Use of Assistive Devices for Bathing by Elderly Who are Not Institutionalized

1996 ◽  
Vol 16 (4) ◽  
pp. 261-286 ◽  
Author(s):  
William C. Mann ◽  
Dianne Hurren ◽  
Machiko Tomita ◽  
Barbara Charvat
Keyword(s):  
Mental Status ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
The Body ◽  
Assistive Devices ◽  
Elderly Persons ◽  
Persons With Disabilities ◽  
Mini Mental Status Exam ◽  
Physical Dysfunction ◽  
Satisfied Users

For elderly persons with disabilities, bathing is a frequent activity that can be both pleasant and dangerous. Bathing involves using water in an environment with hard, smooth surfaces that become slippery when wet, and many falls occur in the bathroom. A variety of assistive devices are available to make bathing safer and more comfortable. Bathing devices rank as one of the most frequently used categories of assistive devices, yet many elders experience problems in the use of bathing devices. Study of bathing devices has been little beyond determination of the frequency of their use. In this article, we developed a hierarchical model for use in prescribing bathing devices related to mobility and support. This model, based on level of disability, is called the Bath Device Prescription Model (BDPM). Subjects were drawn from the University at Buffalo Consumer Assessments Study (n=319), which considers persons older than 60 years with disabilities. Subjects who reported difficulty with bathing (n=294) were divided into two groups based on mental status (Mini Mental Status Exam [MMSE] scores ⩾24 or ⩾23). This model was tested by first determining the level of disability of satisfied users of (1) bath mats, (2) grab bars in the bath area, (3) bath stools, (4) bath chairs, and (5) bath transfer benches. Level of disability was measured with the Sickness Impact Profile-physical dysfunction section (SIP-PDS), the body care and movement subsection of the SIP-PDS, the motor section of the Functional Independence Measure (FIM), and the bathing-washing and drying item of the FIM. Subjects who were having a problem with a bath device, other than installation, maintenance, or access to the bathroom, were considered. Disability scores for these dissatisfied owners of bath devices were compared with the mean score of satisfied users of each bath device. Typically, dissatisfied owners of bath devices were more disabled than satisfied users, suggesting that they would benefit from a higher level device, following the BDPM. This study represents the first reported investigation testing a model for use in the prescription of bath devices.

scholarly journals Evaluation of Treatment in the Smart Home IRIS in terms of Functional Independence and Occupational Performance and Satisfaction

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Julija Ocepek ◽  
Anne E. K. Roberts ◽  
Gaj Vidmar
Keyword(s):  
Elderly People ◽  
Independent Living ◽  
Smart Home ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Performance Measure ◽  
Assistive Technologies ◽  
Occupational Performance ◽  
Convenience Sample ◽  
Persons With Disabilities

The development of assistive technologies, home modifications, and smart homes has rapidly advanced in the last two decades. Health professionals have recognised the benefits of these technologies in improving individual’s quality of life. The Smart Home IRIS was established in 2008 within the University Rehabilitation Institute in Ljubljana with the aim to enable persons with disabilities and elderly people to test various assistive technologies and technical solutions for their independent living. We investigated the effect of treatments in the Smart Home IRIS. A convenience sample of 59 persons with disabilities and elderly people (aged 24–81 years) who were treated in the Smart Home IRIS from April to December 2011 participated. Standardised instruments—the Canadian Occupational Performance Measure (COPM) and the Functional Independence Measure (FIM)—were administered at the first assessment in the Smart Home IRIS and at a second assessment at the participant’s home after 6–12 months. All the outcomes statistically significantly improved from the first to the second assessment. The treatments in the Smart Home IRIS appeared to contribute to higher occupational performance and satisfaction with performance and higher functional independence of persons with disabilities and elderly people.

scholarly journals Use of the Frailty Tools Fi Mds and Fi Rockwood to Predict Outcomes of Inpatient Rehabilitation after Proximal Hip Fracture

