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Journal of Geriatric Physical Therapy
Journal Prestige (SJR): 0.691  Citation Impact (citeScore): 2 Number of Followers: 15  Hybrid journal (It can contain Open Access articles)ISSN (Print) 1539-8412 - ISSN (Online) 2152-0895 Published by LWW Wolters Kluwer  [330 journals]
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- Editor's Message: Changing of the Guard
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Authors: Allison; Leslie K.
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PubDate: Sun, 01 Jan 2023 00:00:00 GMT-
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- CSM 2023 Poster Abstracts
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PubDate: Sun, 01 Jan 2023 00:00:00 GMT-
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- CSM 2023 Platform Abstracts
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PubDate: Sun, 01 Jan 2023 00:00:00 GMT-
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- Balance Confidence and Balance Performance, But Not Fall History Are
Associated With Quality of Life in Community-Dwelling Older Adults: A
Cross Sectional Study-
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Authors: Roberts; Holly J.; Johnson, Kristen M.; Sullivan, Jane E.; Hoppes, Carrie W.
Abstract:
Background and Purpose: Fear of falling (FoF) is highly prevalent in community-dwelling older adults and is associated with low health-related quality of life (QoL). Low QoL is associated with increased health care utilization and is a predictor of future falls, but few studies have examined the relationship between high-level balance and dynamic gait performance and QoL in community-dwelling older adults. The purpose of this cross-sectional study was to determine whether there is a relationship between FoF avoidance behaviors, balance confidence, performance on measures of high-level mobility, and QoL in community-dwelling older adults. The secondary purpose was to determine whether older adults who fall have a different QoL than older adults who have not fallen in the past year.Methods: Eighty-nine community-dwelling older adults (76.33 ± 6.84 years, 54 female, 34 fallers) completed the World Health Organization Quality of Life-BREF (WHOQOL-BREF), Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behavior Questionnaire (FFABQ), Functional Gait Assessment (FGA), and Community Balance and Mobility Scale (CB&M). Correlation and multiple regression analyses were calculated to determine the relationship between the outcome measures and domains on the WHOQOL-BREF.Results and Discussion: Significant correlations were observed between the WHOQOL-BREF physical health domain and the ABC, FFABQ, FGA, and CB&M (ρ= 0.524, −0.509, 0.348, and r = 0.423, respectively), the WHOQOL-BREF psychological domain and the ABC (ρ= 0.284) and FFABQ (ρ=−0.384), and the WHOQOL-BREF environment domain and the ABC (ρ= 0.343) and FFABQ (ρ=−0.406). No correlations were found between WHOQOL-BREF domain scores and a history of falls.Conclusions: Performance-based outcome measures that measure high-level mobility such as the CB&M and FGA, and patient-reported outcome measures for balance confidence and FoF avoidance behavior such as the ABC and FFABQ, are correlated with the physical health QoL domain on the WHOQOL-BREF. The ABC and FFABQ are correlated with psychological and environment QoL. Fall history was not correlated with QoL. Interventions to decrease FoF or improve high-level mobility may improve QoL in community-dwelling older adults.
PubDate: Mon, 09 May 2022 00:00:00 GMT-
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- Home-Based Health Care Interventions for People Aged 75 Years and Above
With Chronic, Noninflammatory Musculoskeletal Pain: A Scoping Review-
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Authors: Chopra; Swati; Kodali, Rama T.; McHugh, Gretl A.; Conaghan, Philip G.; Kingsbury, Sarah R.
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Background and Purpose: Chronic, noninflammatory musculoskeletal pain is common in the aged population and management can be challenging for older people due to multimorbidity, social isolation, and physical frailty. The aim of this scoping review is to summarize and discuss the evidence related to home-based health care interventions for older adults, with chronic, musculoskeletal pain.Methods: A review of the literature using 8 electronic databases (Embase, MEDLINE, CINAHL, PubMed, Cochrane Library, Physiotherapy Evidence Database [PEDro], Scopus, and Web of Science) was performed, following the PRISMA-ScR guidelines. English language published studies that assessed home-based health care intervention/s, in men and women 75 years and older, with chronic, noninflammatory musculoskeletal pain where included. Two authors independently reviewed the articles and extracted data into a preformulated chart.Results and Discussion: The database search identified 4722 studies of which 7 studies met the inclusion criteria. Six of the 7 studies were randomized controlled trials and 5 studies focused on a single-site pain. The type of home-based interventions in the included studies was physical therapy (n = 2), psychotherapy (n = 3), and multimodal therapy (combination of multiple therapies) (n = 2). Participation completion rate was more than 74% in 6 out of 7 studies. Most studies used pain and/or physical function as their primary outcome (n = 6). Music therapy showed a statistically significant reduction in visual analog scale score for pain, and there was a trend toward improvement of pain and function in the physical therapy studies. No significant differences in outcomes between intervention and control groups were observed in the multimodal studies.Conclusion: This review highlights the scarcity of evidence related to home-based health interventions in older people 75 years and older, living with chronic, noninflammatory musculoskeletal pain. The findings were that physical, psychotherapeutic, and multimodal interventions are usually well tolerated and can be delivered as a safe self-management option. There remains a substantial need for more high-quality research with wider range of home-based interventions and comprehensive assessment of outcomes for this age group.
