scholarly journals Rehabilitation under Social Isolation: Outcomes of Older Individuals with Hip Fractures, Admitted to a Postacute Geriatric Rehabilitation Center, during the COVID-19 Pandemic

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Yaara Leibovici-Weissman ◽  
Yochai Levy ◽  
Michal Michaelis ◽  
Avital Hershkovitz
Keyword(s):  
Social Isolation ◽  
Hip Fractures ◽  
Adult Population ◽  
Family Members ◽  
Functional Independence ◽  
Geriatric Rehabilitation ◽  
Control Group ◽  
Rehabilitation Center ◽  
Score Change ◽  
Rehabilitation Outcomes

Background/Aims: The novel coronavirus SARS-CoV-2 is the cause of an ongoing pandemic. The highest mortality rate is observed among the older adult population. During the first wave of the pandemic (March–June 2020), following a national health decree demanding that no visitors or family members be allowed in health institutions, our geriatric rehabilitation center closed gates to all visitors from the outside. We aimed to assess the rehabilitation outcomes of older patients with hip fractures in the first pandemic wave, who underwent rehabilitation under complete social isolation from primary care givers and family members. Methods: This was a retrospective cohort study. It took place at a university-affiliated, major postacute geriatric rehabilitation center. Rehabilitation outcomes measured were discharge functional independence measure (FIM) score and motor FIM score, FIM score change, motor FIM score change, favorable motor FIM effectiveness, length of stay, discharge destination, and home aid at discharge. Results: The study group included 36 patients who were admitted during the first wave of the COVID-19 pandemic (March 1, 2020, to June 30, 2020). The control group comprises 106 individuals with hip fractures who were admitted in the respective time periods during the previous 2 years, that is, March 1, 2018, to June 30, 2018, and March 1, 2019, to June 30, 2019. The facility’s occupancy rates were much lower during the first wave of the pandemic in comparison with previous years (78 and 99%, respectively). Patients showed similar demographics and comorbidities, but the social isolation group was more severely deconditioned upon admission. All rehabilitation outcomes were similar between groups. Conclusion: According to the findings of this retrospective study, social isolation from family and caregivers did not have a detrimental effect on the rehabilitation outcomes of these patients. More evidence must be gathered and presented on the matter.

scholarly journals Efficacy of pulmonary rehabilitation in severe and critical-ill COVID-19 patients: a controlled study

2020 ◽  
Author(s):  
Gilbert Büsching ◽  
Zhongxing Zhang ◽  
Jean Paul Schmid ◽  
Thomas Sigrist ◽  
Ramin Khatami
Keyword(s):  
Pulmonary Rehabilitation ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Controlled Study ◽  
Control Group ◽  
P Value ◽  
Fisher Exact Test ◽  
Rehabilitation Outcomes ◽  
Critical Ill

AbstractSevere and critical ill COVID-19 patients frequently need acute care hospitalization including mechanical ventilation at ICU due to acute respiratory distress. A high proportion of these patients will develop ICU-acquired weakness and a need for rehabilitation. However data on rehabilitation outcomes in these patients are scarce and the efficacy of rehabilitation remains essentially unclear. We therefore compared the rehabilitation outcomes between COVID-19 patients with pneumonia and other patients with common pneumonia to assess their rehabilitation efficacies.We retrospectively compared the performances of six-min walk test (6MWT), chronic respiratory questionnaire (CRQ), and functional independence measure (FIM) at the discharge from pulmonary rehabilitation between 51 Covid-19 patients and 51 patients with common pneumonia using linear regression controlled for baseline values at entrance, age, sex and cumulative Illness rating scale. Fisher exact test was applied to test whether the odd ratios (ORs) of non-improvement/improvement in 6MWT (>30-m) and CRQ (>10-point) at discharge were different between the two groups.Covid-19 patients had similar performances at discharge in 6MWT (P-value=0.14), CRQ (P-value=0.55), and 4.2-point higher (P-value=0.004) in FIM compared to the control group. No differences in the outcomes were found between severe and critical COVID-19 patients. The OR of non-improvement/improvement in 6MWT was 0.30 (P-value=0.13) between COVID-19 and control groups; but the odd of non-improvement in CRQ tended to be 3.02 times higher (P-value =0.075) in COVID-19 group.In-house rehabilitation is effective and suitable for COVID-19 patients irrespective from disease severity. The discrepancy of high physical improvement and relatively low gains of disease related quality of life compared to control patients with common pneumonia is however remarkable. Further studies need to evaluate whether this discrepancy is an indicator of chronic disease development.