2021 ◽  
Vol 8 (3) ◽  
pp. 01-06
Author(s):  
Jochanan Naschitz
Keyword(s):  
Hip Fracture ◽  
Clinical Decision Making ◽  
Frailty Index ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Elderly Persons ◽  
Clinical Frailty Scale ◽  
The Mean ◽  
The Impact

Background Among factors which affect the outcome of rehabilitation after hip fracture, the role of pre-fracture frailty has not been defined. Objective To assess the impact of frailty on rehabilitation outcome in elderly persons with proximal hip fracture. Setting Geriatric rehabilitation center. Design Retrospective observational study. Subjects Forty consecutive patients with proximal hip fracture. Methods The following parameters were calculated: FI-MDS frailty index, Rockwood Clinical Frailty Scale (FI Rockwood), Functional Independence Measure (FIM) on discharge, absolute functional gain (ΔFIM), length of stay (LOS), and FIM gain per day (ΔFIM/LOS). FIM discharge ≥90 and motor FIM discharge >58 indicated success in rehabilitation. Results There were 31 women and 9 men, mean age 80 years. The mean pre-fracture FI MDS was 10 points (SD 5.8) out of 58 possible, the mean FI Rockwood score was 3 (SD 1.7) out of 7 possible. The mean admission FIM was 76.6 (SD 16), the mean discharge FIM was 92.7 (SD 19.3), mean LOS 22.5 days (SD 9.7), mean ΔFIM/LOS 0.8 (SD 0.6). Pre-fracture frailty was associated with worse outcome of rehabilitation: FI MDS predicted discharge FIM ≥90 with OR 0.86, p 0.012; FI Rockwood predicted discharge FIM ≥90 with OR 0.68, p 0.027; FI MDS predicted discharge motor FIM >58 with OR 0.91, p 0.07; FI Rockwood predicted discharge motor FIM >58 with OR 0.71, p 0.027. Conclusions Though pre-fracture frailty correlated with FIM on discharge, neither frailty tool was specific enough to predict success in rehabilitation and the necessary length of rehabilitation. Translating frailty scores in tools adequate for clinical decision making remains an aim for future studies.

scholarly journals Attitudinal barriers from the perspective of people with physical disabilities

2021 ◽  
Vol 28 (1) ◽  
pp. 1-6
Author(s):  
Flávia Canale Cabral ◽  
Andre Tadeu Sugawara ◽  
Marta Imamura ◽  
Linamara Rizzo Battistella
Keyword(s):  
Physical Disabilities ◽  
Depression Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
University Hospital ◽  
Cross Sectional ◽  
Persons With Disabilities ◽  
Attitudinal Barriers ◽  
Cord Injury ◽  
Attitudinal Barrier

Objective:To quantify attitudes toward disabilities, perceived by persons with disabilities (PWDs) treated at a university hospital in Brazil, as well as to determine whether PWD-perceived attitudinal barriers correlate with various factors. Methods This was a cross-sectional, observational study of PWDs who completed the Attitudes to Disability Scale for persons with physical disabilities (ADS-D), which quantifies the perceived attitudinal barrier, the Hospital Anxiety and Depression Scale and the Functional Independence Measure (FIM). The data were correlated with sex, income, depression, FIM score, type of disability and time since the onset of disability. Results: We evaluated 68 patients - 50.0% with a spinal cord injury, 38.2% with one or more amputated limbs and 11.8% with hemiplegia - of whom 66.2% were male, with a mean age of 39.33 ± 12.89 years, a mean of 10.95 ± 4.25 years of schooling, a median time since the onset of disability of 20.5 months (range, 10.5–33.5 months) and a median FIM score of 110.5 (range, 94–116.5). Of the 68 patients, 55.9% perceived their income to be below the national average, and depression was observed in 11.76%. The mean ADS-D total score (61.29 ± 8.75) did not correlate with sex, functionality, type of disability or time since the onset of disability. The perceived magnitude of the attitudinal barrier correlated with income (β-coefficient: −3.91; p = 0.001) and depression (β = −1.74; p < 0.0001). Conclusion: Attitudinal barriers are influenced by income as a facilitator of inclusion and by depression as a barrier to inclusion.