PubDate: Mon, 13 Dec 2021 00:00:00 GMT-
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- Effectiveness of a Supervised Group-Based Otago Exercise Program on
Functional Performance in Frail Institutionalized Older Adults: A
Multicenter Randomized Controlled Trial-
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Authors: García-Gollarte; Fermín; Mora-Concepción, Ania; Pinazo-Hernandis, Sacramento; Segura-Ortí, Eva; Amer-Cuenca, Juan José; Arguisuelas-Martínez, María Dolores; Lisón, Juan Francisco; Benavent-Caballer, Vicent
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Background and Purpose: Because of its high prevalence and association with negative health-related outcomes, frailty is considered one of the most important issues associated with human aging and its mitigation is among the essential public health goals for the 21st century. However, very few studies have focused on institutionalized older adults, despite the knowledge that frailty can be reversible when identified and treated from its earliest stages. Therefore, the objective of this study was to evaluate the effects of a supervised group-based multicomponent exercise program intervention with or without oral nutritional supplementation on functional performance in frail institutionalized older adults.Methods: This was a multicenter randomized controlled trial study with a 6-month intervention period. A total of 111 frail institutionalized older adults (75 years or older) who met at least 3 of the 5 Fried frailty criteria were randomly allocated to the control group (CG; n = 34, mean age = 87.3 ± 5.3 years), a supervised group-based multicomponent Otago Exercise Program group (OEP; n = 39, mean age = 86 ± 5.9 years), or a supervised group-based multicomponent exercise program intervention with oral nutritional supplementation (OEP+N; n = 38, mean age = 84.9 ± 6 years). Measurements included the Timed Up and Go test (TUG), Berg Balance Scale (BBS), Short Physical Performance Battery, repeated chair stand test (STS-5), handgrip strength (HGS), 10-m walking test, and 6-minute walking test, both at baseline and after the 6-month intervention period.Results and Discussion: The between-group analysis by 2-way analysis of covariance showed significant improvement in the TUG [{OEP vs CG: −8.2 seconds, 95% CI [−13.3 to −2.9]; P < .001}; {OEP vs OEP+N: −7.3 seconds, 95% CI [−12.4 to −2.2]; P = .002}], BBS [{OEP vs CG; 8.2 points, 95% CI [5.2 to 11.2]; P < .001}; [{OEP+N vs CG: 4.6 points, 95% CI [1.6 to 7.6]; P < .001}; {OEP vs OEP+N: 3.5 points, 95% CI [0.6 to 6.5]; P = .011}], and HGS [{OEP vs CG: 3.4 kg, 95% CI [1.5 to 5.3]; P < .001}; {OEP+N vs CG: 3.6 kg, 95% CI [1.7 to 5.5]; P < .001}]. Additionally, the within-group analysis showed a significant improvement in the TUG (−6.9 seconds, 95% CI [−9.8 to −4.0]; P < .001) and BBS (4.3 points, 95% CI [2.6 to 5.9]; P < .001) in the OEP group. A significant decrease in the BBS and HGS was shown in the CG.Conclusions: A 6-month supervised group-based multicomponent exercise intervention improved the levels of mobility, functional balance, and HGS in frail institutionalized older adults. Further research will be required to evaluate the nutritional supplementation effects on functional performance to better determine its clinical applicability for tackling frailty.
PubDate: Thu, 19 Aug 2021 00:00:00 GMT-
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- A Feasibility Study of Pain Neuroscience Education and Exercise for
Community-Dwelling Older Adults With Chronic Pain-
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Authors: Heleno; Emanuel; Andias, Rosa; Neto, Maritza; Silva, Anabela G.
