratively summarizing the studies on characteristics, effects, and interventions, we assessed the risk of bias. Among the 31 included studies, 14 studies evaluated independence, 14 studies measured comfort, and three studies assessed both outcomes. Seven interventions significantly improved independence and seven interventions significantly improved comfort. The studies varied highly in intervention components, outcome measures, and quality. Evidence on ADL nursing interventions affecting independence and comfort remains fragmented and inconclusive, limiting guidance for nursing professionals.
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Affiliation(s)
- S Cremer
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.
| | - S Vluggen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - J M de Man-Van-Ginkel
- Department of Gerontology and Geriatrics, Nursing Science, Leiden University Medical Centre, Postzone C-07-Q, Postbus 9600, Leiden, RC 2300, The Netherlands
| | - S F Metzelthin
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - S M Zwakhalen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - M H C Bleijlevens
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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Wu S, Ji H, Won J, Jo EA, Kim YS, Park JJ. The Effects of Exergaming on Executive and Physical Functions in Older Adults With Dementia: Randomized Controlled Trial. J Med Internet Res 2023; 25:e39993. [PMID: 36881445 PMCID: PMC10031442 DOI: 10.2196/39993] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/19/2022] [Accepted: 10/25/2022] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Despite increasing interest in the effects of exergaming on cognitive function, little is known about its effects on older adults with dementia. OBJECTIVE The purpose of this is to investigate the effects of exergaming on executive and physical functions in older adults with dementia compared to regular aerobic exercise. METHODS In total, 24 older adults with moderate dementia participated in the study. Participants were randomized into either the exergame group (EXG, n=13, 54%) or the aerobic exercise group (AEG, n=11, 46%). For 12 weeks, EXG engaged in a running-based exergame and AEG performed a cycling exercise. At baseline and postintervention, participants underwent the Ericksen flanker test (accuracy % and response time [RT]) while recording event-related potentials (ERPs) that included the N2 and P3b potentials. Participants also underwent the senior fitness test (SFT) and the body composition test pre- and postintervention. Repeated-measures ANOVA was performed to assess the effects of time (pre- vs postintervention), group (EXG vs AEG), and group×time interactions. RESULTS Compared to AEG, EXG demonstrated greater improvements in the SFT (F1.22=7.434, P=.01), reduction in body fat (F1.22=6.476, P=.02), and increase in skeletal mass (F1.22=4.525, P=.05), fat-free mass (F1.22=6.103, P=.02), and muscle mass (F1.22=6.636, P=.02). Although there was a significantly shorter RT in EXG postintervention (congruent P=.03, 95% CI 13.581-260.419, incongruent P=.04, 95% CI 14.621-408.917), no changes occurred in AEG. EXG also yielded a shorter N2 latency for central (Cz) cortices during both congruent conditions compared to AEG (F1.22=4.281, P=.05). Lastly, EXG presented a significantly increased P3b amplitude compared to AEG during the Ericksen flanker test (congruent: frontal [Fz] F1.22=6.546, P=.02; Cz F1.22=5.963, P=.23; parietal [Pz] F1.22=4.302, P=.05; incongruent: Fz F1.22=8.302, P=.01; Cz F1.22=15.199, P=.001; Pz F1.22=13.774, P=.001). CONCLUSIONS Our results suggest that exergaming may be associated with greater improvements in brain neuronal activity and enhanced executive function task performance than regular aerobic exercise. Exergaming characterized by both aerobic exercise and cognitive stimulation can be used as an effective intervention to improve cognitive and physical functions in older adults with dementia. TRIAL REGISTRATION Clinical Research Information Service KCT0008238; https://cris.nih.go.kr/cris/search/detailSearch.do/24170.
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Affiliation(s)
- Shanshan Wu
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Hongqing Ji
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Junyeon Won
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, United States
| | - Eun-Ah Jo
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea
| | - Yun-Sik Kim
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Jung-Jun Park
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
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Rahja M, Laver K, Whitehead C, Pietsch A, Oliver E, Crotty M. A systematic review and meta-analysis of reablement interventions for people in permanent residential aged care homes. Age Ageing 2022; 51:6754360. [PMID: 36215172 DOI: 10.1093/ageing/afac208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Most evidence for reablement comes from community-based interventions. OBJECTIVE To determine the effect of reablement interventions provided in permanent residential aged care (PRAC) homes on residents' level of function in activities of daily living (ADL) and quality of life (QoL). DESIGN Systematic review and meta-analysis. SETTING PRAC homes. SUBJECTS Residents in PRAC. METHODS Six databases and grey literature were searched until November 2021. Quantitative studies involving a control group or pre-post evaluation were included. Outcomes of interest were the effectiveness of the reablement intervention on overall ADL or QoL in the last available follow-up. RESULTS Twelve studies involving 2,620 residents were included. The reablement interventions varied; the primary focus areas were organisational approaches (e.g. educating staff; n = 10) and improving physical function (e.g. increasing physical activity; n = 9). Not all studies could be pooled in the meta-analysis due to reported data and heterogeneity. There was no significant effect of reablement intervention versus usual care on ADL function (five studies, standardised mean difference (SMD): 0.17, 95% confidence interval (CI): -0.25 to 0.59, very low quality evidence). Reablement appeared more beneficial than usual care in improving QoL; however, the overall effect was not statistically significant (four studies, SMD: 0.73, 95% CI: -0.07 to 1.52; very low quality evidence). CONCLUSIONS Few studies focus on reablement in PRAC homes and their clinical heterogeneity is considerable. There is insufficient evidence for reablement in terms of improving ADL or QoL for residents in PRAC. Tools that are more sensitive to change may be beneficial.
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Affiliation(s)
- Miia Rahja
- Division of Rehabilitation, Aged and Palliative Care, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, 5042, South Australia, Australia
| | - Kate Laver
- Division of Rehabilitation, Aged and Palliative Care, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, 5042, South Australia, Australia
| | - Craig Whitehead
- Division of Rehabilitation, Aged and Palliative Care, Southern Adelaide Local Health Network, Bedford Park, 5042, South Australia, Australia
| | | | - Eliza Oliver
- Division of Rehabilitation, Aged and Palliative Care, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, 5042, South Australia, Australia
| | - Maria Crotty
- Division of Rehabilitation, Aged and Palliative Care, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, 5042, South Australia, Australia
- Division of Rehabilitation, Aged and Palliative Care, Southern Adelaide Local Health Network, Bedford Park, 5042, South Australia, Australia
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Pinheiro MB, Oliveira JS, Baldwin JN, Hassett L, Costa N, Gilchrist H, Wang B, Kwok W, Albuquerque BS, Pivotto LR, Carvalho-Silva APMC, Sharma S, Gilbert S, Bauman A, Bull FC, Willumsen J, Sherrington C, Tiedemann A. Impact of physical activity programs and services for older adults: a rapid review. Int J Behav Nutr Phys Act 2022; 19:87. [PMID: 35836187 PMCID: PMC9284866 DOI: 10.1186/s12966-022-01318-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Knowledge of which physical activity programs are most effective for older adults in different sub-populations and contexts is limited. The objectives of this rapid review were to: 1) Overview evidence evaluating physical activity programs/services for older adults; and 2) Describe impact on physical activity, falls, intrinsic capacity (physical domain), functional ability (physical, social, and cognitive/emotional domains), and quality of life. Methods We conducted a rapid review of primary studies from 350 systematic reviews identified in a previous scoping review (March 2021: PEDro, MEDLINE, CINAHL, Cochrane Database). For Objective 1, we included intervention studies investigating physical activity programs/services in adults ≥ 60 years. Of these, we included good quality (≥ 6/10 PEDro scale) randomised controlled trials (RCTs) with ≥ 50 participants per group in Objective 2. Results Objective 1: Of the 1421 intervention studies identified from 8267 records, 79% were RCTs, 87% were in high income countries and 39% were good quality. Objective 2: We identified 87 large, good quality RCTs (26,861 participants). Overall activity promotion, structured exercise and recreation/sport had positive impacts (≥ 50% between-group comparisons positive) across all outcome domains. For overall activity promotion (21 intervention groups), greatest impacts were on physical activity (100% positive) and social outcomes (83% positive). Structured exercise (61 intervention groups) had particularly strong impacts on falls (91% positive), intrinsic capacity (67% positive) and physical functioning (77% positive). Recreation/sport (24 intervention groups) had particularly strong impacts on cognitive/emotional functioning (88% positive). Multicomponent exercise (39 intervention groups) had strong impacts across all outcomes, particularly physical activity (95% positive), falls (90% positive) and physical functioning (81% positive). Results for different populations and settings are presented. Conclusion Evidence supporting physical activity for older adults is positive. We outline which activity types are most effective in different populations and settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01318-9.
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Affiliation(s)
- Marina B Pinheiro
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia. .,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Juliana S Oliveira
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jennifer N Baldwin
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Nathalia Costa
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Heidi Gilchrist
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Belinda Wang
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wing Kwok
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Bruna S Albuquerque
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Luiza R Pivotto
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ana Paula M C Carvalho-Silva
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sweekriti Sharma
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Steven Gilbert
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Adrian Bauman
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Fiona C Bull
- Physical Activity Unit, Department of Health Promotion, Division of Universal Health Coverage and Healthier Populations, World Health Organization (WHO), Geneva, Switzerland
| | - Juana Willumsen
- Physical Activity Unit, Department of Health Promotion, Division of Universal Health Coverage and Healthier Populations, World Health Organization (WHO), Geneva, Switzerland
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia.,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, The University of Sydney, Sydney Local Health District, Sydney, Australia. .,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Charles Perkins Centre, The University of Sydney, Sydney, Australia.
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Andrews SC, Parekh D, Brady B, Delbaere K, Hamidul Huque M, Killcross S, Anstey KJ. Associations Between Planned Exercise, Walking, Incidental Physical Activity, and Habit Strength in Older People: A Cross-Sectional Study. J Aging Phys Act 2021;:1-11. [PMID: 34929661 DOI: 10.1123/japa.2021-0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022]
Abstract
Habits play an important role in physical activity (PA) engagement; however, these associations in older people are not well understood. The present study aimed to investigate the relationship between engagement in types of PA and their automaticity in older people, using an observational, cross-sectional design. Current hours engaged in planned exercise (excluding walking), planned walking, and incidental activities and the automaticity of those PA behaviors were measured in 127 community-dwelling Australians aged 65 years and older via an online questionnaire. After controlling for demographic and health factors (age, gender, education level, body mass index, history of falls, and anxiety and depression symptoms), higher automaticity scores were associated with more hours undertaking planned walking and incidental activity but not planned exercise. Although preliminary, these findings indicate that the role of habit in maintaining PA in older people may, therefore, differ depending on the type of activity.
