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Weening-Verbree LF, Schuller AA, Zuidema SU, Hobbelen JSM. A Qualitative Evaluation of the Implementation of an Oral Care Program in Home Care Nursing. Int J Environ Res Public Health 2023; 20:2124. [PMID: 36767491 PMCID: PMC9915185 DOI: 10.3390/ijerph20032124] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
An Oral Care Program (OCP) was implemented in home care nursing teams in a northern province of the Netherlands to improve the oral health and hygiene of older people who make use of formal home care in 2018-2019. The aim of the current study was to evaluate the experiences of the stakeholders involved (older people, home-care nurses and dental hygienists) and to report the experienced impact of OCP, with a qualitative approach. Three dental hygienists, nine home care nurses, and eight older people were interviewed with semi-structured interviews, which were audio recorded, transcribed and analyzed using thematic analysis. The codes derived were grouped into nine main themes. OCP was experienced as mostly positive by all stakeholders involved. The educational part lead to more awareness towards oral care, but should be repeated regularly. Personalized oral care plans for older people were experienced positively, however, obtaining oral care behavior changes appeared to be difficult. Collaboration between dental hygienists and home care nurses lead to a positive experience from both sides The method and intensity of collaboration varied between the teams. To provide better access to oral health care for older people in the community, a long term collaboration between home care nursing teams and dental care professionals in their working area should be established.
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Affiliation(s)
- Lina F. Weening-Verbree
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, Groningen/Friesland, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, 9713 AV Groningen, The Netherlands
| | - Annemarie A. Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, 9713 AV Groningen, The Netherlands
- TNO the Netherlands Organization for Applied Scientific Research, 2333 BE Leiden, The Netherlands
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Johannes S. M. Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, Groningen/Friesland, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
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Cheung SL, Krijnen WP, van der Schans CP, Hobbelen JSM. Frailty, Quality of Life, and Loneliness of Aging in Native and Diasporic Chinese Adults. J Frailty Aging 2023; 12:221-230. [PMID: 37493383 DOI: 10.14283/jfa.2022.27] [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] [Indexed: 07/27/2023]
Abstract
BACKGROUND Global migration has increased in the past century, and aging in a foreign country is relevant to the Chinese diaspora. OBJECTIVE With regard to migration, this study focuses on the places of aging as the context of older Chinese adults. This study aimed to describe the general health and wellbeing of this population with respect to their location. DESIGN This study has a cross sectional design. SETTING AND PARTICIPANTS Participants were recruited who were "aging in place" from Tianjin, China (199 participants), and "aging out of place" from the Netherlands (134 participants). Data from April to May 2019 in China and November 2018 to March 2019 in the Netherlands were aggregated. MEASUREMENTS frailty, QoL and loneliness were used in both samples. RESULTS T-tests and regression analyses demonstrated that social domains of frailty and QoL, as well as loneliness and frailty prevalence characterized the major differences between both places of aging. A correlation analysis and visual correlation network revealed that frailty, quality of life (QoL), and loneliness were more closely related in the aging out of place sample. Social domains of frailty and QoL, as well as the prevalence of loneliness and frailty, characterized the major differences between both places of aging. CONCLUSIONS The findings indicate that frailty, QoL, and loneliness have a complex relationship, confirming that loneliness is a major detriment to the general wellbeing of older Chinese adults aging out of place. This study examined the places of aging of the larger Chinese population and allows a comprehensive understanding of health and wellbeing. The social components, especially loneliness, among the aging out of place Chinese community should receive more attention practice and clinical wise. On the other hand, frailty as well as its prevention is of more importance for the Chinese community aging in place.