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Background and Purpose: Pain prevalence in older adults is high and greatly impacts their functioning. The primary aim of this study was to determine the feasibility of an intervention consisting of pain neuroscience education (PNE) plus exercise for community-dwelling older adults attending primary care, by assessing recruitment rates (inclusion, refusal, and exclusion rates), adverse events, and acceptability of the intervention. Secondary aims were to establish suitable procedures for delivering the intervention and assess the feasibility of data collection for psychosocial and physical functioning.Methods: A mixed-methods feasibility study with 2 groups was conducted. One group received 8 weekly 75-minute sessions of PNE plus exercise (PNE+E) and the other received usual care (UC), which consisted of appointments with the general practitioner. Inclusion, refusal, exclusion, and retention rates, dropouts, and adverse events were assessed. The Brief Pain Inventory, the Pain Catastrophizing Scale, the Tampa Scale, the Geriatric Depression Scale, the World Health Organization Disability Assessment Schedule, the 4-meter walk gait speed test and the 5 times sit-to-stand tests were used for assessment. A focus group interview was conducted with participants from the PNE+E group. Descriptive statistics were used for quantitative data and thematic analysis for qualitative data.Results and Discussion: Of 61 participants recruited, 33 (PNE+E = 22; UC = 11) entered the study, and 24 completed the intervention (PNE+E = 15; UC = 9). The inclusion rate was 54%, the refusal rate was 21%, the exclusion rate was 35%, the dropout rate was 32% in the PNE+E and 18% in the UC, and the retention rate was 68% in the PNE+E group and 82% in the UC group. No adverse events were reported and the intervention was well accepted by participants. Data collection for the clinical outcomes was feasible and results suggested higher improvements in the PNE+E group than in the UC group.Conclusion: PNE+E is possible to implement, safe, and well accepted by community-dwelling older adults independent of their education level. This study informs future studies on practical and methodological strategies that should be considered when designing a PNE+E intervention for older adults, such as adapting the language of the PNE to participants, using relatable metaphors, and encouraging written and exercise homework.
PubDate: Thu, 19 Aug 2021 00:00:00 GMT-
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- Validity of 2 Fall Prevention Strategy Scales for People With Stroke,
Parkinson's Disease, and Multiple Sclerosis-
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Authors: Gervasoni; Elisa; Beghi, Ettore; Corrini, Chiara; Parelli, Riccardo; Bianchi, Elisa; Mestanza Mattos, Fabiola Giovanna; Jonsdottir, Johanna; Montesano, Angelo; Cattaneo, Davide
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Background and Purpose: Falls are a common and persistent concern among people with neurological disorders (PwND), as they frequently result in mobility deficits and may lead to loss of functional independence. This study investigated the ceiling and floor effects, internal consistency, and convergent validity of 2 patient-reported fall prevention strategy scales in PwND.Methods: This is a prospective cohort study. Two-hundred and ninety-nine PwND (111 people with multiple sclerosis, 94 people with Parkinson's disease, and 94 people with stroke) were seen for rehabilitation and assessed. The number of retrospective and prospective falls, use of walking assistive devices, scores on the Fall Prevention Strategy Survey (FPSS), Falls Behavioural Scale (FaB), and balance and mobility scales (Berg Balance Scale, Dynamic Gait Index, Timed Up and Go, 10-m walking test, and Activities-specific Balance Confidence) were analyzed.Results: Total score distributions showed negligible ceiling and floor effects for both the FPSS (ceiling: 0.3%, floor: 0.3%) and the FaB (ceiling: 0%, floor: 0%). The Cronbach α (CI) was of 0.87 (0.85-0.89) for the FPSS and 0.86 (0.84-0.88) for the FaB. In terms of convergent validity, the FPSS and FaB were moderately correlated (Spearman correlation coefficient = 0.65). Moreover, the correlations between the FPSS and FaB and balance and mobility scales ranged from 0.25 to 0.49 (P < .01). Both scales are slightly better able to distinguish between retrospective fallers/nonfallers [area under the curve, AUC (95% CI): FPSS: 0.61 (0.5-0.7); FaB: 0.60 (0.5-0.6)] compared with prospective fallers/nonfallers [AUC (95% CI): FPSS: 0.56 (0.4-0.6); FaB: 0.57 (0.4-0.6)]. Both scales accurately identified individuals who typically required the use of a walking assistive device for daily ambulation [AUC (95% CI): FPSS: 0.74 (0.7-0.8); FaB: 0.69 (0.6-0.7)]. Multiple regression analysis showed that previous falls, use of an assistive device, and balance confidence significantly predicted participants' prevention strategies (FPSS: R2 = 0.31, F(8,159) = 10.5, P < .01; FaB: R2 = 0.31, F(8,164) = 10.89, P < .01).Conclusion: The FPSS and the FaB appear to be valid tools to assess fall prevention strategies in people with neurological disorders. Both scales provide unique and added value in providing information on individual behavior for fall prevention.