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Swales B, Ryde GC, Whittaker AC. A Randomized Controlled Feasibility Trial Evaluating a Resistance Training Intervention With Frail Older Adults in Residential Care: The Keeping Active in Residential Elderly Trial. J Aging Phys Act 2021;:1-25. [PMID: 34510020 DOI: 10.1123/japa.2021-0130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 11/18/2022]
Abstract
Frailty is associated with negative health outcomes, disability, and mortality. Physical activity is an effective intervention to improve functional health status. However, the effect of resistance training on multidimensional health in frail older adults remains unclear. This randomized controlled trial was conducted in a U.K. residential care home to assess feasibility with limited efficacy testing on health and functional outcomes and to inform a future definitive randomized controlled trial. Eleven frail older adults (>65 years) completed a 6-week machine-based resistance training protocol three times a week. Uptake and retention were greater than 80%. The measures and intervention were found to be acceptable and practicable. The analyses indicated large improvements in functional capacity, frailty, and strength in the intervention group compared with the controls. These findings support the feasibility of a definitive randomized controlled trial and reinforce the value of resistance training in this population. This trial was registered with ClinicalTrials.gov: NCT03141879.
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Lee SJ, Park MS, Chang SO. Healthcare Professionals' Perceptions of Function-Focused Care Education for Nursing Home Practitioners. Int J Environ Res Public Health 2021; 18:7587. [PMID: 34300036 DOI: 10.3390/ijerph18147587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022]
Abstract
A nursing home (NH) care environment necessitates a shared cognition-based education model that maintains effective function-focused care (FFC). This study’s aim was to explore healthcare professionals’ perceptions of function-focused care education for the development of an education model using a shared mental model (SMM) in NHs. Semi-structured interviews with 30 interdisciplinary practitioners from four different professions (nurses, physical therapists, occupational therapists, and social workers) and focus group interviews with 12 experts were conducted. Data were analyzed using content analysis, and the education model development was guided by the shared mental models for data interpretation and formation. Our FFC interdisciplinary educational model incorporates four key learning components: learning contents, educational activities, educational goals/outcome, and environment, and four types of SMMs: team, task, team interaction, and equipment. As for educational contents, a team’s competencies with FFC were found to be team knowledge (physical and psychosocial functional care), team skills to perform FFC successfully (motivation, coaching and supporting, managing discomfort), and team attitude (possessing philosophy perceptions regarding FFC). As for learning outcomes, the shared cognition-based education model suggests not only the evaluation of practitioners, but also the assessment of residents’ aspects.
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Dron L, Taljaard M, Cheung YB, Grais R, Ford N, Thorlund K, Jahan F, Nakimuli-Mpungu E, Xavier D, Bhutta ZA, Park JJH, Mills EJ. The role and challenges of cluster randomised trials for global health. Lancet Glob Health 2021; 9:e701-10. [PMID: 33865475 DOI: 10.1016/S2214-109X(20)30541-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022]
Abstract
Evaluating whether an intervention works when trialled in groups of individuals can pose complex challenges for clinical research. Cluster randomised controlled trials involve the random allocation of groups or clusters of individuals to receive an intervention, and they are commonly used in global health research. In this paper, we describe the potential reasons for the increasing popularity of cluster trials in low-income and middle-income countries. We also draw on key areas of global health research for an assessment of common trial planning practices, and we address their methodological shortcomings and pitfalls. Lastly, we discuss alternative approaches for population-level intervention trials that could be useful for research undertaken in low-income and middle-income countries for situations in which the use of cluster randomisation might not be appropriate.
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Baldelli G, De Santi M, De Felice F, Brandi G. Physical activity interventions to improve the quality of life of older adults living in residential care facilities: a systematic review. Geriatr Nurs 2021; 42:806-815. [PMID: 34090224 DOI: 10.1016/j.gerinurse.2021.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Pursuing active aging and maintaining the quality of life (QoL) is essential, particularly in older people living in residential care facilities (RCFs). We evaluated physical activity (PA) as an intervention to improve the QoL in this population, trying to hypothesize future perspectives in this field. METHODS A systematic search was performed on Pubmed. Only randomized control trials or quasi-experimental control group trials were considered. RESULTS Results showed that a high-frequency PA can be effective in older people, allowing them to improve their functional mobility, autonomy, anxiety level, balance, and social interactions. Moreover, a moderate-intensity PA showed the most interesting results, improving all the QoL-related aspects considered. CONCLUSION Results highlight the beneficial effects of multidisciplinary intervention strategies in increasing QoL and QoL-related aspects of RCFs older residents, contemplating PA as the main instrument. However, structured PA is necessary to fully understand which protocol could be the most effective.
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Affiliation(s)
- Giulia Baldelli
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy.
| | - Mauro De Santi
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy
| | | | - Giorgio Brandi
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy
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Motamed-Jahromi M, Kaveh MH. Effective Interventions on Improving Elderly's Independence in Activity of Daily Living: A Systematic Review and Logic Model. Front Public Health 2021; 8:516151. [PMID: 33659228 PMCID: PMC7917261 DOI: 10.3389/fpubh.2020.516151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 11/02/2020] [Indexed: 11/24/2022] Open
Abstract
This systematic review aimed to investigate the types and characteristics of effective interventions when improving the independence of the elderly during activities of daily living. After developing a search strategy, the various databases, including PubMed, Scopus, Cochrane Library, Science Direct, Proquest, and Embase, were searched up to October 16, 2019. The Review Manager 5.1 software was used to determine the risk of bias. The randomized clinical trials were reviewed to find if their interventions' main goal was to improve the elderly's independence in activities of daily living. Data were extracted independently by two authors. Eight randomized controlled trials were included in the final analysis. Three types of interventions were identified and categorized as cognitive training, physical exercises, and multicomponent interventions. All reviewed studies provided evidence of the effectiveness of interventions in improving older people's ability to perform the activities of daily living. However, the lack of uniform measurement indicators to identify and compare the most effective interventions forced us to develop a conceptual framework for designing future interventional research. This conceptual framework included designing tailored interventions, creating an age-friendly environment as well as financial, psychological, and social support. The proposed conceptual framework can also help develop future systematic reviews focusing on a particular intervention type.
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Affiliation(s)
- Mohadeseh Motamed-Jahromi
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Kaveh
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Verstraten CCJMM, Metzelthin SF, Schoonhoven L, Schuurmans MJ, de Man-van Ginkel JM. Optimizing patients' functional status during daily nursing care interventions: A systematic review. Res Nurs Health 2020; 43:478-488. [PMID: 32829518 PMCID: PMC7540410 DOI: 10.1002/nur.22063] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/23/2020] [Indexed: 12/21/2022]
Abstract
Patients often experience a functional decline due to physical inactivity during illness. Nurses can influence the physical activity of patients while assisting them with activities of daily living. The purpose of this study was to identify effective interventions that are embedded in daily nursing care (irrespective of care setting) that aim to optimize the functional status of patients by increasing their physical activity. A systematic review was performed and reported following the preferred reporting items for systematic reviews and meta‐analyses. PubMed, CINAHL, and Cochrane were searched for studies from January 2002 to March 2019. The critical appraisal tools from the Joanna Briggs Institute were used to assess the risk of bias in individual studies. Study characteristics, intervention key components, and reported effects of included studies were extracted, summarized narratively, and compared. Twenty studies, evaluating nine different interventions were included. In these interventions, eight key components were identified. Four components were included in all six interventions with a positive effect on mobility, physical activity, or functional status. These components were: assessment of patient's functionality; goal setting with the patient; establishment of an individualized plan; and engagement of patients in physical and daily activity. The effects were limited due to the risk of bias in the studies, small sample sizes, limited clinical meaning of the effects, and variability of the adherence to the interventions. Multicomponent interventions were the most promising to enhance the functional status of patients. Future research should evaluate these interventions using research methods aiming at producing more rigorous evidence.
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Affiliation(s)
- Carolien C J M M Verstraten
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Silke F Metzelthin
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Lisette Schoonhoven
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Marieke J Schuurmans
- Education Center, UMC Utrecht Academy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Janneke M de Man-van Ginkel
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Brown M, Hooper N, James P, Scott D, Bodger O, John A. A Web-Delivered Acceptance and Commitment Therapy Intervention With Email Reminders to Enhance Subjective Well-Being and Encourage Engagement With Lifestyle Behavior Change in Health Care Staff: Randomized Cluster Feasibility Stud. JMIR Form Res 2020; 4:e18586. [PMID: 32763887 PMCID: PMC7442951 DOI: 10.2196/18586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/29/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Poor mental health and emotional well-being can negatively impact ability to engage in healthy lifestyle behavior change. Health care staff have higher rates of sickness and absence than other public sector staff, which has implications at both individual and societal levels. Individual efforts to self-manage health and well-being which add to the UK mental health prevention agenda need to be supported. OBJECTIVE The objective of this study was to establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based acceptance and commitment therapy intervention in an existing health promotion program, to improve subjective well-being and encourage engagement with lifestyle behavior change. METHODS For this 12-week, 4-armed, randomized controlled cluster feasibility study, we recruited participants offline and randomly allocated them to 1 of 3 intervention arms or control (no well-being intervention) using an automated web-based allocation procedure. Eligibility criteria were current health care staff in 1 Welsh health board, age≥18 years, ability to read English, and ability to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes were randomization procedure, acceptance of intervention, and adherence to and engagement with the wider program. We evaluated health and well-being data via self-assessment at 2 time points, registration and postintervention, using the 14-item Warwick-Edinburgh Mental Well-Being Scale, the 4-item Patient Health Questionnaire, and the 7-item Acceptance and Action Questionnaire-Revised. RESULTS Of 124 participants who provided consent and were randomly allocated, 103 completed full registration and engaged with the program. Most participants (76/103) enrolled in at least one health behavior change module, and 43% (41/96) of those randomly allocated to an intervention arm enrolled in the well-being module. Adherence and engagement was low (7/103, 6.8%), but qualitative feedback was positive. CONCLUSIONS The procedure and randomization process proved feasible, and the addition of the well-being module proved acceptable to health care staff. However, participant engagement was limited, and no one completed the full 12-week program. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale randomized controlled trial, which would be feasible with additional recruitment. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number (ISRCTN) 50074817; http://www.isrctn.com/ISRCTN50074817.
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Affiliation(s)
- Menna Brown
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Nic Hooper
- Department of Health and Social Sciences, University of the West of England, Bristol, United Kingdom
| | - Phillip James
- Department of Computer Science, Swansea University, Swansea, United Kingdom
| | - Darren Scott
- Department of Computer Science, Swansea University, Swansea, United Kingdom
| | - Owen Bodger
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
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Yang Y, van Schooten KS, McKay HA, Sims-Gould J, Hoang RA, Robinovitch SN. Recreational Therapy to Promote Mobility in Long-Term Care: A Scoping Review. J Aging Phys Act 2020; 29:142-61. [PMID: 32723928 DOI: 10.1123/japa.2019-0345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 03/29/2020] [Accepted: 04/29/2020] [Indexed: 11/18/2022]
Abstract
The objective of this study was to explore and synthesize evidence on the effectiveness and implementation of recreational therapy programs to enhance mobility outcomes (e.g., balance, functional performance, fall incidence) for older adults in long-term care. The authors conducted a scoping review of 66 studies following the PRISMA guidelines. Two independent reviewers evaluated each article, and a third reviewer resolved discrepancies. Randomized controlled studies provided strong to moderate evidence that tai chi programs, walking, dancing, and ball games improve flexibility, functional mobility, and balance. Studies assessing program implementation highlighted that program delivery was facilitated by clear instruction, encouragement, attendance documentation, and minimal equipment. This review elucidated the benefit of recreational therapy programs on mobility. It also identified the need for customized programs based on individuals' interests and their physical and mental abilities. These findings and recommendations will assist practitioners in designing effective and feasible recreational therapy programs for long-term care.