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Affiliation(s)
- S L Cheung
- Sie-Long Cheung, Research group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands,
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3
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Dijkstra F, van der Sluis G, Jager-Wittenaar H, Hempenius L, Hobbelen JSM, Finnema E. Facilitators and barriers to enhancing physical activity in older patients during acute hospital stay: a systematic review. Int J Behav Nutr Phys Act 2022; 19:99. [PMID: 35908056 PMCID: PMC9338465 DOI: 10.1186/s12966-022-01330-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/06/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To improve older patients' physical activity (PA) behavior, it is important to identify facilitators and barriers to enhancing PA in older patients (≥ 65 years) during hospitalization from the perspectives of patients, caregivers, and healthcare professionals (HCPs). METHODS In this systematic review, a search of PubMed, CINAHL, PsycINFO, EMBASE, and Web of Science (January 2000-May 2021) was performed, and quantitative, qualitative, and mixed-methods studies were included. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Identified facilitators and barriers were categorized using the social ecological model at the intrapersonal, interpersonal, and institutional levels. RESULTS The 48 included articles identified 230 facilitators and 342 barriers. The main facilitators at the intrapersonal level included: knowledge, awareness, and attitudes; interpersonal level: social support, including encouragement and interdisciplinary collaboration; and institutional level: stimulating physical environment, patient activities and schedules, and PA protocols. The main barriers at the intrapersonal level included: physical health status, having lines or drains, patients' fear, and HCPs' safety concerns; interpersonal level: patient-HCP relation and HCPs' unclear roles; and institutional level: lack of space and resources, including time and equipment. Best evidence synthesis provided moderate level of evidence for three barriers: patients' unwillingness or refusal to move, patients having symptoms, and patients having lines or drains. No moderate level of evidence was found for facilitators. CONCLUSION The PA behavior of older adults during hospitalization is multidimensional. Our overview highlights facilitators and barriers on multilevel scale (intrapersonal, interpersonal, and institutional levels) that guides patients, caregivers, HCPs, and researchers in future clinical practice, and intervention development and implementation.
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Affiliation(s)
- F Dijkstra
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, P.O. Box 1080, 8900, CB, Leeuwarden, The Netherlands.
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
- Department of Health Science, Section of Nursing Research & Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- FAITH research, Groningen/Leeuwarden, The Netherlands.
| | - G van der Sluis
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of Health Strategy and Innovation, Nij Smellinghe Hospital Drachten, Drachten, The Netherlands
| | - H Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L Hempenius
- Geriatric Center, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - J S M Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E Finnema
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, P.O. Box 1080, 8900, CB, Leeuwarden, The Netherlands
- Department of Health Science, Section of Nursing Research & Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
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Weening-Verbree LF, Schuller AA, Zuidema SU, Hobbelen JSM. Evaluation of an Oral Care Program to Improve the Oral Health of Home-Dwelling Older People. Int J Environ Res Public Health 2022; 19:ijerph19127251. [PMID: 35742500 PMCID: PMC9223830 DOI: 10.3390/ijerph19127251] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the impact of the implementation of an Oral Care Program on home care nurses’ attitudes and knowledge about oral health (care) and the impact on older people’s oral health. A pre–post study, without a control group, was conducted. A preventive Oral Care Program (OCP) was designed, focusing on home care nurses and older people, in collaboration with dental hygienists. Implementation was measured with questionnaires at baseline and after 6 months for home care nurses; for older people, implementation was measured at baseline and after 3 months with the Oral Health Assessment Tool and a questionnaire about oral (self) care between January 2018 and September 2019. Although the study design has limitations, the oral health of older people improved significantly after 3 months and the OCP was most beneficial for people with full dentures. The OCP improved knowledge and attitude of home care nurses. The program fitted well with the daily work routines of home care nurses. Individual-centered care plans for older people, education of home care nurses and the expertise of the dental hygienists have added value in home care nursing. Future implementations should focus on older people with natural teeth.