“EFFECT OF MYOFASCIAL RELEASE ON SPASTIC MUSCLES AND FUNCTIONAL OUTCOME IN CHRONIC STROKE SUBJECT”- A RANDOMIZED CONTROL TRIAL

2021 ◽  
pp. 69-71
Author(s):  
Vijal Mewada ◽  
Karishma Barot
Keyword(s):  
Conventional Treatment ◽  
Muscle Power ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Gait Pattern ◽  
The Body ◽  
Myofascial Release ◽  
Randomized Sampling ◽  
Experimental Group

Background: Stroke is damage to the brain from interruption of blood supply causing altered sensations, reduced muscle power and tone, reduced joint mobility and stability, balance, gait impairment leading to plegia or paresis. Hemiplegia causes paralysis of one side of the body leading to inactivity, impaired movements, posture and gait pattern. Spasticity is increase in tonic stretch reexes with exaggerated tendon jerks. Myofascial release is a manipulative treatment that helps reduce fascial tension. Purpose:The aim of study was to nd out the effectiveness of Myofascial Release on spasticity of hamstrings, calf, adductors and biceps muscles in spastic hemiplegic subject. Methodology:Atotal 30 participants of middle aged group were diagnosed with chronic spastic hemiplegia. They were divided in two groups by randomized sampling, of which 15 (controlled group) and 15 (experimental group) who were treated with MFR and conventional treatment. Pre and Post treatment measures of Modied Ashworth Scale, Modied Tardieu Scale, Functional Independence Measure and Berg Balance Scale were evaluated. MFR was given to hamstrings, calf, adductors and biceps muscles for 5 days a week for 12 weeks. Result: MFR and conventional physiotherapy treatment had an excellent effect on the experimental group as compared to the controlled group. Conclusion: The current study concludes that MFR along with conventional treatment has signicant effect in reducing spasticity and improving the functional activities

Motor Impairment as a Predictor of Functional Recovery and Guide to Rehabilitation Treatment After Stroke

2001 ◽  
Vol 15 (3) ◽  
pp. 229-237 ◽  
Author(s):  
Fatima de N. A. P. Shelton ◽  
Bruce T. Volpe ◽  
Mike Reding
Keyword(s):  
Lower Limb ◽  
Prediction Models ◽  
Motor Impairment ◽  
Self Care ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Assistive Devices ◽  
Predictive Values ◽  
Assist Devices

Objective: This study tests three hypotheses relevant for the efficient use of re habilitation services after stroke: (a) the severity of initial motor impairment after stroke predicts discharge motor impairment and self-care mobility scores; (b) identi fication of those unlikely to show improvement in motor impairment can focus reha bilitation efforts on use of compensatory techniques and assist devices; and (c) im provement in self-care mobility scores without change in motor impairment, balance, or cognition is a quantitative estimate of the value of teaching compensatory tech niques and use of assist devices. Methods: We studied 171 sequential patients previ ously independent in the community who were admitted for inpatient rehabilitation within 17 ± 12 SD days of an initial, unilateral, hemispheric, ischemic stroke. Im pairment was assessed using the Fugl-Meyer upper limb motor (ULM), lower limb motor (LLM), and upper plus lower limb total motor (TM) subscores. Disability was assessed using the Functional Independence Measure (FIM), FIM self-care (FIMS), FIM mobility (FIMM), and FIM self-care plus FIM mobility (FIMSM) subscores. Spear- man correlation coefficients tested strength of association between dependent and independent variables, stepwise linear regression tested the effects of clinically rele vant co-variables, and positive and negative predictive values (PPV, NPV) assessed the clinical relevance of outcome-prediction models. Results: The highest correla tions observed were between admission TM scores and the following discharge scores: TM (R = 0.92; p < 0.01), ULM (R = 0.91; p < 0.01), LLM (R = 0.82; p < 0.01), FIMSM (R = 0.67; p < 0.01), FIMM (R = 0.67; p < 0.001), FIM (R = 0.58; p < 0.0001). An admission TM score in the lowest quartile had a PPV of 0.74 for a dis charge ULM score in the lowest quartile. An admission TM score in the highest quar tile had a PPV of 0.86 for a discharge ULM score in the highest quarttle. Similar but weaker PPVs were seen for admission TM scores and discharge LLM scores. Patients without significant change in TM scores (≤2 points) had a 17 ± 9 SD improvement in FIMSM scores. Conclusions: Admission motor impairment scores (a) predict dis charge impairment and activities of daily living mobility functional outcome; and (b) guide treatment toward improving motor impairment versus use of compensatory tech niques and assistive devices. The use of compensatory techniques and assistive devices, without change in motor impairment, is associated with a 17 ± 9 SD improvement in FIMSM score. Key Words: Stroke—Motor recovery—Rehabilitation—Outcome.