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Barrett E, Casey B, Dollard M, McCarthy B, Casey D. Effectiveness of Functionally based Physical Activity Programs on Physical, Psychological, Cognitive, and Adverse Outcomes in Older Adults Living in Nursing Homes: Systematic Review. Activities, Adaptation & Aging 2020. [DOI: 10.1080/01924788.2020.1794352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Eva Barrett
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Blathin Casey
- Physical Activity for Health (Pafh) Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Marie Dollard
- Physiotherapy Department, University Hospital Waterford, Waterford, Ireland
| | - Bernard McCarthy
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Dympna Casey
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
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Bäckström J, Fogelberg J, Gabrielsson G, Lindberg M, Arving C, Hellström K. Reliability and internal consistency of the Swedish version of the MAastrIcht Nurses Activities INventory (MAINtAIN(S)) - A pilot testing of the tool. Geriatr Nurs 2020; 41:790-803. [PMID: 32522423 DOI: 10.1016/j.gerinurse.2020.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the test-retest reliability and internal consistency of the Swedish version of the MAastrIcht Nurses Activities INventory (MAINtAIN(S)) developed to measure nursing staff perceived behaviours and barriers for promotion of everyday activities in nursing home residents. METHOD Nursing staff completed the MAINtAIN(S) questionnaire on two occasions at 3-week intervals. Relative reliability, absolute reliability and internal consistency with Cronbach's alpha were calculated. RESULTS The test--retest reliability of MAINtAIN(S)-behaviours subscales ranged from ICC2. = 0.78--0.91 and MAINtAIN(S)-barriers subscales from ICC2.1 = 0.60--0.84. Cronbach's alpha varied between 0.60 and 0.91 for the different subscales. The MAINtAIN(S) inventory shows acceptable reliability and internal consistency. MAINtAIN(S) seems to be a promising tool for identifying behaviours and barriers in promoting everyday activities in nursing home residents and can be used to develop ward specific interventions for promotion of daily physical activity level in the care of older adults.
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Affiliation(s)
- Josefin Bäckström
- Department of Neuroscience, Psychiatry, Uppsala University, Sweden; Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Jonathan Fogelberg
- Department of Neuroscience, Physiotherapy, Uppsala University, SE-751 24 Uppsala, Sweden
| | - G Gabrielsson
- Department of Neuroscience, Physiotherapy, Uppsala University, SE-751 24 Uppsala, Sweden
| | - M Lindberg
- Department of Neuroscience, Physiotherapy, Uppsala University, SE-751 24 Uppsala, Sweden
| | - Cecilia Arving
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Karin Hellström
- Department of Neuroscience, Physiotherapy, Uppsala University, SE-751 24 Uppsala, Sweden.
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Zheng Z, Gao J, Yang Y. The Enigma of Gender Differences in an Environment-Behavior-Health Model of Elderly People: The Choice Between Individually and Sociality. Int J Environ Res Public Health 2020; 17:ijerph17103483. [PMID: 32429440 PMCID: PMC7277791 DOI: 10.3390/ijerph17103483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022]
Abstract
Gender difference in the health of elderly people has become an important perspective to consider when studying their health. However, the gender differences in terms of “environment–behavior–health” from the social ecology perspective remain unknown. On the basis of survey data from Shanghai, China, including 2839 samples, this study explored the gender differences of outdoor environment–behavior–activity ability in elderly people from two aspects of the mean value of variables and the path relationship, utilizing the structural equation model analysis method combined with social ecology theory. The results showed that, at the level of the mean of variables, the elderly males had significantly higher mean values than the females in terms of individual behaviors, but had significantly lower values in terms of social behaviors. At the level of path relationships, there were similarities in that the health of elderly males was more likely to be affected by individual factors, whereas that of the females was more effected by social factors. Through the great positive effect of the high-level social behaviors, the health of the elderly females was progressively promoted. The study provided some useful insights for future research, aiming at promoting gender-sensitive urban design.
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Affiliation(s)
- Zhenhua Zheng
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Road, Shanghai 200092, China;
| | - Junling Gao
- School of Public Health, Fudan University, 220 Handan Road, Shanghai 200433, China;
| | - Ye Yang
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Road, Shanghai 200092, China;
- Correspondence:
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18
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Keppler AM, Nuritidinow T, Mueller A, Hoefling H, Schieker M, Clay I, Böcker W, Fürmetz J. Validity of accelerometry in step detection and gait speed measurement in orthogeriatric patients. PLoS One 2019; 14:e0221732. [PMID: 31469864 PMCID: PMC6716662 DOI: 10.1371/journal.pone.0221732] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/13/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Mobile accelerometry is a powerful and promising option to capture long-term changes in gait in both clinical and real-world scenarios. Increasingly, gait parameters have demonstrated their value as clinical outcome parameters, but validation of these parameters in elderly patients is still limited. OBJECTIVE The aim of this study was to implement a validation framework appropriate for elderly patients and representative of real-world settings, and to use this framework to test and improve algorithms for mobile accelerometry data in an orthogeriatric population. METHODS Twenty elderly subjects wearing a 3D-accelerometer completed a parcours imitating a real-world scenario. High-definition video and mobile reference speed capture served to validate different algorithms. RESULTS Particularly at slow gait speeds, relevant improvements in accuracy have been achieved. Compared to the reference the deviation was less than 1% in step detection and less than 0.05 m/s in gait speed measurements, even for slow walking subjects (< 0.8 m/s). CONCLUSION With the described setup, algorithms for step and gait speed detection have successfully been validated in an elderly population and demonstrated to have improved performance versus previously published algorithms. These results are promising that long-term and/or real-world measurements are possible with an acceptable accuracy even in elderly frail patients with slow gait speeds.
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Affiliation(s)
- Alexander M. Keppler
- Department for General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Timur Nuritidinow
- Department for General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Arne Mueller
- Translational Medicine, Novartis Institute for Biomedical Research, Basel, Switzerland
| | - Holger Hoefling
- Translational Medicine, Novartis Institute for Biomedical Research, Basel, Switzerland
| | - Matthias Schieker
- Translational Medicine, Novartis Institute for Biomedical Research, Basel, Switzerland
| | - Ieuan Clay
- Translational Medicine, Novartis Institute for Biomedical Research, Basel, Switzerland
| | - Wolfgang Böcker
- Department for General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Julian Fürmetz
- Department for General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
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Vos CM, Saint Arnault DM, Struble LM, Gallagher NA, Larson JL. The Experience and Meaning of Physical Activity in Assisted Living Facility Residents. J Aging Phys Act 2019; 27:406-12. [PMID: 30300049 DOI: 10.1123/japa.2018-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Assisted living (AL) residents engage in very low levels of physical activity (PA), placing them at increased risk for mobility disability and frailty. But many residents in AL may not perceive the need to increase their PA. This study explored the experience, meaning, and perceptions of PA in 20 older adults in AL. The factors associated with PA were also examined. Qualitative data were collected using semistructured interviews and analyzed using phenomenological methodology. Six themes were identified: PA was experienced as planned exercise, activities of daily living, and social activities based on a schedule or routine; PA meant independence and confidence in the future; residents perceived themselves as being physically active; social comparisons influenced perception of PA; personal health influenced PA; motivations and preferences influenced PA. The findings highlight the importance of residents' personal perceptions of PA and effects of the social milieu in the congregate setting on PA.
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Abstract
The objective of the current study was to investigate the perspectives of nursing home (NH) providers regarding the requirements to achieve reimbursement for nursing restorative care (NRC) services and propose recommendations to state agencies to assist NH providers to conduct NRC programs that are person-centered and able to achieve full reimbursement. Methods included a survey of NH providers in one state and a stakeholder focus group to discuss survey findings and develop recommendations. Key findings are that NH providers perceive value to residents from the provision of NRC; providers do not associate these benefits with the stringent reimbursement requirements; and NHs often provide NRC that is individualized, based on resident goals and activity tolerance, as well as realistic given competing demands on staff, even when doing so means giving up reimbursement for NRC services. Recommendations include basing reimbursement for NRC on outcomes rather than the process; reconsideration of the frequency and intensity requirements for NRC components; and increased availability of NRC training/education and resources for providers and case-mix reviewers. [Journal of Gerontological Nursing, 45(5), 5-10.].
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21
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Sahin UK, Kirdi N, Bozoglu E, Meric A, Buyukturan G, Ozturk A, Doruk H. Effect of low-intensity versus high-intensity resistance training on the functioning of the institutionalized frail elderly. Int J Rehabil Res 2018; 41:211-7. [PMID: 29620558 DOI: 10.1097/MRR.0000000000000285] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Frailty has emerged as an important risk factor for disability. Age-related declines in physical and physiological function lead to increased risk of loss of independence and poor quality of life. Recent evidence has shown the effectiveness of physical exercise programmes in preventing or reversing frailty. The aim of this study was to evaluate changes in the functioning of frail elderly individuals after undergoing resistance training for 3 days a week for 8 weeks. The effectiveness of exercise training was investigated in 48 frail elderly individuals who were randomly assigned to the following intervention groups: high-intensity (HI; n=16; age: 69-96 years) or low-intensity (LI; n=16; age: 77-93 years) strength training groups or a control group (n=16; age: 76-93 years) with no specific exercise programme. Participants were assessed for muscle strength, physical function, activities of daily living, depression and quality of life. The HI group had significantly better results (P<0.05) on the Short Physical Performance Test than the LI group; however, the LI group did show a significant improvement in those scores, whereas the scores of the control group worsened. Results for the other evaluations were similarly favourable in both exercise groups (P>0.05). The study showed that LI exercise was as effective as HI exercise for most parameters tested. Exercise training is useful for the prevention or treatment of frailty, as it improves functioning by contributing positively to muscle strength, gait, balance and quality of life.