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Affiliation(s)
- Lina F. Weening-Verbree
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands;
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, A. Deusinglaan 1, FB 21, 9713 AV Groningen, The Netherlands;
- Correspondence:
| | - Annemarie A. Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, A. Deusinglaan 1, FB 21, 9713 AV Groningen, The Netherlands;
- TNO the Netherlands Organisation for Applied Scientific Research, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, FA21, P.O. Box 196, 9700 AD Groningen, The Netherlands;
| | - Johannes S. M. Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands;
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, FA21, P.O. Box 196, 9700 AD Groningen, The Netherlands;
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Reinders JJ, Hobbelen JSM, Tieland M, Weijs PJM, Jager-Wittenaar H. Interprofessional Treatment of Malnutrition and Sarcopenia by Dietitians and Physiotherapists: Exploring Attitudes, Interprofessional Identity, Facilitators, Barriers, and Occurrence. J Multidiscip Healthc 2022; 15:1247-1260. [PMID: 35669447 PMCID: PMC9166899 DOI: 10.2147/jmdh.s358237] [Citation(s) in RCA: 1] [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: 02/18/2022] [Accepted: 04/27/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose Malnutrition and sarcopenia require dietetic and physiotherapy interventions. In this study, we aimed to compare interprofessional identity of dietitians and physiotherapists, as well as attitudes towards, facilitators and barriers for, and occurrence of interprofessional treatment of malnutrition and sarcopenia by both professions. Methods A cross-sectional online survey was distributed from December 4, 2021 until January 31, 2022 through an international online network platform for professionals (LinkedIn). Practitioners working as dietitian or physiotherapist in a healthcare setting were eligible for participation. Outcome measures concerned perceptions regarding shared problem domains, interprofessional treatment, attitudes towards interprofessional treatment, interprofessional identity, facilitators, and barriers. A Chi2-test, Mann–Whitney U-test, and Spearman’s Rho correlation were calculated. Results Data from 53 physiotherapists and 48 dietitians were included. Malnutrition is considered a shared problem domain by both professions (U = 1248.000; p = 0.858). While sarcopenia is treated by both professions (U = 1260.000; p = 0.927), physiotherapists consider sarcopenia more often a shared problem domain compared to dietitians (U = 1003.000; p = 0.044). Attitudes towards interprofessional treatment were mostly positive (73%, n = 35 and 87%, n = 46 respectively). Interprofessional identity of dietitians was lower compared to physiotherapists (median = 4.0 versus median = 4.3 respectively; U = 875.000, p = 0.007). This was explained by lower interprofessional belonging (median = 4.0 versus median = 4.8 respectively; U = 771.000, p < 0.001) and lower interprofessional commitment (median = 4.0 versus median = 4.3 respectively; U = 942.500, p = 0.023). Interprofessional identity was correlated with efficient means of communication (r = 0.30, p = 0.003) and bureaucracy (r = −0.21, p = 0.034). Other barriers reported included available time, financial compensation, interprofessional knowledge, and obtaining extra care. Most reported facilitators concerned role clarity, clarity of expertise, and willingness of others to collaborate. Conclusion Dietitians and physiotherapists have different interprofessional identities, but both are advocates of interprofessional treatment. Both professions mostly treat malnutrition and sarcopenia individually and have different perceptions regarding sarcopenia as shared problem domain. Facilitators were mainly related to clarity and commitment while barriers were mainly related to resources.
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Affiliation(s)
- Jan-Jaap Reinders
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands.,Research Group on Interprofessional Identity and Collaboration, Kaunas University of Applied Sciences, Kaunas, Lithuania.,Lifelong Learning, Education & Assessment Research Network (LEARN), Research Institute SHARE, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Johannes S M Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands.,Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Michael Tieland
- Research Group Nutrition and Exercise, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Research Group Nutrition and Exercise, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.,Department of Nutrition and Dietetics, VU University, Amsterdam UMC, Amsterdam, the Netherlands
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands.,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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6
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Dekker AD, Wissing MBG, Ulgiati AM, Bijl B, van Gool G, Groen MR, Grootendorst ES, van der Wal IA, Hobbelen JSM, De Deyn PP, Waninge A. Dementia in people with severe or profound intellectual (and multiple) disabilities: Focus group research into relevance, symptoms and training needs. J Appl Res Intellect Disabil 2021; 34:1602-1617. [PMID: 34212466 PMCID: PMC8597061 DOI: 10.1111/jar.12912] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/23/2021] [Accepted: 05/16/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Differentiating dementia from baseline level of functioning is difficult among people with severe/profound intellectual (and multiple) disabilities. Moreover, studies on observable dementia symptoms are scarce. This study examined (a) the relevance of dementia diagnosis, (b) observable symptoms and (c) training/information needs. METHODS Four explorative focus groups were held with care professionals and family members who have experience with people with severe/profound intellectual (and multiple) disabilities (≥40 years) and decline/dementia. RESULTS Thematic analysis showed that participants wanted to know about a dementia diagnosis for a better understanding and to be able to make informed choices (question 1). Using a categorisation matrix, cognitive and behavioural changes were shown to be most prominent (question 2). Participants indicated that they needed enhanced training, more knowledge development and translation, and supportive organisational choices/policies (question 3). CONCLUSIONS Timely identifying/diagnosing dementia allows for a timely response to changing needs. This requires a better understanding of symptoms.
