Integrating a Prevention Care Path into the Daily Life of Older Adults with Mobility Disability Risk: Introducing a Predictive Response Model to Exercise

Recent studies have shown balance recovery can be enhanced via task-specific training, referred to as perturbation-based balance training (PBT). These interventions rely on principles of motor learning where repeated exposure to task-relevant postural perturbations results in more effective compensatory balance responses. Evidence indicates that compensatory responses trained using PBT can be retained for many months and can lead to a reduction in falls in community-dwelling older adults. A notable shortcoming with PBT is that it does not transfer well to similar but contextually different scenarios (e.g., falling sideways versus a forward trip). Given that it is not feasible to train all conditions in which someone could fall, this limited transfer presents a conundrum; namely, how do we best use PBT to appropriately equip people to deal with the enormous variety of fall-inducing scenarios encountered in daily life? In this perspective article, we draw from fields of research that explore how general learning can be promoted. From this, we propose a series of methods, gleaned from parallel streams of research, to inform and hopefully optimize this emerging field where people receive training to specifically improve their balance reactions.

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Validation of IMU-based gait event detection during curved walking and turning in older adults and Parkinson’s Disease patients

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-021-00828-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Robbin Romijnders ◽

Elke Warmerdam ◽

Clint Hansen ◽

Julius Welzel ◽

Gerhard Schmidt ◽

...

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Daily Life ◽

Neurological Diseases ◽

Detection Performance ◽

Measurement Unit ◽

Straight Line ◽

Optical Motion ◽

Task Conditions

Abstract Background Identification of individual gait events is essential for clinical gait analysis, because it can be used for diagnostic purposes or tracking disease progression in neurological diseases such as Parkinson’s disease. Previous research has shown that gait events can be detected from a shank-mounted inertial measurement unit (IMU), however detection performance was often evaluated only from straight-line walking. For use in daily life, the detection performance needs to be evaluated in curved walking and turning as well as in single-task and dual-task conditions. Methods Participants (older adults, people with Parkinson’s disease, or people who had suffered from a stroke) performed three different walking trials: (1) straight-line walking, (2) slalom walking, (3) Stroop-and-walk trial. An optical motion capture system was used a reference system. Markers were attached to the heel and toe regions of the shoe, and participants wore IMUs on the lateral sides of both shanks. The angular velocity of the shank IMUs was used to detect instances of initial foot contact (IC) and final foot contact (FC), which were compared to reference values obtained from the marker trajectories. Results The detection method showed high recall, precision and F1 scores in different populations for both initial contacts and final contacts during straight-line walking (IC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%), slalom walking (IC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%), and turning (IC: recall $$\ge$$ ≥ 85%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 91%; FC: recall $$\ge$$ ≥ 84%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 89%). Conclusions Shank-mounted IMUs can be used to detect gait events during straight-line walking, slalom walking and turning. However, more false events were observed during turning and more events were missed during turning. For use in daily life we recommend identifying turning before extracting temporal gait parameters from identified gait events.

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The effect of exercise on quality of life and activities of daily life in frail older adults: A systematic review of randomised control trials

Experimental Gerontology ◽

10.1016/j.exger.2021.111287 ◽

2021 ◽

Vol 147 ◽

pp. 111287

Author(s):

Evan Campbell ◽

Fanny Petermann-Rocha ◽

Paul Welsh ◽

Carlos Celis-Morales ◽

Jill P. Pell ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Daily Life ◽

Frail Older Adults ◽

Activities Of Daily Life ◽

Randomised Control Trials

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Longitudinal Association Between Education and Disability in Older Adults Living in Iceland

Innovation in Aging ◽

10.1093/geroni/igaa057.1274 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 396-396

Author(s):

Milan Chang ◽

Olof Geirsdottir ◽

Lenore Launer ◽

Vilmundur Gudnasson ◽

Palmi Jonsson ◽

...