scholarly journals EHealth in geriatric rehabilitation: a systematic review of effectiveness, feasibility and usability (Preprint)

2020 ◽  
Author(s):  
Jules Jaques Marie Kraaijkamp ◽  
Eléonore F van Dam van Isselt ◽  
Anke Persoon ◽  
Anke Versluis ◽  
Niels H. Chavannes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Mixed Methods ◽  
Older Patients ◽  
Current Evidence ◽  
Geriatric Rehabilitation ◽  
Control Group ◽  
Successful Implementation ◽  
Rehabilitation Outcomes ◽  
Ehealth Intervention

BACKGROUND eHealth has the potential to improve outcomes in older adults receiving geriatric rehabilitation. However, evidence on (cost)effectiveness in post-acute geriatric rehabilitation is scarce, and the successful implementation and use of eHealth in geriatric rehabilitation is not self-evident. OBJECTIVE The aim of this systematic review is to assess the effectiveness, usability and feasibility of eHealth interventions in older adults in geriatric rehabilitation. METHODS Seven databases were searched for randomized controlled trials, non-randomized studies, quantitative descriptive studies, qualitative research and mixed methods studies that applied eHealth interventions during geriatric rehabilitation. Included studies investigated effectiveness, usability and/or feasibility of eHealth in older patients with a mean age of ≥70 who received geriatric rehabilitation. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT) and a narrative synthesis was conducted using a Harvest plot. RESULTS In total 34 were selected, with clinical heterogeneity across studies, and high exclusion rates reported in 7studies. Outcomes related to participation and usability were infrequently reported. In 16 studies eHealth was found to be at least as effective as non-eHealth interventions (73% of the included studies with a control group), 6 studies found eHealth interventions to be more effective than non-eHealth interventions (27%), and 2 studies reported beneficial outcomes in favor of the non-eHealth interventions (9%). Overall, the identified studies showed that eHealth is often feasible and can potentially improve rehabilitation outcomes, especially in combination with another (non)eHealth intervention. Simple eHealth interventions were more likely to be feasible for older patients receiving geriatric rehabilitation. CONCLUSIONS Current evidence on eHealth in older patients receiving geriatric rehabilitation is diverse, making it challenging to compare outcomes and draw conclusions. Furthermore, a lack of evidence on usability might hamper the implementation of eHealth. eHealth applications in geriatric rehabilitation show promise but more research is required, including research with a focus on usability and participation

Effectiveness of Child to Parent Communication Using Information Package on Food Hygiene

2018 ◽  
Vol 3 (07) ◽  
Author(s):  
Ms. Sonam Yangchen Bhutia ◽  
Dr. Sushma Kumari Saini ◽  
Dr. Manmeet Kaur ◽  
Dr. Sandhya Ghai
Keyword(s):  
School Children ◽  
Home Visit ◽  
Controlled Trial ◽  
Family Members ◽  
Sampling Technique ◽  
Control Group ◽  
Food Hygiene ◽  
Parent Communication ◽  
Post Test ◽  
Randomised Controlled