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Affiliation(s)
- Alain D. Dekker
- Department of Neurology and Alzheimer CenterUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of Practice‐Oriented Scientific Research (PWO)Alliade Care GroupHeerenveenThe Netherlands
| | - Maureen B. G. Wissing
- Department of Neurology and Alzheimer CenterUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of Practice‐Oriented Scientific Research (PWO)Alliade Care GroupHeerenveenThe Netherlands
- Research Group Healthy Ageing, Allied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
| | - Aurora M. Ulgiati
- Department of Neurology and Alzheimer CenterUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of Practice‐Oriented Scientific Research (PWO)Alliade Care GroupHeerenveenThe Netherlands
| | - Bas Bijl
- Advisium's Heeren LooAmersfoortThe Netherlands
| | | | | | | | - Ina A. van der Wal
- Department of Practice‐Oriented Scientific Research (PWO)Alliade Care GroupHeerenveenThe Netherlands
| | - Johannes S. M. Hobbelen
- Research Group Healthy Ageing, Allied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
- Department of General Practice & Elderly Care MedicineUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Peter P. De Deyn
- Department of Neurology and Alzheimer CenterUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Institute Born‐BungeUniversity of AntwerpenAntwerpBelgium
- Department of Neurology and Memory ClinicHospital Network Antwerp (ZNA) Middelheim and Hoge BeukenAntwerpBelgium
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
- Department of Health PsychologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Royal Dutch VisioVriesThe Netherlands
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Wissing MBG, Ulgiati AM, Hobbelen JSM, De Deyn PP, Waninge A, Dekker AD. The neglected puzzle of dementia in people with severe/profound intellectual disabilities: A systematic literature review of observable symptoms. J Appl Res Intellect Disabil 2021; 35:24-45. [PMID: 34219327 PMCID: PMC9292142 DOI: 10.1111/jar.12920] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/18/2020] [Revised: 05/17/2021] [Accepted: 06/04/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Dementia is increasingly prevalent in people with severe/profound intellectual disabilities. However, early detection and diagnosis of dementia is complex in this population. This study aimed to identify observable dementia symptoms in adults with severe/profound intellectual disabilities in available literature. METHOD A systematic literature search was conducted in PubMed, PsycINFO and Web of Science with an exhaustive search string using a combination of search terms for severe/profound intellectual disabilities and dementia/ageing. RESULTS Eleven studies met inclusion criteria. Cognitive decline, behavioural and psychological alterations, decline in activities of daily living as well as neurological and physical changes were found. CONCLUSIONS Only a very limited number of studies reported symptoms ascribed to dementia in adults with severe/profound intellectual disabilities. Given the complexity of signalling and diagnosing dementia, dedicated studies are required to unravel the natural history of dementia in this population.
