EFFECTS OF GAIT AND ACTIVITIES OF DAILY LIVING MODIFICATIONS FOR IMPROVING KNEE JOINT FUNCTION IN COMMUNITY-DWELLING MIDDLE-AGED AND OLDER PEOPLE: A RANDOMIZED CONTROL STUDY

2021 ◽  
pp. 2150007
Author(s):  
Susumu Ota ◽  
Remi Fujita ◽  
Hiroshi Ohko ◽  
Aiko Imai

Knee osteoarthritis is highly prevalent in middle-aged and older people, and biomechanical interventions include modifications of the gait and activities of daily living (ADL). This study investigated the effects of gait and ADL modifications compared with conventional exercise for improving knee function in community-dwelling middle-aged and older people. Fifty middle-aged and older people were randomly allocated to the control ([Formula: see text]) or intervention ([Formula: see text]) groups. The control group performed conventional straight leg raising and knee joint range of motion exercises, and the intervention group modified their gait by decreasing the knee adduction moment and increasing hip muscle activities, and performed range of motion exercises in a bathtub. In both groups, the program was implemented for 12 weeks. The Japan knee OA measure score, walking speed, and hip abduction strength significantly improved in both the control and intervention groups. The health-related quality of life (Short Form 8: SF-8) was significantly improved in the intervention group compared with the control group. Gait and ADL modifications achieved effects similar to those of conventional knee joint exercise, and might be more effective for improving physical function-related quality of life.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Arkers Kwan Ching WONG ◽  
Frances Kam Yuet WONG ◽  
Jenny Sau Chun NGAI ◽  
Shirley Yu Kan HUNG ◽  
Wah Chun LI

Abstract Background Previous studies supporting discharged patients are hospital-based which admission criteria tend to include mainly those with complex needs and/or specific disease conditions. This study captured the service gap where these non-frail older patients might have no specific medical problem upon discharge but they might encounter residual health and social issues when returning home. Methods Discharged community-dwelling non-frail older adults from an emergency medical ward were recruited and randomized into either intervention (n = 37) or control (n = 38) group. The intervention group received a 12-week complex interventions that included structured assessment, health education, goal empowerment, and care coordination supported by a health-social team. The control group received usual discharge care and monthly social call. The primary outcome was health-related quality of life (HRQoL). Secondary outcomes included activities of daily living (ADL), the presence of depressive symptoms, and the use of health services. The outcomes were measured at pre-intervention (T1) and at three months post-intervention (T2). The independent t-test or the Mann-Whitney U test was used to analyze the group differences in HRQoL, ADL, and presence of depressive symptoms according to the normality of data. Results Analysis showed that the intervention group experienced a statistically significantly improvement in the mental component scale of quality of life (p = .036), activities of daily living (p = .005), and presence of depressive symptoms (p = .035) at T2 compared with at T1. No significant differences were found in the control group. Conclusions Supporting self-care is necessary to enable community-dwelling non-frail older adults to be independent to the fullest extent possible in the community. The promising results found in this pilot study suggested that the integration of the health-social partnership into transitional care practice is effective and can be sustained in the community. Future studies can draw on these findings and maximize the integrated care quality during the transition phase. Trial registration NCT04434742 (date: 17 June 2020, retrospectively registered).


2005 ◽  
Vol 23 (10) ◽  
pp. 2378-2388 ◽  
Author(s):  
Lene Thorsen ◽  
Eva Skovlund ◽  
Sigmund B. Strømme ◽  
Kjersti Hornslien ◽  
Alv A. Dahl ◽  
...  

Purpose To evaluate the effectiveness of a supervised home-based flexible training program on cardiorespiratory fitness (CRF), mental distress, and health-related quality of life (HRQOL) parameters in young and middle-aged cancer patients shortly after curative chemotherapy. Patients and Methods One hundred eleven patients age 18 to 50 years who had received chemotherapy for lymphomas or breast, gynecologic, or testicular cancer completed the trial. These patients were randomly allocated to either an intervention group (n = 59), which underwent a 14-week training program, or a control group (n = 52) that received standard care. Primary outcome was change in CRF, as determined by Åstrand-Rhyming indirect bicycle ergometer test (maximum oxygen uptake [VO2max]), between baseline (T0) and follow-up (T1). Secondary outcomes were mental distress, as assessed by the Hospital Anxiety and Depression Scale, and HRQOL, as assessed by the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire. Two-way analysis of covariance was used to analyze changes from T0 to T1. Results VO2max increased by 6.4 mL/kg–1/min–1 in patients in the intervention group and by 3.1 mL/kg–1/min–1 in patients in the control group (P < .01). The fatigue score decreased by 17.0 points in the control group compared with only 5.8 points in the intervention group (P < .01). There were no intergroup differences in mental distress or HRQOL. Conclusion A supervised, home-based, flexible training program has significant effect on CRF in young and middle-aged cancer patients shortly after curative chemotherapy, but it has no favorable effect on patients' experience of fatigue, mental distress, or HRQOL.


