Exercise Interventions With Trained Home Helpers for Preventing Loss of Autonomy and Falls in Community-Dwelling Older Adults Receiving Home Heath Physical Therapy T4H

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Anthony Mézière ◽  
Nadia Oubaya ◽  
Valérie Michel-Pellegrino ◽  
Bertrand Boudin ◽  
Marine Neau ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Community Dwelling ◽  
Exercise Interventions ◽  
Loss Of Autonomy ◽  
Community Dwelling Older Adults ◽  
Home Helpers

scholarly journals Implementation of a Cost-Effective Physical Therapy Approach (Coach2Move) to Improve Physical Activity in Community-Dwelling Older Adults With Mobility Problems: Protocol for a Cluster-Randomized, Stepped Wedge Trial

2019 ◽  
Vol 100 (4) ◽  
pp. 653-661 ◽  
Author(s):  
Ward Heij ◽  
Steven Teerenstra ◽  
Lieke Sweerts ◽  
J Bart Staal ◽  
Maria W G Nijhuis-van der Sanden ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Therapy ◽  
Physical Therapist ◽  
Community Dwelling ◽  
Stepped Wedge ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults ◽  
Stepped Wedge Trial ◽  
Insight Into

Abstract Background Coach2Move is a personalized treatment strategy by physical therapists to elicit physical activity in community-dwelling older adults with mobility problems. Objective The primary objective of this study is to assess the effectiveness and cost-effectiveness of the implementation of Coach2Move compared with regular care physical therapy in daily clinical practice. Design, Setting, Participants, and Intervention A multicenter cluster-randomized stepped wedge trial is being implemented in 16 physical therapist practices (4 clusters of 4 practices in 4 steps) in the Netherlands. The study aims to include 400 older adults (≥70 years) living independently with mobility problems and/or physically inactive lifestyles. The intervention group receives physical therapy conforming to the Coach2Move strategy; the usual care group receives typical physical therapist care. Measurements Measurements are taken at baseline and 3, 6, and 12 months after the start of treatment. The primary outcomes for effectiveness are the amount of physical activity (LASA Physical Activity Questionnaire) and functional mobility (Timed Up and Go test). Trial success can be declared if at least 1 parameter improves while another does not deteriorate. Secondary outcomes are level of frailty (Evaluative Frailty Index for Physical Activity), perceived effect (Global Perceived Effect and Patient Specific Complaints questionnaire), quality of life (EQ-5D-5 L), and health care expenditures. Multilevel linear regression analyses are used to compare the outcomes between treatment groups according to an intention-to-treat approach. Alongside the trial, a mixed-methods process evaluation is performed to understand the outcomes, evaluate therapist fidelity to the strategy, and detect barriers and facilitators in implementation. Limitations An important limitation of the study design is the inability to blind treating therapists to study allocation. Discussion The trial provides insight into the effectiveness and cost-effectiveness of the Coach2Move strategy compared with usual care. The process evaluation provides insight into influencing factors related to outcomes and implementation.

scholarly journals Resistance training improves mobility disability in community-dwelling older adults: a meta-analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 904-904
Author(s):  
Christina Prevett ◽  
Kevin Moncion ◽  
Stuart Phillips ◽  
Julie Richardson ◽  
Ada Tang
Keyword(s):  
Older Adults ◽  
Resistance Training ◽  
Physical Function ◽  
Gait Speed ◽  
Positive Impact ◽  
Community Dwelling ◽  
Mobility Disability ◽  
Exercise Interventions ◽  
Walking Capacity ◽  
Community Dwelling Older Adults

Abstract Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p<0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p<0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p<0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.

scholarly journals Management of Falls in Community-Dwelling Older Adults: Clinical Guidance Statement From the Academy of Geriatric Physical Therapy of the American Physical Therapy Association

2015 ◽  
Vol 95 (6) ◽  
pp. 815-834 ◽  
Author(s):  
Keith G. Avin ◽  
Timothy A. Hanke ◽  
Neva Kirk-Sanchez ◽  
Christine M. McDonough ◽  
Tiffany E. Shubert ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Fall Risk ◽  
Gap Analysis ◽  
Physical Therapists ◽  
Community Dwelling ◽  
Health Concern ◽  
Clinical Guidance ◽  
Practice Committee ◽  
Community Dwelling Older Adults

Background Falls in older adults are a major public health concern due to high prevalence, impact on health outcomes and quality of life, and treatment costs. Physical therapists can play a major role in reducing fall risk for older adults; however, existing clinical practice guidelines (CPGs) related to fall prevention and management are not targeted to physical therapists. Objective The purpose of this clinical guidance statement (CGS) is to provide recommendations to physical therapists to help improve outcomes in the identification and management of fall risk in community-dwelling older adults. Design and Methods The Subcommittee on Evidence-Based Documents of the Practice Committee of the Academy of Geriatric Physical Therapy developed this CGS. Existing CPGs were identified by systematic search and critically appraised using the Appraisal of Guidelines, Research, and Evaluation in Europe II (AGREE II) tool. Through this process, 3 CPGs were recommended for inclusion in the CGS and were synthesized and summarized. Results Screening recommendations include asking all older adults in contact with a health care provider whether they have fallen in the previous year or have concerns about balance or walking. Follow-up should include screening for balance and mobility impairments. Older adults who screen positive should have a targeted multifactorial assessment and targeted intervention. The components of this assessment and intervention are reviewed in this CGS, and barriers and issues related to implementation are discussed. Limitations A gap analysis supports the need for the development of a physical therapy–specific CPG to provide more precise recommendations for screening and assessment measures, exercise parameters, and delivery models. Conclusion This CGS provides recommendations to assist physical therapists in the identification and management of fall risk in older community-dwelling adults.