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22
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Htut TZC, Hiengkaew V, Jalayondeja C, Vongsirinavarat M. Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial. Eur Rev Aging Phys Act 2018; 15:10. [PMID: 30305852 PMCID: PMC6169073 DOI: 10.1186/s11556-018-0199-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/24/2018] [Indexed: 12/25/2022] Open
Abstract
Background Physical exercise (PE), virtual reality-based exercise (VRE), and brain exercise (BE) can influence physical and cognitive conditions in older persons. However, it is not known which of the three types of exercises provide the best effects on physical and cognitive status, and which exercise is preferred by older persons. This study compared the effects of PE, VRE, and BE on balance, muscle strength, cognition, and fall concern. In addition, exercise effort perception and contentment in older persons was evaluated. Methods Eighty-four older persons (n = 84) were randomly selected for PE, VRE, BE, and control groups. The exercise groups received 8-week training, whereas the control group did not. Balance was assessed by Berg Balance Scale (BBS) and Timed Up and Go test (TUG), muscle strength by 5 Times Sit to Stand (5TSTS) and left and right hand grip strength (HGS), cognition by Montreal Cognitive Assessment (MoCA) and Timed Up and Go test Cognition (TUG-cog), fall concern by Fall Efficacy Scale International (FES-I), exercise effort perception by Borg category ratio scale (Borg CR-10), and exercise contentment by a questionnaire. Results After exercise, PE significantly enhanced TUG and 5TSTS to a greater extent than VRE (TUG; p = 0.004, 5TSTS; p = 0.027) and BE (TUG; p = 0,012, 5TSTS; p < 0.001). VRE significantly improved MoCA (p < 0.001) and FES-I (p = 0.036) compared to PE, and 5TSTS (p < 0.001) and FES-I (p = 0.011) were improved relative to BE. MoCA was significantly enhanced by BE compared to PE (p < 0.001) and both MoCA and TUG-cog were improved compared to VRE (p = 0.04). PE and VRE significantly (p < 0.001) increased Borg CR-10 in all exercise sessions, whereas BE showed a significant improvement (p < 0.001) in the first 4 sessions. Participants had a significantly greater satisfaction with BE than controls (p = 0.006), and enjoyed VRE and BE more than PE (p < 0.001). Subjects in all exercise groups exhibited benefits compared to the control group (p < 0.001). Conclusions PE provided the best results in physical tests, VRE produced measurable improvements in physical and cognition scores, while BE enhanced cognition ability in older persons. Older persons preferred VRE and BE compared to PE. Both exercises are suggested to older persons to improve physical and cognitive conditions.
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Affiliation(s)
- Thwe Zar Chi Htut
- Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd., Salaya, Phutthamonthon, Nakhon Pathom, 73170 Thailand
| | - Vimonwan Hiengkaew
- Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd., Salaya, Phutthamonthon, Nakhon Pathom, 73170 Thailand
| | - Chutima Jalayondeja
- Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd., Salaya, Phutthamonthon, Nakhon Pathom, 73170 Thailand
| | - Mantana Vongsirinavarat
- Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd., Salaya, Phutthamonthon, Nakhon Pathom, 73170 Thailand
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Abstract
BACKGROUND Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012. OBJECTIVES To assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals. SEARCH METHODS We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017. SELECTION CRITERIA Randomised controlled trials of interventions for preventing falls in older people in residential or nursing care facilities, or hospitals. DATA COLLECTION AND ANALYSIS One review author screened abstracts; two review authors screened full-text articles for inclusion. Two review authors independently performed study selection, 'Risk of bias' assessment and data extraction. We calculated rate ratios (RaR) with 95% confidence intervals (CIs) for rate of falls and risk ratios (RRs) and 95% CIs for outcomes such as risk of falling (number of people falling). We pooled results where appropriate. We used GRADE to assess the quality of evidence. MAIN RESULTS Thirty-five new trials (77,869 participants) were included in this update. Overall, we included 95 trials (138,164 participants), 71 (40,374 participants; mean age 84 years; 75% women) in care facilities and 24 (97,790 participants; mean age 78 years; 52% women) in hospitals. The majority of trials were at high risk of bias in one or more domains, mostly relating to lack of blinding. With few exceptions, the quality of evidence for individual interventions in either setting was generally rated as low or very low. Risk of fracture and adverse events were generally poorly reported and, where reported, the evidence was very low-quality, which means that we are uncertain of the estimates. Only the falls outcomes for the main comparisons are reported here.Care facilitiesSeventeen trials compared exercise with control (typically usual care alone). We are uncertain of the effect of exercise on rate of falls (RaR 0.93, 95% CI 0.72 to 1.20; 2002 participants, 10 studies; I² = 76%; very low-quality evidence). Exercise may make little or no difference to the risk of falling (RR 1.02, 95% CI 0.88 to 1.18; 2090 participants, 10 studies; I² = 23%; low-quality evidence).There is low-quality evidence that general medication review (tested in 12 trials) may make little or no difference to the rate of falls (RaR 0.93, 95% CI 0.64 to 1.35; 2409 participants, 6 studies; I² = 93%) or the risk of falling (RR 0.93, 95% CI 0.80 to 1.09; 5139 participants, 6 studies; I² = 48%).There is moderate-quality evidence that vitamin D supplementation (4512 participants, 4 studies) probably reduces the rate of falls (RaR 0.72, 95% CI 0.55 to 0.95; I² = 62%), but probably makes little or no difference to the risk of falling (RR 0.92, 95% CI 0.76 to 1.12; I² = 42%). The population included in these studies had low vitamin D levels.Multifactorial interventions were tested in 13 trials. We are uncertain of the effect of multifactorial interventions on the rate of falls (RaR 0.88, 95% CI 0.66 to 1.18; 3439 participants, 10 studies; I² = 84%; very low-quality evidence). They may make little or no difference to the risk of falling (RR 0.92, 95% CI 0.81 to 1.05; 3153 participants, 9 studies; I² = 42%; low-quality evidence).HospitalsThree trials tested the effect of additional physiotherapy (supervised exercises) in rehabilitation wards (subacute setting). The very low-quality evidence means we are uncertain of the effect of additional physiotherapy on the rate of falls (RaR 0.59, 95% CI 0.26 to 1.34; 215 participants, 2 studies; I² = 0%), or whether it reduces the risk of falling (RR 0.36, 95% CI 0.14 to 0.93; 83 participants, 2 studies; I² = 0%).We are uncertain of the effects of bed and chair sensor alarms in hospitals, tested in two trials (28,649 participants) on rate of falls (RaR 0.60, 95% CI 0.27 to 1.34; I² = 0%; very low-quality evidence) or risk of falling (RR 0.93, 95% CI 0.38 to 2.24; I² = 0%; very low-quality evidence).Multifactorial interventions in hospitals may reduce rate of falls in hospitals (RaR 0.80, 95% CI 0.64 to 1.01; 44,664 participants, 5 studies; I² = 52%). A subgroup analysis by setting suggests the reduction may be more likely in a subacute setting (RaR 0.67, 95% CI 0.54 to 0.83; 3747 participants, 2 studies; I² = 0%; low-quality evidence). We are uncertain of the effect of multifactorial interventions on the risk of falling (RR 0.82, 95% CI 0.62 to 1.09; 39,889 participants; 3 studies; I² = 0%; very low-quality evidence). AUTHORS' CONCLUSIONS In care facilities: we are uncertain of the effect of exercise on rate of falls and it may make little or no difference to the risk of falling. General medication review may make little or no difference to the rate of falls or risk of falling. Vitamin D supplementation probably reduces the rate of falls but not risk of falling. We are uncertain of the effect of multifactorial interventions on the rate of falls; they may make little or no difference to the risk of falling.In hospitals: we are uncertain of the effect of additional physiotherapy on the rate of falls or whether it reduces the risk of falling. We are uncertain of the effect of providing bed sensor alarms on the rate of falls or risk of falling. Multifactorial interventions may reduce rate of falls, although subgroup analysis suggests this may apply mostly to a subacute setting; we are uncertain of the effect of these interventions on risk of falling.
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Affiliation(s)
- Ian D Cameron
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Suzanne M Dyer
- DHATR Consulting120 Robsart StreetParksideSouth AustraliaAustralia5063
| | - Claire E Panagoda
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health DistrictSt LeonardsNSWAustralia2065
| | - Geoffrey R Murray
- Illawarra Shoalhaven Local Health DistrictAged Care, Rehabilitation and Palliative CareWarrawongAustralia
| | - Keith D Hill
- Curtin UniversitySchool of Physiotherapy and Exercise Science, Faculty of Health SciencesGPO Box U1987PerthWestern AustraliaAustralia6845
| | - Robert G Cumming
- Sydney Medical School, University of SydneySchool of Public HealthRoom 306, Edward Ford Building (A27)Fisher RoadSydneyNSWAustralia2006
| | - Ngaire Kerse
- University of AucklandDepartment of General Practice and Primary Health CarePrivate Bag 92019AucklandNew Zealand
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Barrett E, Gillespie P, Newell J, Casey D. Feasibility of a physical activity programme embedded into the daily lives of older adults living in nursing homes: protocol for a randomised controlled pilot feasibility study. Trials 2018; 19:461. [PMID: 30157920 PMCID: PMC6114037 DOI: 10.1186/s13063-018-2848-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/07/2018] [Indexed: 01/28/2023] Open
Abstract
Background Older adults living in nursing homes spend the majority of their time inactive. The associated levels of chronic disease place an increasing burden on healthcare systems. Physical activity (PA) interventions delivered through exercise classes may be resource-intensive and require specialist staff. The aim of this study is to explore the feasibility and acceptability of a PA programme embedded into the daily lives of older adults living in nursing homes and to examine the preliminary effects of this on physical mobility and quality of life. Methods A randomised controlled pilot feasibility study, including embedded qualitative and economic components will be carried out. Two randomly selected nursing homes will take part in the study; participants (n = 20) in one nursing home will receive a three-month PA intervention and participants (n = 20) in the other will be a usual care control. Nursing home staff will be provided with training and support to monitor participants PA programmes. Feasibility data will be collected on recruitment, randomisation, assessment and intervention procedures. Criteria for progression of the pilot feasibility study to a definitive trial will be specified. The Timed Up and Go test, Nottingham Health Profile, 10-Metre Walk test, the Investigating Choice Experiments for the Preferences of Older People Capability index and the Bangor Goal Setting Interview will be assessed at baseline, three-month and 12-month follow-up. Between-group and within-individual effects will be estimated using appropriate linear mixed models. Semi-structured interviews will be conducted with staff and participants of the intervention group within one month after the intervention to explore the feasibility and acceptability of the programme. A subset of control participants will be interviewed to describe usual care. Economic data will be collected to examine costs of the intervention in comparison with costs in the control group. Discussion The findings will facilitate refinement of the PA programme and development of a clear protocol for subsequent evaluation of the PA intervention in a definitive randomised controlled trial. Trial registration ClinicalTrials.gov, NCT03484715. Registered on 30 March 2018. Electronic supplementary material The online version of this article (10.1186/s13063-018-2848-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eva Barrett
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.
| | - Paddy Gillespie
- Health Economics and Policy Analysis Centre, National University of Ireland Galway, Galway, Ireland
| | - John Newell
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Dympna Casey
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
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Lopez P, Izquierdo M, Radaelli R, Sbruzzi G, Grazioli R, Pinto RS, Cadore EL. Effectiveness of Multimodal Training on Functional Capacity in Frail Older People: A Meta-Analysis of Randomized Controlled Trials. J Aging Phys Act 2018; 26:407-18. [PMID: 28952861 DOI: 10.1123/japa.2017-0188] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this meta-analysis, we investigated the effect of resistance training (RT) alone or included in a multimodal training on physical frailty outcomes, and whether different variables of RT prescription affect these outcomes. We identified 15 relevant studies searching through MEDLINE, Cochrane Central Register of Controlled Trials, SPORTDiscus, and PEDro database. Postintervention standardized mean difference scores were computed and combined using fixed effects meta-analysis. Analyses have shown positive effects of interventions on maximum strength, gait speed, and Timed Up and Go test. Further analyses have shown significant greater effect of shorter periods on maximum strength. Regarding RT prescription, percentage of one-repetition maximum showed significant effect on physical variables, whereas RT based on rate of perceived effort presented lower effect in the Timed Up and Go test. Although multimodal training is an effective intervention to increase physical capacity, caution should be taken regarding the period and the method to control RT intensity to optimize enhancements in frail older people.