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Affiliation(s)
- Maureen B G Wissing
- Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Practice-Oriented Scientific Research (PWO), Alliade Care Group, Heerenveen, The Netherlands
| | - Aurora M Ulgiati
- Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Practice-Oriented Scientific Research (PWO), Alliade Care Group, Heerenveen, The Netherlands
| | - Johannes S M Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter P De Deyn
- Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Institute Born-Bunge, University of Antwerpen, Antwerp, Belgium.,Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Royal Dutch Visio, Vries, The Netherlands
| | - Alain D Dekker
- Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Practice-Oriented Scientific Research (PWO), Alliade Care Group, Heerenveen, The Netherlands
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8
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Zhang X, Liu Y, Van der Schans CP, Krijnen W, Hobbelen JSM. Frailty among older people in a community setting in China. Geriatr Nurs 2020; 41:320-324. [PMID: 31959415 DOI: 10.1016/j.gerinurse.2019.11.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 12/19/2022]
Abstract
Frailty is the most common manifestation of serious health issues in the world, and it is becoming more prevalent worldwide as the aging population grows. Changes that occur in an individual during the aging process have physical, psychological, social, and environmental aspects that make an individual more frail. In China, older people may live in communities for aging individuals. This study aimed to describe the presence and severity of frailty and to analyze influencing factors among this population in China. The Frailty Index 35 (FI-35) scale, which includes 35 items in physical, psychological, social, and environmental domains, was used to investigate frailty. The FI-35 score ranges from zero to one, with a score closer to one indicating greater frailty. Biographical, socioeconomic, and lifestyle factors were measured as potential determinants of frailty. We relied on the November 2017-February 2018 waves of the Chinese cross-sectional study survey that comprised a sample of 513 adults, aged 60 or older, who were living in China. Linear regression was performed to identify factors associated with FI-35 scores. We categorized the determinants of frailty into three models: Model 1: biographical variables; Model 2: biographical and socioeconomic variables; and Model 3: biographical, economic, and lifestyle variables. Frailty scores ranged from 0.00 to 0.89, with a median of 0.31, and the prevalence of frailty was 67.6%. The final model obtained after variable selection included age, minority status, marriage status, income, diet, and exercise. The adjusted R-squared indicated that the analysis explained 13.8% of the variance in frailty scores. Adding household, marriage status, education level, medical insurance, and income as elements in Model 2 explained 25.7%. Adding diet, smoking, drinking, exercise, and hobbies in Model 3 explained 27.9%. The degree of frailty varies considerably among Chinese community-dwelling older people and is partly determined by biographical, socioeconomic, and lifestyle factors.
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Affiliation(s)
- Xiaohong Zhang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China; Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands
| | - Yanhui Liu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - C P Van der Schans
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Health Psychology, Groningen, the Netherlands
| | - W Krijnen
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands
| | - J S M Hobbelen
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands.
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9
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Van Deun B, Hobbelen JSM, Cagnie B, Van Eetvelde B, Van Den Noortgate N, Cambier D. Reproducible Measurements of Muscle Characteristics Using the MyotonPRO Device: Comparison Between Individuals With and Without Paratonia. J Geriatr Phys Ther 2019; 41:194-203. [PMID: 28005829 DOI: 10.1519/jpt.0000000000000119] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The MyotonPRO is a portable device that measures muscle tone and biomechanical muscle properties objectively. MyotonPRO has already proven to be effective in measuring muscle properties in healthy and diseased populations. However, to the best of our knowledge, it has never been tested in individuals suffering from paratonia, a form of hypertonia frequently accompanying dementia. The aims of the present study were to (1) compare muscle tone, elasticity, and stiffness between 3 different subpopulations of young and old healthy adults and individuals with paratonia, and (2) investigate the intra- and interrater reproducibility of MyotonPRO measurements of the biceps brachii (BB) muscle in each subpopulation. METHODS MyotonPRO measurements of muscle tone, elasticity, and dynamic stiffness were carried out by 2 investigators on 2 different days over the BB muscles of 54 participants (18 healthy young adults, 20 healthy older adults, and 16 older individuals with paratonia). Muscle properties were compared between subpopulations using ANOVA/Welch and post hoc tests. Reliability (intraclass correlation coefficient) and agreement parameters (standard error of measurement and the minimal detectable change) were calculated. RESULTS Statistically significant differences between subpopulations were found in all parameters, except for stiffness between healthy elderly and individuals with paratonia. In the healthy subpopulations, (a) intrarater reliability was very high and intrarater agreement was good between 2 consecutive series, (b) between days intrarater reliability was low to high and intrarater agreement was variable, (c) interrater reliability was high to very high and interrater agreement was good. In individuals with paratonia, (a) intrarater reliability was moderate to high and agreement was variable between series, (b) between days intrarater reliability was poor to moderate and agreement was poor, (c) interrater reliability ranged from low to high with poor agreement. CONCLUSIONS MyotonPRO measurements of the BB muscle showed good reproducibility in both healthy subpopulations, particularly for measurements performed within the same day. In individuals with paratonia, reliability and agreement were substantially lower. MyotonPRO can be used in clinical assessment and research. However, in individuals with paratonia, careful interpretation of results is required. Research in a larger sample of persons with paratonia at different stages of disease severity is recommended.