PubDate: Fri, 13 Aug 2021 00:00:00 GMT-
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- Associations Between Cognitive Function, Balance, and Gait Speed in
Community-Dwelling Older Adults with COPD-
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Authors: Gore; Shweta; Blackwood, Jennifer; Ziccardi, Tyler
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Background and Purpose: Older adults with chronic obstructive pulmonary disease (COPD) are at risk for physical and cognitive impairment. Cognitive function is associated with falls in older adults. However, it is unknown whether a relationship exists between cognitive function and falls in patients with COPD. The aim of this study was to examine the relationships between cognitive function, balance, and gait speed in older adults with COPD.Patients and Methods: A secondary analysis was performed using data from the 2010 wave of the Health and Retirement Study (HRS). Cognitive (immediate and delayed recall, executive function) and physical (gait speed, tandem balance time) measure data were extracted for older adults with COPD (n = 382) and an age-matched control group without COPD (n = 382) who met inclusion/exclusion criteria. Multivariate linear regression modeling was performed to examine associations between cognitive function and mobility or balance while controlling for age, gender, body mass index, grip strength, and education.Results: In older adults with COPD, delayed recall was significantly associated with tandem balance performance (β= 1.42, P < .05). Other cognitive measures were not associated with gait speed or balance.Conclusion: In older adults with COPD, one of four cognitive functions was associated with a static standing balance task. Screening of cognitive function, specifically delayed recall, should be a part of the management of falls in this population.
PubDate: Thu, 29 Jul 2021 00:00:00 GMT-
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- Circumstances and Factors Associated With Falls Among Community-Dwelling
Older Adults Diagnosed With Heart Disease Using the International Mobility
in Aging Study (IMIAS)-
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Authors: Aburub; Ala' S.; Phillips, Susan P.; Curcio, Carmen-Lucia; Guerra, Ricardo Oliveira; Khalil, Hanan; Auais, Mohammad
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Background and Purpose: To identify the circumstances of falls and the factors associated with falls among older adults with cardiovascular disease (CVD).Methods: Baseline (2012) data from the International Mobility in Aging Study (IMIAS), a cross-sectional study, were used. Falling was measured by the subjective question, “Have you fallen in the last 12 months?” Several subjective questions were asked to obtain information about the circumstances of falls. Potential clinical factors associated with falling were cognitive status, depressive symptoms, physical performance, grip strength, visual acuity, and fear of falling (FOF). These clinical factors were measured respectively with the Leganes Cognitive Test, the Center for Epidemiological Studies Scales Depressive Symptoms, the Short Physical Performance Battery, a Jamar handgrip dynamometer, the Early Treatment Diabetic Retinopathy Study (ETDRS) tumbling E chart placed at 2 m, and the Falls Efficacy Scale-International. A χ2 test was used to determine whether there were significant differences in fall circumstances among older adults with and without CVD. Two-sample t tests were used to test for any significant differences between older adults with and without CVD. Bonferroni correction was applied to limit type I errors and was corrected to .007. Simple and multiple logistic regressions identified which clinical factors were associated with falling.Results: A total of 429 older adults with CVD (mean age 69.5 ± 2.9) and 431 older adults without CVD (69.2 ± 2.9) participated in the study. Approximately 53% of fallers with CVD had 2 or more falls compared with fallers without CVD (39%). The most common location for falling was at home (43%) for fallers with CVD or in the street (50%) for fallers without CVD. Approximately 9% of fallers with CVD needed to be hospitalized while only 3% of fallers without CVD were admitted to the hospital. Approximately 42% of fallers with CVD had some residual sequelae (eg, being unable to walk around the house or do housework) compared with only 27% of fallers without CVD. Fallers with CVD had significantly (P value < .007) more depressive symptoms (mean ± SD, 14.7 ± 12.9) and poorer physical performance (8.4 ± 3.0) compared with fallers without CVD (10.1 ± 9.4 and 9.6 ± 2.5, respectively); however FOF was the only significant clinical factor (P value < .05) associated with falling for older adults with CVD.Conclusions: Incidence of recurrent falls is higher among older adults with CVD than those without CVD. Circumstances of falls among fallers with CVD differ from those identified among fallers without CVD. Fear of falling was the only predictor of fall history among older adults with CVD. The results suggest the merit of considering FOF when designing prevention and intervention programs to reduce falls among older adults with CVD.