scholarly journals A Case Report on Korean Medical Treatment for a Patient with Quadriplegia and Impaired Cognition as Neurological Sequelae after Ingestion of Herbicides

2021 ◽  
Vol 42 (5) ◽  
pp. 904-915
Author(s):  
Sang-song Shim ◽  
Jae-yoon Ahn ◽  
Hyo-won Jin ◽  
Jong-min Yun ◽  
Byung-soon Moon
Keyword(s):  
Case Report ◽  
Medical Treatment ◽  
Clinical Symptoms ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Toxic Encephalopathy ◽  
Manual Muscle Test ◽  
Neurological Sequelae ◽  
Mini Mental Status Exam ◽  
Impaired Cognition

This study is a case report of Korean medicine treatment for a patient with quadriplegia and impaired cognition as neurological sequelae after ingestion of herbicides. A 59-year-old man with toxic encephalopathy and hypoxic encephalopathy after the ingestion of herbicides was treated with acupuncture, Hyulbuchuko-tang mixed with Ondam-tang-gami (血府逐瘀湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), and Modified Barthel Index (MBI). After three months of treatment, clinical symptoms improved. The motor function improved (MMT on both sides, Gr. 3+F/4G →Gr. 4-G~4G/4+G), cognition improved (K-MMSE, 13→21), and ADL (Activities of Daily Living) scores also improved (FIM 41→74; MBI 20→63). Korean medical treatment could effectively treat neurological sequelae after ingestion of herbicides in this case.

Clinically Relevant Behaviors in Elderly Hip Fracture Inpatients

2002 ◽  
Vol 32 (3) ◽  
pp. 249-259 ◽  
Author(s):  
Helen H. Dorra ◽  
Eric J. Lenze ◽  
Yookyung Kim ◽  
Benoit H. Mulsant ◽  
Michael C. Munin ◽  
...  
Keyword(s):  
Mental Health ◽  
Hip Fracture ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Elderly Persons ◽  
Depression And Anxiety ◽  
Rehabilitation Outcome ◽  
Rehabilitation Hospital ◽  
Outcome Behaviors

Objective: To examine the range of behaviors documented by inpatient rehabilitation staff and the association of these behaviors with functional outcome, in elderly persons undergoing rehabilitation after hip fracture. Method: Subjects were 137 patients, aged 60 and older, admitted to a rehabilitation hospital after a hip fracture, defined as having either a good or poor rehabilitation outcome based on change in Functional Independence Measure motor subscale scores during the course of their admission. Their charts were systematically reviewed for nursing and therapy staff documentation of behaviors. Prevalence of behaviors was compared between good and poor rehabilitation outcome groups. Results: Disturbances in cognition and rehabilitation participation were common and were associated with poorer rehabilitation outcome. Behaviors reflective of depression and anxiety were relatively uncommon and not associated with rehabilitation outcome. Conclusions: Rehabilitation staff frequently detect and document disturbances in cognition and participation that are associated with poorer rehabilitation outcome. It is recommended that staff observations be routinely added to mental health evaluations. Additionally, routine mental health screening and required staff documentation of behaviors would improve case detection rate.

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