School children can act as change agent not only for families but for community. The study aimed to assess effectiveness of information package on knowledge and practices of parents/family members of school children studying in Govt. Sr. Sec. School on food hygiene in Dhanas and Daddu Majra Colony, UT, Chandigarh. A non-randomised controlled trial was conducted on 201 school children studying in VIIth standard and their parents/family members. Purposive sampling technique was utilised to enrol 101 in case and 100 participants in control group. Interview schedule for knowledge assessment and observation checklist for assessing the practices of parents/ family members was used. Pre assessment of both the groups was done by a home visit. Experimental group school children were educated on food hygiene as per the protocol. Pre and post-test knowledge of school children on food hygiene was assessed and were asked to disseminate the information to their parents/family members.  After 15 days, second time home visit was done to the parents/family members of both the groups for the post assessment of knowledge and practices. Significant improvement in knowledge and practices of parents/family members related to food hygiene was observed. Hence, school children can be an effective tool in health related knowledge dissemination which can further promote healthy practices.

Association of the CD14 C159T and the Toll-like receptor 4 Asp299Gly polymorphisms with various phenotypes of asthma in adults from Crimea

2020 ◽  
Vol 41 (2) ◽  
pp. 134-140
Author(s):  
Yuriy Bisyuk ◽  
Andrew Dubovyi ◽  
Ilona DuBuske ◽  
Viktor Litus ◽  
Lawrence M. DuBuske
Keyword(s):  
Late Onset ◽  
Adult Population ◽  
Additive Models ◽  
Atopic Asthma ◽  
Control Group ◽  
Nucleotide Polymorphisms ◽  
Toll Like Receptor ◽  
Toll Like Receptor 4 ◽  
Single Nucleotide ◽  
Gender And Age

Background: This study assessed gene polymorphisms of the CD14 receptor (C-159T) and Toll-like receptor 4 (Asp299Gly) in a patient population in Crimea, Ukraine, stratified by clinical (early versus late onset; frequent versus occasional relapses; fixed versus reversible obstruction) and immunologic (atopic versus nonatopic; eosinophilic; neutrophilic or paucigranulocytic inflammation) subtype. Methods: Two polymorphisms, CD14 C-159T and TLR4 Asp299Gly, were assessed in 331 patients with asthma. The control group included 285 volunteers who were nonatopic. The single nucleotide polymorphisms were studied by using polymerase chain reaction with electrophoretic detection. Results: There were increased odds of asthma development in patients with the Asp299Gly TLR4 mutation compared with the general population underdominant odds ratio (OR) 1.52 [95% confidence interval (CI), 1.00‐2.32] and overdominant (OR 1.55 [95% CI, 1.01‐2.38]) models after adjustment for gender and age. In addition, mutations in this gene decreased the odds of nonatopic asthma in underdominant (OR 0.26 [95% CI, 0.07‐0.93]; p = 0.027), overdominant (OR 0.27 [95% CI, 0.07‐0.96]; p = 0.033), and log-additive models (OR 0.26 [95% CI, 0.07‐0.93]; p = 0.026) compared with the atopic subgroup after adjustment for gender, age, number of exacerbations, and type of airway inflammation. Allele frequencies for CD14 and TLR4 polymorphisms did not show statistical differences between the patients with asthma and the control subjects. Conclusion: CD14 C-159T polymorphisms were not associated with asthma in the adult population in Crimea. TLR4 Asp299Gly polymorphisms were associated with asthma and with decreased odds of nonatopic asthma compared with atopic asthma in the adult population in Crimea.