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De Vriendt P, Cornelis E, Vanbosseghem R, Desmet V, Van de Velde D. Enabling meaningful activities and quality of life in long-term care facilities: The stepwise development of a participatory client-centred approach in Flanders. Br J Occup Ther 2018. [DOI: 10.1177/0308022618775880] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Meaningful activities of daily living promote the quality of life of residents of long-term care facilities. This project aimed to develop an approach to enable meaningful activities of daily living and to guide long-term care facilities in a creative and innovative attitude towards residents' meaningful activities of daily living. Method The approach was developed in six steps: (1) in-depth-interviews with 14 residents; (2) a survey with 171 residents; (3) a systematic map and synthesis review on interventions enriching meaningful activities of daily living; (4) qualitative analysis of 24 ‘good examples’ and, to support future implementation, (5) focus groups with staff ( n = 69). Results determined the components of the new approach which was (6) pilot-tested in one long-term care facility. Quantitative and qualitative data were gathered concerning benefits for the residents and feasibility for the staff. Results A client- and activity-oriented approach was developed, characterised by an active participatory attitude of residents and staff and a systematic iterative process. Significant positive effects were found for the number of activities, the satisfaction with the leisure offered, the social network, medication use, but not for quality of life. The approach appeared to be feasible. Conclusion This approach stimulates residents' meaningful activities of daily living and social life. Further investigation is needed to evaluate its outcome and implementation potentials.
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Affiliation(s)
- Patricia De Vriendt
- Professor, Research Group Innovation in Health Care and Department of Occupational Therapy, Artevelde University College, Gent, Belgium; Faculty of Medicine and Pharmacy, Department of Gerontology and Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium; Faculty of Medicine and Health Sciences, Rehabilitation Sciences and Physiotherapy, Department of Occupational Therapy, Ghent University, Gent, Belgium
| | - Elise Cornelis
- Occupational Therapist, University Hospital Brussels, Belgium; PhD Candidate Gerontology, Faculty of Medicine and Pharmacy, Department of Gerontology and Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium; Lecturer and Researcher, Department of Occupational Therapy, Artevelde University College, Gent, Belgium
| | - Ruben Vanbosseghem
- Lecturer and Researcher, Department of Nursing, Artevelde University College, Research Group Innovation in Health Care, Gent, Belgium
| | - Valerie Desmet
- Occupational Therapist, Lecturer and Researcher, Department of Occupational Therapy, Artevelde University College, Gent, Belgium
| | - Dominique Van de Velde
- Professor Faculty of Medicine and Health Sciences, Rehabilitation Sciences and Physiotherapy, Department of Occupational Therapy, Ghent University, Gent, Belgium; Department of Occupational Therapy, Artevelde University College, Gent, Belgium
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Skelton DA, Mavroeidi A. Which strength and balance activities are safe and efficacious for individuals with specific challenges (osteoporosis, vertebral fractures, frailty, dementia)?: A Narrative review. J Frailty Sarcopenia Falls 2018; 3:85-104. [PMID: 32300697 PMCID: PMC7155323 DOI: 10.22540/jfsf-03-085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2018] [Indexed: 12/29/2022] Open
Abstract
Physical activity guidelines advocate the inclusion of strength and balance activities, twice a week, for adults and older adults, but with caveat that in some individuals there will be certain movements and activities that could lead to adverse events. This scoping review summarizes the evidence about how safe and efficacious these activities are in older adults with specific challenges that might make them more prone to injury (e.g. having recently fractured or at risk of fracture (osteoporosis) or those who are frail or who have cognitive impairment). The review identified that for prevention of falls in people with a falls history and/or frailer older adults, structured exercise programmes that incorporate progressive resistance training (PRT) with increasing balance challenges over time are safe and effective if performed regularly, with supervision and support, over at least 6 months. Some minor adverse effects mainly transient musculoskeletal pain) have been reported. For those with a higher risk of falls and fractures (very poor balance, vertebral fractures), supervised structured exercise programmes are most appropriate. People with diagnosed osteoporosis should be as active as possible and only avoid activities with a high risk of falls if they are naïve to those activities. For those in transition to frailty who have poor strength and balance, exercises that are known to help maintain strength and balance (such as Tai Chi) are effective in preventing a decline in falls risk. For the very frail older adult, supervised structured exercise that has PRT, balance training and some endurance work, supervised and progressed by a trained person are advocated.
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Affiliation(s)
- Dawn A. Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Alexandra Mavroeidi
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Bolano D, Berchtold A, Bürge E. The Heterogeneity of Disability Trajectories in Later Life: Dynamics of Activities of Daily Living Performance Among Nursing Home Residents. J Aging Health 2018; 31:1315-1336. [DOI: 10.1177/0898264318776071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This study investigated the variability in activities of daily living (ADL) trajectories among 6,155 nursing home residents using unique and rich observational data. Method: The impairment in ADL performance was considered as a dynamic process in a multi-state framework. Using an innovative mixture model, such states were not defined a priori but inferred from the data. Results: The process of change in functional health differed among residents. We identified four latent regimes: stability or slight deterioration, relevant change, variability, and recovery. Impaired body functions and poor physical performance were main risk factors associated with degradation in functional health. Discussion: The evolution of disability in later life is not completely gradual or homogeneous. Steep deterioration in functional health can be followed by periods of stability or even recovery. The current condition can be used to successfully predict the evolution of ADL allowing to set and target different care priorities and practices.
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Affiliation(s)
| | | | - Elisabeth Bürge
- University of Applied Sciences, Western Switzerland, Geneva, Switzerland
- Deceased on June 8, 2015
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29
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Lehto V, Jolanki O, Valvanne J, Seinelä L, Jylhä M. Understanding functional ability: Perspectives of nurses and older people living in long-term care. J Aging Stud 2017; 43:15-22. [PMID: 29173510 DOI: 10.1016/j.jaging.2017.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/22/2017] [Accepted: 09/01/2017] [Indexed: 11/25/2022]
Abstract
The functional ability of older people has come to play a significant role in their care. Policies and public debate promote active aging and the need to maintain functioning in old age, including among older people living in long-term care. This study explores the meanings given to functional ability in the interview talk of long-term care nurses (n=24) and older people living in long-term care (n=16). The study is based on discourse analysis and positioning theory. In this study, accounts of functioning differed between nurses and older residents. For the nurses, functional ability was about the basic functions of everyday life, and they often used formal and theoretical language, whereas for older long-term care residents, functional ability was a more versatile concept. Being active was promoted, particularly in the nurses' talk but also sometimes in residents' talk, thereby reflecting the public discourse about functioning. In their talk, the nurses positioned themselves in relation to functional ability as competent professionals and active caregivers. In residents' talk, we found three positions: an active individual taking care of him or herself, a recipient of help, and a burden to nurses. To move in a direction that promotes activity and rehabilitative care, a better understanding of older people's individual needs and their own views of functional ability is needed.
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Affiliation(s)
- Vilhelmiina Lehto
- Faculty of Social Sciences, University of Tampere, Finland; Gerontology Research Center, University of Tampere, University of Jyväskylä, Finland.
| | - Outi Jolanki
- Department of Social Sciences and Philosophy, University of Jyväskylä, Finland; Faculty of Social Sciences, University of Tampere, Finland; Gerontology Research Center, University of Tampere, University of Jyväskylä, Finland
| | - Jaakko Valvanne
- Faculty of Medicine and Life Sciences, University of Tampere, Finland; Gerontology Research Center, University of Tampere, University of Jyväskylä, Finland; Geriatric Unit, Tampere University Hospital, Finland; Social Services and Outpatient Care, Welfare Services, Tampere, Finland
| | - Lauri Seinelä
- Faculty of Medicine and Life Sciences, University of Tampere, Finland; Gerontology Research Center, University of Tampere, University of Jyväskylä, Finland; Purchaser for the Promotion for senior citizens welfare, Tampere, Finland; Pirkanmaan erikoislääkäripalvelu Oy, Tampere, Finland
| | - Marja Jylhä
- Faculty of Social Sciences, University of Tampere, Finland; Gerontology Research Center, University of Tampere, University of Jyväskylä, Finland
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Kuk NO, Bours GJ, Hamers JP, Kempen GI, Zijlstra GR. Feasibility of the Translating Innovations into Practice-toolbox (TIP-toolbox): A mixed-methods study for implementing activity innovations in nursing homes. Geriatr Nurs 2017; 38:498-504. [DOI: 10.1016/j.gerinurse.2017.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/02/2017] [Accepted: 03/06/2017] [Indexed: 11/26/2022]
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Kagwa SA, Boström AM, Ickert C, Slaughter SE. Optimising mobility through the sit-to-stand activity for older people living in residential care facilities: A qualitative interview study of healthcare aide experiences. Int J Older People Nurs 2017; 13. [DOI: 10.1111/opn.12169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 08/21/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Sharon A. Kagwa
- Division of nursing; Department of Neurobiology, Care science and Society; Karolinska Institutet; Huddinge Sweden
| | - Anne-Marie Boström
- Division of nursing; Department of Neurobiology, Care science and Society; Karolinska Institutet; Huddinge Sweden
- Department of Geriatric Medicine; Danderyd Hospital; Stockholm Sweden
- Western Norway University of Applied Sciences; Haugesund Norway
- Faculty of Nursing; University of Alberta; Edmonton AB Canada
| | - Carla Ickert
- Faculty of Nursing; University of Alberta; Edmonton AB Canada
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Kuk NO, Zijlstra GAR, Bours GJJW, Hamers JPH, Tan FES, Kempen GIJM. Promoting Functional Activity Among Nursing Home Residents: A Cross-Sectional Study on Barriers Experienced by Nursing Staff. J Aging Health 2017; 30:605-623. [PMID: 28553799 DOI: 10.1177/0898264316687407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To obtain insight into (a) the prevalence of nursing staff-experienced barriers regarding the promotion of functional activity among nursing home residents, and (b) the association between these barriers and nursing staff-perceived promotion of functional activity. METHOD Barriers experienced by 368 nurses from 41 nursing homes in the Netherlands were measured with the MAastrIcht Nurses Activity INventory (MAINtAIN)-barriers; perceived promotion of functional activities was measured with the MAINtAIN-behaviors. Descriptive statistics and hierarchical linear regression analyses were performed. RESULTS Most often experienced barriers were staffing levels, capabilities of residents, and availability of resources. Barriers that were most strongly associated with the promotion of functional activity were communication within the team, (a lack of) referral to responsibilities, and care routines. DISCUSSION Barriers that are most often experienced among nursing staff are not necessarily the barriers that are most strongly associated with nursing staff-perceived promotion of functional activity.