2018 ◽  
Vol 12 (5) ◽  
pp. 1593-1603
Author(s):  
Michał Rabijewski ◽  
Lucyna Papierska ◽  
Radosław Maksym ◽  
Ryszard Tomasiuk ◽  
Anna Kajdy ◽  
...  

The aim of this study was to compare health-related quality of life (HRQoL) between men with prediabetes (PD) and a control group as well as to investigate the relationship between HRQoL and anabolic hormones. The analysis was carried out in 176 middle-aged (40–59 years) and elderly (60 80 years) men with PD, and 184 control peers. PD was defined according the American Diabetes Association and HRQoL was assessed by the SF-36 questionnaire. Total testosterone (TT), calculated free testosterone, dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) were measured. Analysis of the standardized physical and mental component summary scores (SF-36p and SF-36m) revealed that patients with PD had lower SF-36p and SF-36m than control group ( p < .02 and p < .001). Middle-aged men with PD had lower SF-36p and SF-36m than control peers, whereas elderly men with PD had lower only SF-36p. In men with PD negative correlations between glycated hemoglobin (HbA1c) and SF-35m score ( r = −0.3768; p = .02) and between HbA1c and SF-36p score ( r = −0.3453; p = .01) were reported. In middle-aged prediabetic men, SF-36p was associated with high free testosterone and low HbA1c while SF-36m with high TT and high DHEAS. In elderly patients with PD, SF-36p was associated with high TT, high IGF-1, and low HbA1c, while SF-36m correlated with high free testosterone and high DHEAS. In conclusion, PD in men is associated with decreased HRQoL in comparison with healthy men, and generally better quality of life is associated with higher testosterone, higher free testosterone, higher DHEAS, and lower HbA1c.


2009 ◽  
Vol 21 (6) ◽  
pp. 1171-1179 ◽  
Author(s):  
Sally Wai-chi Chan ◽  
Helen FK Chiu ◽  
Wai-tong Chien ◽  
William Goggins ◽  
David Thompson ◽  
...  

ABSTRACTBackground: Depression is a common psychological problem among older people. Health-related quality of life (HRQoL) is now recognized by healthcare providers as an important treatment goal for people with depression. This study aimed to identify predictors of change in HRQoL among older people with depression.Methods: In a longitudinal study, data were collected when participants were newly diagnosed with a depressive disorder at a regional outpatient department in Hong Kong and 12 months later. Seventy-seven Chinese participants aged 65 years or older completed the study. Measures included the Physical Health Condition Checklist (PHCC), Geriatric Depression Scale (GDS), Modified Barthel Index (MBI), Instrumental Activities of Daily Living (IADL) scale, Social Support Questionnaire (SSQ), and World Health Organization Quality of Life Scale-Brief Version (WHOQOL).Results: Significant improvements between the first and second assessments were noted in the total WHOQOL scores, GDS scores, and the number of the social support. The results of linear regression models showed that the increases in the IADL scores and decreases in the PHCC and GDS scores were significantly associated with higher final WHOQOL scores.Discussion: Treatment for depression was effective in improving the participants’ overall condition and their perceived HRQoL. The results suggest that interventions to alleviate older people's level of depression, manage their physical ill health and enhance their instrumental activities of daily living ability could help improve their perceived HRQoL.


2016 ◽  
Vol 62 (9) ◽  
pp. 848-852 ◽  
Author(s):  
GABRIEL GRIZZO CUCATO ◽  
RAPHAEL MENDES RITTI-DIAS ◽  
MAYSA SEABRA CENDOROGLO ◽  
JOSÉ MARIA MALUF DE CARVALHO ◽  
FÁBIO NASRI ◽  
...  