Adipokines as Potential Biomarkers in the Neurorehabilitation of Obese Stroke Patients

2020 ◽  
Vol 17 (4) ◽  
pp. 437-445
Author(s):  
Irene Ciancarelli ◽  
Giovanni Morone ◽  
Marco Iosa ◽  
Stefano Paolucci ◽  
Loris Pignolo ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Functional Recovery ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Enzyme Linked Immunosorbent Assay ◽  
Stroke Patients ◽  
Rehabilitation Outcomes ◽  
Before And After ◽  
Forward Stepwise ◽  
Clinical Measures

Background: Limited studies concern the influence of obesity-induced dysregulation of adipokines in functional recovery after stroke neurorehabilitation. Objective: To investigate the relationship between serum leptin, resistin, and adiponectin and functional recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential significance as prognostic markers of rehabilitation outcomes was also verified. Methods: Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale (mRS), and Functional Independence Measure (FIM). Results: Compared to controls, higher leptin and resistin values and lower adiponectin values were observed in stroke patients before neurorehabilitation and no correlations were found between adipokines and clinical outcome measures. Neurorehabilitation was associated with improved scores of BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and resistin together increased adiponectin were detected in stroke patients, while leptin decreased but not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score, and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified leptin as prognostic factor for BI, mRS, and FIM. Conclusions: Our data show the effectiveness of neurorehabilitation in modulating adipokines levels and suggest that leptin could assume the significance of biomarker of functional recovery.

The effects of information platform-based nursing on preventing venous thromboembolism (VTE) in patients with hip fractures (Preprint)

2020 ◽  
Author(s):  
Yuan Gao ◽  
Xiaojie Fu ◽  
Mingxing Lei ◽  
Pengbin Yin ◽  
Qingmei Wang ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Subgroup Analysis ◽  
Nursing Intervention ◽  
Control Group ◽  
Study Group ◽  
Drug Compliance ◽  
Information Platform ◽  
The Difference ◽  
Length Of Hospitalization

BACKGROUND Mobile apps are becoming increasingly relevant to health care. Apps have been used to improve symptoms, quality of life, and adherence for oral drugs in patients with cancers, pregnancy, or chronic diseases, and the results were satisfying . OBJECTIVE This study aims to develop an information platform with the help of a mobile app and then evaluate whether information platform-based nursing can improve patient’s drug compliance and reduce the incidence of VTE in patients with hip fractures. METHODS We retrospectively analyzed hip fracture patients performed with traditional prevention and intervention of VTE (control group) between January 2008 and November 2012, and prospectively analyzed hip fracture patients conducted with nursing intervention based on the information platform (study group) between January 2016 and September 2017. The information platform can be divided into medical and nursing care end and the patient’s end. Based on the information platform, we could implement risk assessments, monitoring management and early warnings, preventions and treatments, health educations, follow-up and other aspects of nursing interventions for patients. We compared basic characteristics, outcomes including drug compliance, VTE occurrence, and mean length of hospitalization between the two groups. Besides, a subgroup analysis was performed in the study group according to different drug compliances. RESULTS Regarding baseline data, patients in the study group had more morbidities than those in the control group (P<0.05). The difference of drug compliance between the two groups was statistically significant (P<0.001): 64.7% of the patients in the control group had poor drug compliance and only 6.1% patients had poor drug compliance in the study group. In terms of VTE, 126 patients (10.7%) in the control group had VTE, while only 35 patients (7.1%) in the study group had VTE, and the difference was statistically significant (P=0.024). Moreover, the average length of hospitalization in the study group was also significantly lower than that in the control group (10.4 d vs. 13.7 d, P=0.000). Subgroup analysis of the study group showed that the incidence of VTE in patients with non-compliance, partial compliance, and good compliance was 56.7%, 5.8% and 2.8%, respectively (P=0.000). CONCLUSIONS Poor drug compliance leads to higher VTE occurrence. The information platform-based nursing can effectively improve the compliance of patients with hip fracture and thus significantly reduce the incidence of VTE.