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Affiliation(s)
- Nienke O Kuk
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - G A Rixt Zijlstra
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - Gerrie J J W Bours
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands.,2 Research Centre for Autonomy and Participation for Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Jan P H Hamers
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - Frans E S Tan
- 3 Department of Methodology and Statistics, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - Gertrudis I J M Kempen
- 1 Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands
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Tsujimoto T, Ikemoto T, Kurisuno M, Akao M, Miyagawa H, Inoue M, Arai YCP, Ushida T, Deie M. Effects of regular water- and land-based exercise on physical function after 5 years: A long-term study on the well-being of older Japanese adults. Geriatr Gerontol Int 2017; 17:2116-2123. [DOI: 10.1111/ggi.13045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 01/24/2017] [Accepted: 02/20/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Tomoya Tsujimoto
- Department of Orthopedic Surgery; Aichi Medical University; Nagakute Japan
| | - Tatsunori Ikemoto
- Institute of Physical Fitness, Sports Medicine and Rehabilitation; Aichi Medical University; Nagakute Japan
- Sports Medical Science Center; Aichi Medical University; Nagakute Japan
| | - Makoto Kurisuno
- Department of Orthopedic Surgery; Aichi Medical University; Nagakute Japan
| | - Machiko Akao
- Department of Orthopedic Surgery; Aichi Medical University; Nagakute Japan
- Sports Medical Science Center; Aichi Medical University; Nagakute Japan
| | - Hirofumi Miyagawa
- Institute of Physical Fitness, Sports Medicine and Rehabilitation; Aichi Medical University; Nagakute Japan
- Sports Medical Science Center; Aichi Medical University; Nagakute Japan
| | - Msayuki Inoue
- Institute of Physical Fitness, Sports Medicine and Rehabilitation; Aichi Medical University; Nagakute Japan
| | - Young-Chang P. Arai
- Institute of Physical Fitness, Sports Medicine and Rehabilitation; Aichi Medical University; Nagakute Japan
| | - Takahiro Ushida
- Institute of Physical Fitness, Sports Medicine and Rehabilitation; Aichi Medical University; Nagakute Japan
| | - Masataka Deie
- Department of Orthopedic Surgery; Aichi Medical University; Nagakute Japan
- Sports Medical Science Center; Aichi Medical University; Nagakute Japan
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Van Malderen L, De Vriendt P, Mets T, Verté D, Gorus E. Experiences and Effects of Structurally Involving Residents in the Nursing Home by Means of Participatory Action Research: A Mixed Method Study. J Am Med Dir Assoc 2017; 18:495-502. [PMID: 28238674 DOI: 10.1016/j.jamda.2016.12.072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 12/13/2016] [Accepted: 12/23/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to examine the effects of introducing participatory action research (PAR) within the nursing home (NH) on residents' quality of life (QoL) and NH experience and participation, and to explore their experiences with PAR. DESIGN A mixed methods design was chosen, including a clustered randomized controlled trial (RCT) and qualitative interviews. SETTING For the RCT, 3 NHs were randomly allocated to 3 conditions: an intervention (weekly PAR activity), an active control (weekly reminiscence-activity), or passive control (care as usual). The qualitative study took place in the intervention NH. PARTICIPANTS Within the RCT, about 30 residents were recruited for assessments per NH, including 9 PAR participants and 10 reminiscence participants. Qualitative interviews were held with all PAR participants (residents and internal moderator). INTERVENTION PAR is a method to structurally involve residents in the NH operation. Weekly PAR sessions were held with 9 residents and 2 moderators. Here, residents critically analyzed and discussed the NH operation, identified possible problems, suggested improvements, which were further implemented by the NH and monitored by the PAR group. MEASUREMENTS Residents' NH experience (NH Active Aging Survey), QoL (Anamnestic Comparison Self-Assessment), and experienced participation (Impact on Participation and Autonomy) were measured in the RCT at pre-test, post-test (6 months), and follow-up (12 months). The qualitative study took into account interviews with the PAR stakeholders after 6 months. RESULTS The RCT showed residents' QoL improving more between pre-test and follow-up in the intervention and active control NH compared with the passive control NH. No other effects were observed. The qualitative data revealed a positive PAR experience. Participants enjoyed the activity and indicated various positive influences. Still, there was room for improvement, including communication toward other residents and between staff. CONCLUSIONS Notwithstanding the modest quantitative effects, PAR led to positive experiences and can have a future in the NH when solving some limitations.
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Affiliation(s)
- Lien Van Malderen
- Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation Flanders, Brussels, Belgium.
| | - Patricia De Vriendt
- Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Artevelde University College, Ghent, Belgium
| | - Tony Mets
- Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dominique Verté
- Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Geriatric Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Rugbeer N, Ramklass S, Mckune A, van Heerden J. The effect of group exercise frequency on health related quality of life in institutionalized elderly. Pan Afr Med J 2017; 26:35. [PMID: 28451013 PMCID: PMC5398226 DOI: 10.11604/pamj.2017.26.35.10518] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 11/16/2016] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. METHODS One hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures. RESULTS A significant difference was noted in social function post training 2X/week (MD = -13.85, 95% CI [-24.66, -3.38], p = 0.017, d = 0.674) and 3X/week (MD = -13.30, 95% CI [-21.81, -5.59], p = 0.003, d = 0.712) a week. Training 3X/week a week provided an additional benefit in vitality (MD = -7.55, 95% CI [-13.16, -1.91], p = 0.018, d =0. 379). Improvements in mental component summary scale post training 2X/week (MD = -4.08, 95% CI [-7.67, -0.42], p = 0.033, d = 0.425) and 3X/week (MD = -6.67, 95% CI [-10.92, -2.33], p = 0.005, d = 0.567) a week was further noted. CONCLUSION Mental health and social health benefits can be obtained irrespective of exercise frequency 2X/week or 3X/week. The exercise intervention at a frequency 3X/ week was more effective in improving mental component summary due to a larger effect size obtained compared to the exercise frequency of 2X/week. Additional benefits in vitality were achieved by exercising 3X/week. This may assist the elderly in preserving their independence.
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Affiliation(s)
- Nivash Rugbeer
- Biokinetics, Exercise and Leisure Sciences (Sport Science), School of Health Sciences, UKZN, Westville Campus, Durban, South Africa
| | - Serela Ramklass
- School of Clinical Medicine, College of Health Science, Medical Campus, University of Kwa-Zulu Natal, Main Building, Durban, South Africa
| | - Andrew Mckune
- Biokinetics, Exercise and Leisure Sciences (Sport Science), School of Health Sciences, UKZN, Westville Campus, Durban, South Africa
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, ACT, 2601, Australia
| | - Johan van Heerden
- Biokinetics, Exercise and Leisure Sciences (Sport Science), School of Health Sciences, UKZN, Westville Campus, Durban, South Africa
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Yuri Y, Takabatake S, Nishikawa T, Oka M, Fujiwara T. The effects of a life goal-setting technique in a preventive care program for frail community-dwelling older people: a cluster nonrandomized controlled trial. BMC Geriatr 2016; 16:101. [PMID: 27175793 PMCID: PMC4866031 DOI: 10.1186/s12877-016-0277-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 05/05/2016] [Indexed: 11/25/2022] Open
Abstract
Background Frailty among older people is associated with an increased risk of needing care. There have been many reports on preventive care programs for frail older people, but few have shown positive effects on disability prevention. Physical exercise programs for frail older people affect elements such as physical fitness and balance, but are less effective for disability outcomes and are not followed up in the longer term. We developed a life goal-setting technique (LGST). Our objective was to determine the effect of a LGST plus standard preventive care program for community-dwelling frail older people. Methods We used a cluster nonrandomized controlled trial with seven intervention and nine matched control groups, with baseline assessment and follow-up at 3, 6, and 9 months. Participants were 176 frail older people, aged 65 years or over, living in the community in Izumi, Osaka, Japan. All participants attended regular 120 min preventive care exercise classes each week, over 3 months. They also received oral care and nutrition education. The intervention groups alone received life goal-setting support. We assessed outcomes longitudinally, comparing pre-intervention with follow-up. The primary outcome measure was health improvement according to the Japanese Ministry of Health, Labour and Welfare’s “Kihon Checklist” for assessment of frailty and quality of life (QOL), analyzed with a two-way ANOVA and post-test comparison. Secondary outcomes included physical functions and assessment of life goals. Results The improvement on the Kihon Checklist for the intervention group was approximately 60 % from baseline to 9-months follow-up; the control group improved by approximately 40 %. The difference between groups was significant at 3-month (p = 0.043) and 6-month (p = 0.015) follow-ups but not at 9-month (p = 0.098) follow-up. Analysis of QOL yielded a significant time × group interaction effect (p = 0.022). The effect was significant at 3 months in the intervention group, but at no time in the control group. Conclusion A 3-month exercise program helped to decrease frailty and improve QOL in frail older people, and the addition of LGST increased its effectiveness. The LGST is a feasible and promising intervention for reducing risk of needing care. Trial registration UMIN000021485. Registered 15 March 2016.
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Affiliation(s)
- Yoshimi Yuri
- Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, Osaka, Japan. .,Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan.
| | - Shinichi Takabatake
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan
| | - Tomoko Nishikawa
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan
| | - Mari Oka
- Elderly Care Office, Izumi, Osaka, Japan
| | - Taro Fujiwara
- Izumi Rehabilitation Home-Visit Nursing Care Station, Osaka, Japan
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Adam D, Ramli A, Shahar S. Effectiveness of a Combined Dance and Relaxation Intervention on Reducing Anxiety and Depression and Improving Quality of Life among the Cognitively Impaired Elderly. Sultan Qaboos Univ Med J 2016; 16:e47-53. [PMID: 26909213 DOI: 10.18295/squmj.2016.16.01.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/10/2015] [Accepted: 08/18/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Cognitive impairment is a common problem among the elderly and is believed to be a precursor to dementia. This study aimed to explore the effectiveness of a combined dance and relaxation intervention as compared to relaxation alone in reducing anxiety and depression levels and improving quality of life (QOL) and cognitive function among the cognitively impaired elderly. METHODS This quasi-experimental study was conducted between May and December 2013 in Peninsular Malaysia. Subjects from four government residential homes for older adults aged ≥60 years with mild to moderate cognitive function as assessed by the Mini-Mental State Examination were included in the study. Subjects were divided into an intervention group and a control group; the former participated in a combined poco-poco dance and relaxation intervention whilst the latter participated in relaxation exercises only. Both groups participated in two sessions per week for six weeks. Anxiety and depression were self-assessed using the Hospital Anxiety and Depression Scale and QOL was self-assessed using the Quality of Life in Alzheimer's Disease questionnaire. RESULTS A total of 84 elderly subjects were included in the study; 44 were in the intervention group and 40 were in the control group. When compared to control subjects, those in the intervention group showed significantly decreased anxiety (P <0.001) and depression (P <0.001) levels as well as improved QOL (P <0.001) and cognitive impairment (P <0.001). CONCLUSION Dance as a form of participation-based physical exercise was found to reduce anxiety and depression levels and improve QOL and cognitive function among the studied sample of cognitively impaired elderly subjects in Malaysia.