scholarly journals Making Geriatric Assessment Work: Selecting Useful Measures

2001 ◽  
Vol 81 (6) ◽  
pp. 1233-1252 ◽  
Author(s):  
Jessie M VanSwearingen ◽  
Jennifer S Brach
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Older People ◽  
Psychometric Properties ◽  
Physical Function ◽  
Physical Performance ◽  
Reliability And Validity ◽  
Community Dwelling ◽  
Frail Older People ◽  
Community Dwelling Older Adults

Abstract Often the goal of physical therapy is to reduce morbidity and prevent or delay loss of independence. The purpose of this article is to describe issues to consider when selecting measures of physical function for use with community-dwelling adults over the age of 65 years. We chose 16 measures of physical function for review because they have been used in studies of community-dwelling older adults and some psychometric properties of reliability and validity have been described in the literature. Three major issues are discussed: (1) appropriateness of the measure for community-dwelling older adults, (2) practical aspects of test administration, and (3) psychometric properties. These issues are illustrated using examples from the 16 measures. Two scenarios, applying the measures to the assessment of physical performance of community-dwelling well older people and to the assessment of physical performance of community-dwelling frail older people, are used to illustrate how this information can be used.

scholarly journals Exercise for falls prevention in community-dwelling older adults: trial and participant characteristics, interventions and bias in clinical trials from a systematic review

2019 ◽  
Vol 5 (1) ◽  
pp. e000663 ◽  
Author(s):  
Christopher A C M Ng ◽  
Nicola Fairhall ◽  
Geraldine Wallbank ◽  
Anne Tiedemann ◽  
Zoe A Michaleff ◽  
...  
Keyword(s):  
Older Adults ◽  
Tai Chi ◽  
Allocation Concealment ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Intervention Programme ◽  
Exercise Interventions ◽  
Participant Characteristics ◽  
Randomised Controlled ◽  
Community Dwelling Older Adults

IntroductionThere is strong evidence that exercise prevents falls in community-dwelling older people. This review summarises trial and participant characteristics, intervention contents and study quality of 108 randomised trials evaluating exercise interventions for falls prevention in community-dwelling older adults.MethodsMEDLINE, EMBASE, CENTRAL and three other databases sourced randomised controlled trials of exercise as a single intervention to prevent falls in community-dwelling adults aged 60+ years to May 2018.Results108 trials with 146 intervention arms and 23 407 participants were included. Trials were undertaken in 25 countries, 90% of trials had predominantly female participants and 56% had elevated falls risk as an inclusion criterion. In 72% of trial interventions attendance rates exceeded 50% and/or 75% of participants attended 50% or more sessions. Characteristics of the trials within the three types of intervention programme that reduced falls were: (1) balance and functional training interventions lasting on average 25 weeks (IQR 16–52), 39% group based, 63% individually tailored; (2) Tai Chi interventions lasting on average 20 weeks (IQR 15–43), 71% group based, 7% tailored; (3) programmes with multiple types of exercise lasting on average 26 weeks (IQR 12–52), 54% group based, 75% tailored. Only 35% of trials had low risk of bias for allocation concealment, and 53% for attrition bias.ConclusionsThe characteristics of effective exercise interventions can guide clinicians and programme providers in developing optimal interventions based on current best evidence. Future trials should minimise likely sources of bias and comply with reporting guidelines.

The Correlation Between the 2-Minute Step Test and Body Mass Index in Thai Community-Dwelling Older Adults

2021 ◽  
Vol 104 (9) ◽  
pp. 1483-1487
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Physical Therapy ◽  
Body Mass ◽  
Test Body ◽  
Normal Weight ◽  
Community Dwelling ◽  
Step Test ◽  
Elderly Subjects ◽  
Community Dwelling Older Adults

Objective: To determine and compare the 2-minute step test (2MST) scores among different body mass index (BMI) of elderly subjects and to predict the cardiorespiratory performance in community-dwelling older adults. Materials and Methods: Ninety subjects, aged 60 or older were assigned for cardiorespiratory performance using the 2MST. Results: There were significant differences in the 2MST scores among normal weight, overweight, and obese elders. The lowest score of the 2MST was found in obese elders when compared with normal weight and overweight elders. Moreover, BMI was negatively correlated with the 2MST (r=–0.83, p<0.05). Conclusion: Community-dwelling obese elders had decreased cardiorespiratory performance, and BMI was negatively correlated with cardiorespiratory performance in obese elders. Keywords: 2-minute step test; Body mass index; Elderly; Cardiorespiratory performance; Physical therapy

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