PubDate: Wed, 30 Jun 2021 00:00:00 GMT-
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- Assessment of the Concurrent Validity of the ICF Core Set to Classify the
Physical Health of Community-Dwelling Older Adults in Relation to
Self-Rated Health-
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Authors: Oliveira; Naama Samai Costa; Monteiro, Isabel Oliveira; Ruaro, João Afonso; Dantas, Diego de Sousa; Lima, Núbia Maria Freire Vieira; Fernandes, Aline Braga Galvão Silveira; Nobre, Thaiza Teixeira Xavier; da Câmara, Saionara Maria Aires
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Background and Purpose: The present study aimed to assess the concurrent validity of the International Classification of Functioning, Disability and Health (ICF) core set to classify physical health of older adults in relation to self-rated health.Methods: This is a methodological study conducted in Santa Cruz, Rio Grande do Norte (RN) state, in Northeastern Brazil, with 101 community-dwelling older adults. The participants rated their health status, which was classified into 3 groups: very good, fair, and poor/very poor. An interview was then conducted using self-reported and objective measurements to classify physical health according to the ICF core set. It consists of 30 categories, 14 of which belong to the body function (b) component, 4 to body structures (s), 9 to activities and participation (d), and 3 related to environmental factors (e). To analyze the compromised and problematic categories in the ICF, an impairment index was created for each component. The relationship between self-rated health and the impairment indexes was assessed using the multinomial logistic regression test adjusted for age, sex, schooling, and perception of income sufficiency.Results: A greater likelihood of poor or very poor self-rated health was found in older individuals with the highest impairment index in (b) (odds ratio [OR] = 1.18; P < .001); (s) (OR = 1.11; P≤ .001); (d) capacity (OR = 1.09; P = .02); and (d) performance (OR = 1.08; p = 0.01).Conclusion: The results suggest that the ICF core set is a valid instrument to assess the physical health of older adults, since it is associated with self-rated health and shows potential for use in clinical practice and scientific research, with universal language regarding functionality and physical health in older adults.
PubDate: Tue, 15 Jun 2021 00:00:00 GMT-
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- Pulmonary Function as a Predictor of Frailty Syndrome in
Community-Dwelling Older Adults-
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Authors: dos Santos; Nara L. O.; Pegorari, Maycon S.; Silva, Caroline de F. R.; Jamami, Maurício; Matos, Areolino P.; Pinto, Ana Carolina P. N.; Ohara, Daniela G.
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Background and Purpose: Diminished pulmonary function is associated with negative health outcomes and pulmonary impairment, and can be associated with frailty. The objectives of this study were to compare pulmonary function between frail, prefrail, and nonfrail older adults; to verify the association between pulmonary function and frailty syndrome; and to establish cut-off points for pulmonary function variables for predicting frailty.Methods: A cross-sectional study was conducted with 379 community-dwelling older adults of both sexes. Spirometry was used to measure pulmonary function criteria (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV1; and FEV1/FVC ratio). The presence of frailty was evaluated with Fried's frailty phenotype. Statistical analysis included a multinomial logistic regression model. Pulmonary function cut-off points for discriminating frailty syndrome were established through analysis of the receiver operating characteristic curves.Results and Discussion: The study participants were a median of 69.0 (64.0-74.0) years old, and 12.4% presented frailty while 58% presented prefrailty. Frail and prefrail older adults presented significantly lower median FVC and FEV1 values—FVC = 1.89 L (1.45-2.31) and FEV1 = 1.60 L (1.24-1.91); FVC = 2.07 L (1.62-2.67) and FEV1 = 1.66 L (1.32-2.09), respectively—than nonfrail participants—FVC = 2.53 L (1.96-3.16) and FEV1 = 2.01 L (1.54-2.43). The adjusted analysis indicated that FEV1 (odds ratio [OR] = 0.63; 95% confidence interval [CI], 0.39-0.99) and the FVC (OR = 0.68; 95% CI, 0.48-0.96) were inversely associated with prefrailty and that FVC (OR = 0.52; 95% CI, 0.29-0.94) was associated with frailty. Cut-off points for prefrailty (FVC ≤2.3 L and FEV1≤1.86 L) and frailty (FVC ≤2.07 L and FEV1≤1.76 L) were established.Conclusions: Pulmonary function was lower in frail and prefrail older adults than in their nonfrail peers. Frailty and prefrailty were inversely associated with pulmonary function. Cut-off points for FEV1 and FVC for discriminating frailty were established and may allow pulmonary function to serve as an indicator of frailty in older adults.
PubDate: Wed, 02 Jun 2021 00:00:00 GMT-
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