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Affiliation(s)
- Dina Adam
- Programme of Physiotherapy, School of Rehabilitation Science, Universiti Kebangsaan Malaysia, Bangi, Malaysia;; Physiotherapy Department, Faculty of Allied Health Sciences, Cyberjaya University College of Medical Sciences, Cyberjaya, Malaysia
| | - Ayiesah Ramli
- Programme of Physiotherapy, School of Rehabilitation Science, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Suzana Shahar
- Programme of Dietetics, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Bangi, Malaysia
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de Labra C, Guimaraes-Pinheiro C, Maseda A, Lorenzo T, Millán-Calenti JC. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr 2015; 15:154. [PMID: 26626157 PMCID: PMC4667405 DOI: 10.1186/s12877-015-0155-4] [Citation(s) in RCA: 393] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/23/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Low physical activity has been shown to be one of the most common components of frailty, and interventions have been considered to prevent or reverse this syndrome. The purpose of this systematic review of randomized, controlled trials is to examine the exercise interventions to manage frailty in older people. METHODS The PubMed, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched using specific keywords and Medical Subject Headings for randomized, controlled trials published during the period of 2003-2015, which enrolled frail older adults in an exercise intervention program. Studies where frailty had been defined were included in the review. A narrative synthesis approach was performed to examine the results. The Physiotherapy Evidence Database (PEDro scale) was used to assess the methodological quality of the selected studies. RESULTS Of 507 articles, nine papers met the inclusion criteria. Of these, six included multi-component exercise interventions (aerobic and resistance training not coexisting in the intervention), one included physical comprehensive training, and two included exercises based on strength training. All nine of these trials included a control group receiving no treatment, maintaining their habitual lifestyle or using a home-based low level exercise program. Five investigated the effects of exercise on falls, and among them, three found a positive impact of exercise interventions on this parameter. Six trials reported the effects of exercise training on several aspects of mobility, and among them, four showed enhancements in several measurements of this outcome. Three trials focused on the effects of exercise intervention on balance performance, and one demonstrated enhanced balance. Four trials investigated functional ability, and two showed positive results after the intervention. Seven trials investigated the effects of exercise intervention on muscle strength, and five of them reported increases; three trials investigated the effects of exercise training on body composition, finding improvements in this parameter in two of them; finally, one trial investigated the effects of exercise on frailty using Fried's criteria and found an improvement in this measurement. Exercise interventions have demonstrated improvement in different outcome measurements in frail older adults, however, there were large differences between studies with regard to effect sizes. CONCLUSIONS This systematic review suggested that frail older adults seemed to benefit from exercise interventions, although the optimal program remains unclear. More studies of this topic and with frail populations are needed to select the most favorable exercise program.
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Affiliation(s)
- Carmen de Labra
- Research, Development and Innovation Department, Gerontological Complex La Milagrosa, Provincial Association of Pensioners and Retired People (UDP) from A Coruña, Avenida de Cádiz-5, E-15008, A Coruña, Spain.
| | - Christyanne Guimaraes-Pinheiro
- Gerontology Research Group, Department of Medicine, Faculty of Health Sciences, Universidade da Coruña, Campus de Oza, E-15071, A Coruña, Spain.
| | - Ana Maseda
- Gerontology Research Group, Department of Medicine, Faculty of Health Sciences, Universidade da Coruña, Campus de Oza, E-15071, A Coruña, Spain.
| | - Trinidad Lorenzo
- Research, Development and Innovation Department, Gerontological Complex La Milagrosa, Provincial Association of Pensioners and Retired People (UDP) from A Coruña, Avenida de Cádiz-5, E-15008, A Coruña, Spain.
| | - José C Millán-Calenti
- Gerontology Research Group, Department of Medicine, Faculty of Health Sciences, Universidade da Coruña, Campus de Oza, E-15071, A Coruña, Spain.
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Giné-Garriga M, Vidal-Garcia E, Gómara-Toldrà N, Roman-Viñas B, Roqué-Fíguls M. Combined Effects of Diet and Exercise or Diet Alone to Improve Physical Function in Community-Dwelling Older Adults: A Systematic Review of the Literature. Curr Nutr Rep 2015. [DOI: 10.1007/s13668-015-0119-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
Einleitung
Besonders ältere und alte Menschen leiden häufig unter chronischen Erkrankungen, die ursächlich für Funktionseinbußen sind und gleichzeitig das Risiko des Abrutschens in Pflegebedürftigkeit in sich bergen. Doch auch pflegebedürftige Menschen verfügen über gesundheitliche Potenziale, die es durch Gesundheitsförderung und Prävention zu stärken gilt. Der Bewegungsförderung kommt dabei eine besondere Bedeutung zu, jedoch fehlt es noch an auf die Zielgruppe abgestimmten Interventionen
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Affiliation(s)
- Annett Horn
- * Dr. Annett HornUniversität BielefeldFakultät für GesundheitswissenschaftenArbeitsgruppe Versorgungsforschung und PflegewissenschaftUniversitätsstr. 2533501 Bielefeld
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Giné-Garriga M, Roqué-Fíguls M, Coll-Planas L, Sitjà-Rabert M, Salvà A. Physical Exercise Interventions for Improving Performance-Based Measures of Physical Function in Community-Dwelling, Frail Older Adults: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2014; 95:753-769.e3. [DOI: 10.1016/j.apmr.2013.11.007] [Citation(s) in RCA: 278] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 11/08/2013] [Accepted: 11/13/2013] [Indexed: 12/25/2022]
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Slaughter SE, Estabrooks CA, Jones CA, Wagg AS, Eliasziw M. Sustaining Transfers through Affordable Research Translation (START): study protocol to assess knowledge translation interventions in continuing care settings. Trials 2013; 14:355. [PMID: 24160483 PMCID: PMC4231466 DOI: 10.1186/1745-6215-14-355] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/17/2013] [Indexed: 11/16/2022] Open
Abstract
Background Bridging the research-practice gap is an important research focus in continuing care facilities, because the population of older adults (aged 65 years and over) requiring continuing care services is the fastest growing demographic among countries in the Organisation for Economic Co-operation and Development (OECD). Unlicensed practitioners, known as health care aides, provide the majority of care for residents living in continuing care facilities. However, little research examines how to sustain health care aide behavior change following initial adoption of current research evidence. Methods/Design We will conduct a phase III, multicentre, cluster randomized controlled trial (RCT) using a stratified 2 × 2 additive factorial design, including an embedded process evaluation, in 24 supportive living facilities within the health zone of Edmonton, AB, Canada. We will determine which combination of frequency and intensity of reminders most effectively sustains the completion of the sit-to-stand activity by health care aides with residents. Frequency refers to how often a reminder is implemented; intensity refers to whether a reminder is social or paper-based. We will compare monthly reminders with reminders implemented every 3 months, and we will compare low intensity, paper-based reminders and high intensity reminders provided by a health care aide peer. Using interviews, questionnaires, and observations, Sustaining Transfers through Affordable Research Translation (START) will evaluate the processes that inhibit or promote the mobility innovation’s sustainability among health care aides in daily practice. We will examine how the reminders are implemented and perceived by health care aides and licensed practical nurses, as well as how health care aides providing peer reminders are identified, received by their peers, and supported by their supervisors. Discussion START will connect up-to-date innovation research with the practice of health care aides providing direct care to a growing population of older Albertans. The project’s reach extends to both supportive living and long-term care settings. Furthermore, START has the potential to introduce and sustain a broad range of innovations in various care areas, such as dementia care, wound care, and pain management – domains where the uptake and sustainability of innovations also encounter significant challenges. By identifying the optimal frequency and intensity of knowledge translation interventions, we hope to enable continuing care organizations to efficiently integrate care innovations into the day-to-day care of residents. Trial registration ClinicalTrials.gov, NCT01746459
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Affiliation(s)
- Susan E Slaughter
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB T6G 1C9, Canada.
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Putnam M, Morrow-Howell N, Inoue M, Greenfield JC, Chen H, Lee Y. Suitability of public use secondary data sets to study multiple activities. Gerontologist 2013; 54:818-29. [PMID: 23899622 DOI: 10.1093/geront/gnt074] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE OF THE STUDY The aims of this study were to inventory activity items within and across U.S. public use data sets, to identify gaps in represented activity domains and challenges in interpreting domains, and to assess the potential for studying multiple activity engagement among older adults using existing data. DESIGN AND METHODS We engaged in content analysis of activity measures of 5U.S. public use data sets with nationally representative samples of older adults. Data sets included the Health & Retirement Survey (HRS), Americans' Changing Lives Survey (ACL), Midlife in the United States Survey (MIDUS), the National Health Interview Survey (NHIS), and the Panel Study of Income Dynamics survey (PSID). Two waves of each data set were analyzed. RESULTS We identified 13 distinct activity domains across the 5 data sets, with substantial differences in representation of those domains among the data sets, and variance in the number and type of activity measures included in each. IMPLICATIONS Our findings indicate that although it is possible to study multiple activity engagement within existing data sets, fuller sets of activity measures need to be developed in order to evaluate the portfolio of activities older adults engage in and the relationship of these portfolios to health and wellness outcomes. Importantly, clearer conceptual models of activity broadly conceived are required to guide this work.