SUMMARY Objective To compare the health-related quality of life (HRQL) indicators between institutionalized and community-dwelling elderly men and women. Method This was a cross-sectional study with a sample of 496 elderly men and women, surveyed by researchers at a private hospital that attends institutionalized and community-dwelling elderly. HRQL (World Health Organization Quality of Life), daily living activities (Katz questionnaire), and instrumental daily living activities (Lawton questionnaire), mini-mental state examination, handgrip strength test, and function capacity (timed up and go test) were obtained. Results Institutionalized men presented higher scores in physical and psychological domains of HRQL compared to elderly men living alone (p<0.05). Among women, the scores in all domains (physical, psychological, relationship, and environment) were similar between institutionalized and community-dwelling individuals. Conclusion Institutionalized elderly men reported better scores in physical and psychological domains of HRQL compared to their community-dwelling pairs, while both institutionalized and community-dwelling elderly women presented similar HRQL.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 612-613
Author(s):  
Aung Zaw Zaw Phyo ◽  
Joanne Ryan ◽  
David A Gonzalez-Chica ◽  
Nigel P Stocks ◽  
Christopher M Reid ◽  
...  

Abstract Previous studies have revealed that poor health-related quality of life (HRQoL) is associated with a higher risk of hospital readmission and mortality in patients with cardiovascular disease (CVD). The association between HRQoL and incident CVD is still limited for general older people. This study explored the associations between baseline HRQoL and incident and fatal CVD in community-dwelling Australian and the United States older people enrolled in ASPREE clinical trial. A cohort of 19,106 individuals aged 65 to 98 years, who were initially free of CVD, dementia, or disability, were followed between March 2010 and June 2017. The SF-12 questionnaire was used to assess HRQoL, and the physical (PCS) and mental component scores (MCS) of SF-12 were derived using norm-based methods. Incident major adverse CVD events included fatal CVD (death due to atherothrombotic CVD), hospitalizations for heart failure, myocardial infarction or stroke. Analyses were performed using Cox proportional-hazard regression. Over a median 4.7 follow-up years, there were 922 incident CVD events, 203 fatal CVD events, 171 hospitalizations for heart failure, 355 fatal or nonfatal myocardial infarction and 403 fatal or nonfatal strokes. A 10-unit higher PCS, but not MCS, was associated with a lower risk of incident CVD (HR=0.86, 95%CI 0.79-0.92), hospitalization for heart failure (HR=0.72, 95%CI 0.60-0.85), and myocardial infarction (HR=0.85, 95%CI 0.75-0.96). Neither PCS nor MCS was associated with fatal CVD events or stroke. Physical HRQoL can be used in combination with clinical data to identify the incident CVD risk among community-dwelling older people.


2020 ◽  
pp. 073346482096651
Author(s):  
Hye-Min Park ◽  
Jinsei Jung ◽  
Jong-Koo Kim ◽  
Yong-Jae Lee

This study investigated the relationship of tinnitus with mental health and health-related quality of life (QoL) in older people. Data source included 5,129 community-dwelling men and women ≥60 years old from the Korean National Health and Nutrition Examination Survey. Tinnitus was categorized into three groups: normal, tolerable tinnitus, and annoying tinnitus. Mental health and health-related QoL were assessed according to three dimensions (depressive mood, psychological distress, and suicidal ideation) and five domains (impaired mobility, impaired self-care, impaired usual activities, pain/discomfort, and anxiety/depression). The odds ratios (ORs) and 95% confidence intervals (CIs) of mental health and health-related QoL were calculated using multiple logistic regression analyses. Annoying tinnitus was positively and independently associated with deteriorated mental health and health-related QoL, suggesting comprehensive care is needed in older people with annoying tinnitus.


2019 ◽  
Vol 24 (7) ◽  
pp. 315-322
Author(s):  
Junko Ohashi ◽  
Toshiki Katsura

As the world's population ages, efforts to improve quality of life (QOL) in old age are gaining public attention. In this study, a programme was conducted for older people with the aim of clarifying their life goals related to QOL and the meaning of their existence, and the effect of the programme in improving QOL was evaluated. Participants were randomly assigned to the intervention or control group after registration. The program consisted of four 90-minute classes. The primary outcome was the Philadelphia Geriatric Center Morale Scale score (PGC), and changes in outcomes were compared between groups. The intervention group had significantly improved PGC scores (P<0.003). Further, the scores of PGC subscales ‘Acceptance of one's own ageing’ and ‘Lonely dissatisfaction’ showed significant improvements after the intervention (P<0.001). The findings suggest the effectiveness of the developed program in improving QOL in people aged ≥65 years.


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