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Affiliation(s)
- Bieke Van Deun
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Johannes S M Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Birgit Van Eetvelde
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | | | - Dirk Cambier
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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Nijholt W, Beek LT, Hobbelen JSM, van der Vaart H, Wempe JB, van der Schans CP, Jager-Wittenaar H. The added value of ultrasound muscle measurements in patients with COPD: An exploratory study. Clin Nutr ESPEN 2019; 30:152-158. [PMID: 30904216 DOI: 10.1016/j.clnesp.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 11/08/2018] [Accepted: 01/03/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Malnutrition and sarcopenia are common nutrition (-related) disorders in patients with COPD and are associated with negative health outcomes and mortality. This study aims to correlate ultrasound measured rectus femoris size with fat-free mass and muscle function in patients with COPD. METHODS Patients with COPD, at the start of a pulmonary rehabilitation program, were asked to participate in this study. Rectus femoris (RF) size (thickness in cm, cross-sectional area [CSA] in cm2) was determined by ultrasound. Fat-free mass index (FFMI in kg/m2) was estimated with bioelectrical impedance analyses, using a disease-specific equation. Handgrip strength (HGS) was measured in kilograms and the five times sit to stand test (in seconds, higher scores indicating decreased strength) was performed to assess leg muscle power. The Incremental Shuttle Walk Test (ISWT, in m) was used to assess maximal exercise capacity. RESULTS In total, 44 patients with COPD (mean age 59.8 ± 8.6 years, 43% male, median FEV1%pred 37 [IQR = 23-52]) were included. Greater RF-CSA and thickness were associated with higher FFMI (r = 0.57, p < 0.001; r = 0.53, p = 0.003, respectively) and HGS (CSA r = 0.58, p < 0.001, thickness r = 0.48, p = 0.009). No significant correlations between RF-thickness, CSA, and leg muscle power were found (r = -0.33, p = 0.091; r = -0.35, p = 0.073, respectively). Furthermore, no correlation between RF size and maximal exercise capacity was observed (thickness r = 0.21, p = 0.297, CSA r = 0.22, p = 0.274). CONCLUSIONS This exploratory study shows that in patients with COPD, rectus femoris size is moderately correlated with FFMI and HGS. Future studies should focus on the role of ultrasound in evaluating nutritional status.
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Affiliation(s)
- Willemke Nijholt
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.