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Affiliation(s)
- Michelle Putnam
- School of Social Work, Simmons College, Boston, Massachusetts.
| | - Nancy Morrow-Howell
- Brown School of Social Work and Center for Aging, Washington University in St. Louis, Missouri
| | - Megumi Inoue
- Graduate School of Social Work, Boston College, Chestnut Hill, Massachusetts
| | - Jennifer C Greenfield
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - Huajuan Chen
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - YungSoo Lee
- Department of Social Welfare, University of Incheon, Yeonsu-gu, Incheon, Korea
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Nord C. A day to be lived. Elderly peoples' possessions for everyday life in assisted living. J Aging Stud 2013; 27:135-42. [DOI: 10.1016/j.jaging.2012.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Revised: 11/17/2012] [Accepted: 12/08/2012] [Indexed: 11/23/2022]
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Crocker T, Forster A, Young J, Brown L, Ozer S, Smith J, Green J, Hardy J, Burns E, Glidewell E, Greenwood DC. Physical rehabilitation for older people in long-term care. Cochrane Database Syst Rev 2013:CD004294. [PMID: 23450551 DOI: 10.1002/14651858.cd004294.pub3] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The worldwide population is progressively ageing, with an expected increase in morbidity and demand for long-term care. Physical rehabilitation is beneficial in older people, but relatively little is known about effects on long-term care residents. This is an update of a Cochrane review first published in 2009. OBJECTIVES To evaluate the benefits and harms of rehabilitation interventions directed at maintaining, or improving, physical function for older people in long-term care through the review of randomised and cluster randomised controlled trials. SEARCH METHODS We searched the trials registers of the following Cochrane entities: the Stroke Group (May 2012), the Effective Practice and Organisation of Care Group (April 2012), and the Rehabilitation and Related Therapies Field (April 2012). In addition, we searched 20 relevant electronic databases, including the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2009, Issue 4), MEDLINE (1966 to December 2009), EMBASE (1980 to December 2009), CINAHL (1982 to December 2009), AMED (1985 to December 2009), and PsycINFO (1967 to December 2009). We also searched trials and research registers and conference proceedings; checked reference lists; and contacted authors, researchers, and other relevant Cochrane entities. We updated our searches of electronic databases in 2011 and listed relevant studies as awaiting assessment. SELECTION CRITERIA Randomised studies comparing a rehabilitation intervention designed to maintain or improve physical function with either no intervention or an alternative intervention in older people (over 60 years) who have permanent long-term care residency. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and extracted data. We contacted study authors for additional information. The primary outcome was function in activities of daily living. Secondary outcomes included exercise tolerance, strength, flexibility, balance, perceived health status, mood, cognitive status, fear of falling, and economic analyses. We investigated adverse effects, including death, morbidity, and other events. We synthesised estimates of the primary outcome with the mean difference; mortality data, with the risk ratio; and secondary outcomes, using vote-counting. MAIN RESULTS We included 67 trials, involving 6300 participants. Fifty-one trials reported the primary outcome, a measure of activities of daily living. The estimated effects of physical rehabilitation at the end of the intervention were an improvement in Barthel Index (0 to 100) scores of six points (95% confidence interval (CI) 2 to 11, P = 0.008, seven studies), Functional Independence Measure (0 to 126) scores of five points (95% CI -2 to 12, P = 0.1, four studies), Rivermead Mobility Index (0 to 15) scores of 0.7 points (95% CI 0.04 to 1.3, P = 0.04, three studies), Timed Up and Go test of five seconds (95% CI -9 to 0, P = 0.05, seven studies), and walking speed of 0.03 m/s (95% CI -0.01 to 0.07, P = 0.1, nine studies). Synthesis of secondary outcomes suggested there is a beneficial effect on strength, flexibility, and balance, and possibly on mood, although the size of any such effect is unknown. There was insufficient evidence of the effect on other secondary outcomes. Based on 25 studies (3721 participants), rehabilitation does not increase risk of mortality in this population (risk ratio 0.95, 95% CI 0.80 to 1.13). However, it is possible bias has resulted in overestimation of the positive effects of physical rehabilitation. AUTHORS' CONCLUSIONS Physical rehabilitation for long-term care residents may be effective, reducing disability with few adverse events, but effects appear quite small and may not be applicable to all residents. There is insufficient evidence to reach conclusions about improvement sustainability, cost-effectiveness, or which interventions are most appropriate. Future large-scale trials are justified.
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Affiliation(s)
- Tom Crocker
- Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Trust,Bradford, UK
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Ayan C, Cancela J, Gutiérrez A, Prieto I. Influence of the cognitive impairment level on the performance of the Timed “Up & Go” Test (TUG) in elderly institutionalized people. Arch Gerontol Geriatr 2013; 56:44-9. [DOI: 10.1016/j.archger.2012.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 05/31/2012] [Accepted: 06/02/2012] [Indexed: 11/18/2022]
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Grönstedt H, Frändin K, Bergland A, Helbostad JL, Granbo R, Puggaard L, Andresen M, Hellström K. Effects of Individually Tailored Physical and Daily Activities in Nursing Home Residents on Activities of Daily Living, Physical Performance and Physical Activity Level: A Randomized Controlled Trial. Gerontology 2013; 59:220-9. [DOI: 10.1159/000345416] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 10/25/2012] [Indexed: 11/19/2022] Open
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Van Malderen L, Mets T, Gorus E. Interventions to enhance the Quality of Life of older people in residential long-term care: a systematic review. Ageing Res Rev 2013; 12:141-50. [PMID: 22504403 DOI: 10.1016/j.arr.2012.03.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 03/22/2012] [Accepted: 03/30/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE In residential long-term care (LTC), a growing interest exists in the older residents' Quality of Life (QoL). The Active Ageing-concept (AA) extended this focus, since AA has the aim to enhance QoL by optimising the opportunities for health, participation and security. In LTCs, AA can be outlined by 9 determinants. This systematic review aimed at identifying interventions to improve the QoL of LTC-residents. These interventions were organised according to the AA-determinants. METHODS PubMed, Web of Science, Psychinfo and Sociological Abstracts were screened systematically. Articles were excluded when they only concerned a specific group of LTC-residents. RESULTS Thirty five relevant articles, encompassing 3910 subjects were found. These concerned interventions concentrating on one or more of the 9 AA-determinants. The largest proportion of interventions regarded the physical activity level or the psychological factors of the residents. Overall, no systematic effects on QoL could be found and a low methodological quality was generally present. CONCLUSION Currently, studies aimed at enhancing the QoL of older LTC-resident are limited and often directed to physical and psychological interventions. The lack of a systematic effect on QoL is possibly related to the fact that these interventions were often not multidimensional, whereas QoL is a multidimensional concept.
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Cameron ID, Gillespie LD, Robertson MC, Murray GR, Hill KD, Cumming RG, Kerse N. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 2012; 12:CD005465. [PMID: 23235623 DOI: 10.1002/14651858.cd005465.pub3] [Citation(s) in RCA: 254] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010. OBJECTIVES To assess the effectiveness of interventions designed to reduce falls by older people in care facilities and hospitals. SEARCH METHODS We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (March 2012); The Cochrane Library 2012, Issue 3; MEDLINE, EMBASE, and CINAHL (all to March 2012); ongoing trial registers (to August 2012), and reference lists of articles. SELECTION CRITERIA Randomised controlled trials of interventions to reduce falls in older people in residential or nursing care facilities or hospitals. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and extracted data. We used a rate ratio (RaR) and 95% confidence interval (CI) to compare the rate of falls (e.g. falls per person year) between intervention and control groups. For risk of falling we used a risk ratio (RR) and 95% CI based on the number of people falling (fallers) in each group. We pooled results where appropriate. MAIN RESULTS We included 60 trials (60,345 participants), 43 trials (30,373 participants) in care facilities, and 17 (29,972 participants) in hospitals.Results from 13 trials testing exercise interventions in care facilities were inconsistent. Overall, there was no difference between intervention and control groups in rate of falls (RaR 1.03, 95% CI 0.81 to 1.31; 8 trials, 1844 participants) or risk of falling (RR 1.07, 95% CI 0.94 to 1.23; 8 trials, 1887 participants). Post hoc subgroup analysis by level of care suggested that exercise might reduce falls in people in intermediate level facilities, and increase falls in facilities providing high levels of nursing care.In care facilities, vitamin D supplementation reduced the rate of falls (RaR 0.63, 95% CI 0.46 to 0.86; 5 trials, 4603 participants), but not risk of falling (RR 0.99, 95% CI 0.90 to 1.08; 6 trials, 5186 participants).For multifactorial interventions in care facilities, the rate of falls (RaR 0.78, 95% CI 0.59 to 1.04; 7 trials, 2876 participants) and risk of falling (RR 0.89, 95% CI 0.77 to 1.02; 7 trials, 2632 participants) suggested possible benefits, but this evidence was not conclusive.In subacute wards in hospital, additional physiotherapy (supervised exercises) did not significantly reduce rate of falls (RaR 0.54, 95% CI 0.16 to 1.81; 1 trial, 54 participants) but achieved a significant reduction in risk of falling (RR 0.36, 95% CI 0.14 to 0.93; 2 trials, 83 participants).In one trial in a subacute ward (54 participants), carpet flooring significantly increased the rate of falls compared with vinyl flooring (RaR 14.73, 95% CI 1.88 to 115.35) and potentially increased the risk of falling (RR 8.33, 95% CI 0.95 to 73.37).One trial (1822 participants) testing an educational session by a trained research nurse targeting individual fall risk factors in patients at high risk of falling in acute medical wards achieved a significant reduction in risk of falling (RR 0.29, 95% CI 0.11 to 0.74).Overall, multifactorial interventions in hospitals reduced the rate of falls (RaR 0.69, 95% CI 0.49 to 0.96; 4 trials, 6478 participants) and risk of falling (RR 0.71, 95% CI 0.46 to 1.09; 3 trials, 4824 participants), although the evidence for risk of falling was inconclusive. Of these, one trial in a subacute setting reported the effect was not apparent until after 45 days in hospital. Multidisciplinary care in a geriatric ward after hip fracture surgery compared with usual care in an orthopaedic ward significantly reduced rate of falls (RaR 0.38, 95% CI 0.19 to 0.74; 1 trial, 199 participants) and risk of falling (RR 0.41, 95% CI 0.20 to 0.83). More trials are needed to confirm the effectiveness of multifactorial interventions in acute and subacute hospital settings. AUTHORS' CONCLUSIONS In care facilities, vitamin D supplementation is effective in reducing the rate of falls. Exercise in subacute hospital settings appears effective but its effectiveness in care facilities remains uncertain due to conflicting results, possibly associated with differences in interventions and levels of dependency. There is evidence that multifactorial interventions reduce falls in hospitals but the evidence for risk of falling was inconclusive. Evidence for multifactorial interventions in care facilities suggests possible benefits, but this was inconclusive.
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Affiliation(s)
- Ian D Cameron
- Rehabilitation Studies Unit, SydneyMedical School Northern, The University of Sydney, Ryde, Australia.
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Lackie R, Bisset L. The power of home rehabilitation: a single case study. International Journal of Therapy and Rehabilitation 2012. [DOI: 10.12968/ijtr.2012.19.12.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This single case study reports on an 81-year-old woman who underwent a rehabilitation programme initially in a hospital inpatient setting, then in a home setting. There was a clinically significant improvement in functional outcomes following the home-based rehabilitation, but not following the inpatient rehabilitation programme. This case study illustrates that empowerment of the patient may sometimes be greater in the home environment, possibly due to different roles taken by the patient and therapist in the home compared with roles taken in a hospital environment. This patient reported feelings of being in more control at home, with greater capacity to set their own goals, and improved feelings of motivation with this increased level of engagement. This increased empowerment can lead to more effective outcomes for patients undergoing rehabilitation in the home, and must be considered as an ideal rehabilitation environment for some patients.
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Affiliation(s)
- Rebecca Lackie
- Transition Care Program, Gold Coast Hospital and Health Service, Australia and
| | - Leanne Bisset
- School of Rehabilitation Science, Griffith University, Gold Coast Campus, Australia
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