“Consideration of patients as networked units to identify opportunities and motivation to enhance capability”: A mixed methods study to explore a personalised Digital Health Hub Model of Care for hip fractures in South Australia (Preprint)

2021 ◽  
Author(s):  
Lalit Yadav ◽  
Tiffany K Gill ◽  
Anita Taylor ◽  
Jen DeYoung ◽  
Mellick J Chehade
Keyword(s):  
Hip Fractures ◽  
Digital Health ◽  
Family Members ◽  
South Australia ◽  
Aged Care ◽  
Mixed Methods Study ◽  
Residential Aged Care ◽  
Model Of Care ◽  
Factors Influencing

UNSTRUCTURED Introduction Majority of older people with hip fractures once admitted to acute hospital care are unable to return to their pre-fracture level of independence and a significant number are either newly admitted or return to residential aged care. Patient education involves family members and/or residential aged care staff as networked units, crucial for empowerment through improving health literacy. Advancement of digital technology has led to evolving solutions around optimising health care including self-management of chronic disease conditions and telerehabilitation. The aim of this study is to understand perspectives of older patients with hip fractures, their family members and residential aged carers, to inform the development of a digitally enabled model of care using a personalised digital health hub (pDHH). Methods A mixed methods study was conducted at a public tertiary care hospital in South Australia involving patients aged 50 years and above along with their family members and residential aged carers. Quantitative data, including basic demographic characteristics, access to computers and Internet were analysed using descriptive statistics. Spearman’s Rank Order Correlation was used to examine correlations between the perceived role of a pDHH in improving health and likelihood of subsequent usage. Whereas qualitative data included series of open-ended questions and findings were interpreted using constructs of capability, opportunity and motivation to help understand the factors influencing the likelihood of potential pDHH use Results Overall, 100 people were recruited in the study, representing 55 patients, 13 family members and 32 residential aged carers. The mean age of patients was 76.4 years (SD-8.4, age range 54-88) and females represented 60% of patients. Although a moderate negative correlation existed with increasing age and likelihood of pDHH usage (ρ= -0.50, p<0.001) the perceived role of the DHH in improving health had a strong positive correlation with the likelihood of pDHH usage by self (ρ=0.71, p<0.001) and by society, including friends and family members (ρ=0.75, p<0.001). Of particular note, almost all the patients (98%) believed they had a family member or friend /carer who would be able to help them to use a digital health platform. Whereas our qualitative findings suggest emphasising on complex interplay of capability, opportunity and motivation as crucial factors while designing a pDHH enabled model of care for hip fractures at a local context level. Conclusion Findings from this study contributed to understand the dynamics around capabilities, motivation and opportunities of patients, family members and formal carers as a “patient networked unit”. Future research recommendation must involve co-creation guided by iterative processes through improving understanding of factors influencing development and successful integration of complex digital healthcare interventions in real-world scenarios.

A Family Training Program for Adventitiously Blinded and Low Vision Veterans

1984 ◽  
Vol 78 (10) ◽  
pp. 473-478 ◽  
Author(s):  
Arlene Dumas ◽  
Alan D. Sadowsky
Keyword(s):  
Training Program ◽  
Exploratory Study ◽  
Marked Reduction ◽  
Interpersonal Relations ◽  
Low Vision ◽  
Family Members ◽  
Rehabilitation Center ◽  
Rehabilitation Process ◽  
The Family ◽  
Sight Loss

The family training program at the Western Blind Rehabilitation Center is an integral part of the rehabilitation process for adventitiously blinded and low vision adults. An exploratory study was conducted to assess which aspects of the training were most outstanding and to inquire how the program affected interpersonal relations and attitudes towards sight loss. Results showed a marked reduction in stated problems immediately after the training and over a three-and-a-half-year period of time. The study demonstrates similar benefits for older family members, those receiving shortened programs, and those who have been living with sight loss for many years.

scholarly journals Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
pp. 215145932098629 ◽  
Author(s):  
Yulia Bugaevsky ◽  
Yochai Levy ◽  
Avital Hershkovitz ◽  
Irena Ocheretny ◽  
Adaya Nissenholtz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence ◽  
Functional Improvement ◽  
Orthopedic Department ◽  
Successful Recovery

Introduction: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. Level of Evidence: Level IV

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