| | - Lies Ter Beek
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Haren, Groningen, the Netherlands
| | - Johannes S M Hobbelen
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands
| | - Hester van der Vaart
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Haren, Groningen, the Netherlands
| | - Johan B Wempe
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Haren, Groningen, the Netherlands
| | - Cees P van der Schans
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Health Psychology Research, Groningen, the Netherlands
| | - Harriët Jager-Wittenaar
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Maxillofacial Surgery, Groningen, the Netherlands
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Nijholt W, Scafoglieri A, Jager-Wittenaar H, Hobbelen JSM, van der Schans CP. The reliability and validity of ultrasound to quantify muscles in older adults: a systematic review. J Cachexia Sarcopenia Muscle 2017; 8:702-712. [PMID: 28703496 PMCID: PMC5659048 DOI: 10.1002/jcsm.12210] [Citation(s) in RCA: 227] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/27/2017] [Accepted: 03/20/2017] [Indexed: 11/06/2022] Open
Abstract
This review evaluates the reliability and validity of ultrasound to quantify muscles in older adults. The databases PubMed, Cochrane, and Cumulative Index to Nursing and Allied Health Literature were systematically searched for studies. In 17 studies, the reliability (n = 13) and validity (n = 8) of ultrasound to quantify muscles in community-dwelling older adults (≥60 years) or a clinical population were evaluated. Four out of 13 reliability studies investigated both intra-rater and inter-rater reliability. Intraclass correlation coefficient (ICC) scores for reliability ranged from -0.26 to 1.00. The highest ICC scores were found for the vastus lateralis, rectus femoris, upper arm anterior, and the trunk (ICC = 0.72 to 1.000). All included validity studies found ICC scores ranging from 0.92 to 0.999. Two studies describing the validity of ultrasound to predict lean body mass showed good validity as compared with dual-energy X-ray absorptiometry (r2 = 0.92 to 0.96). This systematic review shows that ultrasound is a reliable and valid tool for the assessment of muscle size in older adults. More high-quality research is required to confirm these findings in both clinical and healthy populations. Furthermore, ultrasound assessment of small muscles needs further evaluation. Ultrasound to predict lean body mass is feasible; however, future research is required to validate prediction equations in older adults with varying function and health.
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Affiliation(s)
- Willemke Nijholt
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aldo Scafoglieri
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johannes S M Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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de Vries NM, van Ravensberg CD, Hobbelen JSM, van der Wees PJ, Olde Rikkert MGM, Staal JB, Nijhuis-van der Sanden MWG. The Coach2Move Approach: Development and Acceptability of an Individually Tailored Physical Therapy Strategy to Increase Activity Levels in Older Adults With Mobility Problems. J Geriatr Phys Ther 2016; 38:169-82. [PMID: 25621385 DOI: 10.1519/jpt.0000000000000038] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Despite the positive effects of physical activity on numerous aspects of health, many older adults remain sedentary even after participating in physical activity interventions. Standardized exercise programs do not necessarily bring about the behavioral change that is necessary. Therefore, a patient-centered approach is needed. The purpose of this study was to develop and assess the acceptability and potential effectiveness of the Coach2Move strategy; a physical therapy (PT) approach aimed at improving the long-term level of physical activity in mobility-limited older adults. METHODS The Coach2Move strategy was developed on the basis of 2 systematic literature studies and expert consultations. Multiple focus group meetings and a Delphi procedure were organized to gain consensus on the Coach2Move strategy. Acceptability and potential effectiveness were studied in a pilot study with a pre-/postdesign in which 2 physical therapists and 12 patients participated. To assess acceptability, patients were interviewed, discussion were held with the involved physical therapists was held, and health records were studied. Potential effectiveness was tested measuring the level of physical activity, frailty, quality of life, and mobility before and after treatment. RESULTS On the basis of the literature study and expert consultations, an algorithm based on the Hypothesis Oriented Algorithm for Clinicians Part II was developed: the Coach2Move approach. Key elements of the Coach2Move approach include an extensive intake using motivational interviewing, clinical reasoning, coaching to increase physical activity and self-management, focusing on meaningful activities, and working according to 3 patient-tailored intervention profiles with a predefined number of sessions. The pilot study showed high appraisal of the strategy by both physical therapists and patients. Moreover, a potential effect on the level of physical activity, frailty, quality of life, and mobility was observed. DISCUSSION AND CONCLUSION Because the pilot study was not randomized or controlled and included a small sample, no conclusions can be drawn about the effectiveness of the Coach2Move strategy. However, all suggestions made in this study were implemented in an ongoing, randomized controlled trial in which the Coach2Move strategy will be compared to usual care PT. In conclusion, the Coach2Move strategy can be considered acceptable in PT practice and showed potential benefits. The results on the (cost-)effectiveness of this strategy based on a large, randomized, controlled trial are expected in 2014.
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Affiliation(s)
- Nienke M de Vries
- 1Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands. 2Dutch National Institute of Allied Health Professions (NPi), Amersfoort, the Netherlands. 3Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands. 4Department of Geriatrics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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Nijholt W, Jager-Wittenaar H, Visser M, van der Schans CP, Hobbelen JSM. Are a Healthy Diet and Physical Activity Synergistically Associated with Cognitive Functioning in Older Adults? J Nutr Health Aging 2016; 20:525-32. [PMID: 27102791 DOI: 10.1007/s12603-015-0610-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Previous research has demonstrated that being both physically active and adhering a healthy diet is associated with improved cognitive functioning; however, it remains unclear whether these factors act synergistically. We investigated the synergistic association of a healthy diet and being physically active with cognitive functioning. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Data from the Longitudinal Aging Study Amsterdam (LASA) were used. We analyzed data from 2,165 community dwelling adults who were aged 55-85 years, 56% of whom were female. Cognitive functioning was assessed by the Mini-Mental State Examination (MMSE), an MMSE score of >26 indicates good cognitive functioning. Physical activity was assessed by the LASA Physical Activity Questionnaire and was considered sufficient if the person engaged in moderately intense physical activity ≥ 20 min/day. A healthy diet score was based on the intake of fruit, vegetables and fish. Each of the food groups was assigned a score that ranged from 1 (well below the Dutch guideline for a healthy diet) to 4 (well above the Dutch guideline for a healthy diet), and the scores were aggregated to determine a healthy diet (healthy ≥ 9 points). Multiple logistic and linear regression analyses were used to examine the (synergistic) association among physical activity, a healthy diet and cognitive functioning. All analyses were adjusted for potential chronic diseases and lifestyle confounders. RESULTS Of all of the participants, 25% were diagnosed with a cognitive impairment (MMSE ≤26), 80% were physically active and 41% had a healthy diet. Sixty three percent of the participants both adhered to a healthy diet and were physically active. Sufficient daily physical activity (OR=2.545 p<.001) and adherence to a healthy diet (OR=1.766 p=.002) were associated with good cognitive functioning. After adjusting for confounding factors, sufficient physical activity was not significantly related to cognitive functioning (p=.163); however adherence to a healthy diet remained significantly associated with good cognitive functioning (p=.017). No interaction among sufficient physical activity, healthy diet adherence and good cognitive functioning was observed (crude: p=.401, adjusted: p=.216). CONCLUSION The results of this cross-sectional study indicate that adherence to a healthy diet is inde-pendently related to cognitive functioning. Being physically active does not modify this association. Furthermore, these two lifestyle factors do not synergistically relate to cognitive functioning.
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Affiliation(s)
- W Nijholt
- Willemke Nijholt, MSc. Hanze University of Applied Sciences, School of Health Care Studies, Eyssoniusplein 18, 9714 CE Groningen, The Netherlands, E-mail: , Phone number: +31.6.20 42 66 73
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Hobbelen JSM, Koopmans RTCM, Verhey FRJ, Van Peppen RPS, de Bie RA. Paratonia: a Delphi procedure for consensus definition. J Geriatr Phys Ther 2006; 29:50-6. [PMID: 16914066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND AND PURPOSE Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a Delphi procedure with known experts in the field to establish an operational consensus definition of paratonia. METHODS The Delphi procedure involved an anonymous and multistage approach presented as a questionnaire, with each stage building on the results of the previous one in order to reach consensus on the definition of paratonia. RESULTS Eight of 17 experts agreed to participate in the study. After 4 rounds, the participants reached consensus on the following definition: paratonia is a form of hypertonia with an involuntary variable resistance during passive movement. The nature of paratonia may change with progression of dementia (eg, from active assistance (aka Mitgehen) to active resistance). The degree of resistance depends on the speed of movement (eg, slow > low resistance, fast > high resistance). The degree of paratonia is proportional to the amount of force applied and increases with progression of dementia. The resistance to passive movement is in any direction and there is no clasp-knife phenomenon. CONCLUSION The Delphi procedure resulted in a comprehensive, operational definition of paratonia. Future research should focus on the reliability and validity of this definition.
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Affiliation(s)
- Johannes S M Hobbelen
- Physiotherapy Research Vitalis Zorggroep Eindhoven, Vlasmeersestraat 5, 5261 TA Vught, the Netherlands.
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