Keyword(s):

Older Adults ◽

Low Socioeconomic Status ◽

Late Life ◽

Mobility Disability ◽

College And University ◽

Disability Status ◽

Adl Disability ◽

And Gender ◽

Access To Medical Care ◽

Life Education

Abstract BACKGROUND: Disabilities among older adults are associated with cumulative adversities such as low socioeconomic status (SES), poor nutrition, and lack of access to medical care and education. However, there is little evidence on the long-term association between education and disability status among older adults in Iceland. The aim of the study was to examine the association between mid-life education and prevalence of disability in activities of daily living (ADL) and mobility disability in late-life using 25 years of longitudinal data. METHODS: A large community-based population residing in Reykjavik, Iceland participated in a longitudinal study with an average of 25 years of follow-up (N=5764, mean age 77±6 yrs, 57.7% of women) Mid-life education was categorized into 2 groups (primary and secondary versus college and university). Disability status in late life was defined with ADL and mobility disability with a binary outcome (no difficulty versus any difficulty). Logistic regression analysis was used to examine the association. RESULTS: After controlling for age and gender, and midlife health risk factors, those who had high education at mid-life were less likely to have ADL disability (Odds Ratio (OR) = 0.75, 95% Confidence Interval (CI): 0.64 ~ 0.88, P ≤ 0.001) and mobility disability (OR = 0.72, 95% CI: 0.61 ~ 0.86, P < 0.001) compared with those who had low education in mid-life. CONCLUSION: People with high mid-life education were less likely to have ADL and mobility disability after 25 years later.

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Declining energy predicts incident mobility disability and mortality risk in healthy older adults

Journal of the American Geriatrics Society ◽

10.1111/jgs.17372 ◽

2021 ◽

Author(s):

Briana N. Sprague ◽

Xiaonan Zhu ◽

Rebecca C. Ehrenkranz ◽

Qu Tian ◽

Theresa A. Gmelin ◽

...

Keyword(s):

Older Adults ◽

Mortality Risk ◽

Mobility Disability ◽

Healthy Older Adults

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Identification of Research Trends in Aging in Place Using Text Mining Analysis

Innovation in Aging ◽

10.1093/geroni/igaa057.163 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 50-50

Author(s):

Ha Neul Kim ◽

Seok In Nam

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Text Mining ◽

Independent Living ◽

Daily Life ◽

Aging In Place ◽

Research Trends ◽

Life Activity ◽

Daily Life Activity

Abstract Since 1980s professionals and social service providers have focused on aging at the place where people lived. This is the initial concept of the Aging in Place (AIP). Over 40 years, the topics have developed and extended to other disciplines welcoming different perspectives in the study of AIP. Therefore, this study aims to understand the overall research trends in Aging in Place (AIP) studies using text mining analysis to track the evolvement of AIP subtopics not only in Gerontology but also in various fields. To identify the topic trends, we collected the titles, abstracts, and keywords from 1,372 international articles that were published from 1981 to 2019. Then, keywords were extracted and cleaned based on precedent literature and discussions. We analyzed the keywords based on the degree of centrality and visualized the keyword-networks using VOSviewer and Pajek. Top-most popular keywords are “independent living”, “housing”, “older adults”, “home care”, “daily life activity” and “quality of life.” The change in topic trends shows that in the 1980s to early-2000s, research focused on organization and management level of intervention, home(housing) for the older adults, long term care. In the mid-2010s, health-related topics such as daily life activity, health service, health care delivery and quality of life have emerged. Recently, the topics have extended further to technology, caregiver, well-being, and environment design, environmental planning that support independent living of oneself. The research result shows that the interdisciplinary approach regarding AIP is not only inevitable but also encouraged for an in-depth discussion of the field.

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Environmental Demands Associated With Community Mobility in Older Adults With and Without Mobility Disabilities

Physical Therapy ◽

10.1093/ptj/82.7.670 ◽

2002 ◽

Vol 82 (7) ◽

pp. 670-681 ◽

Cited By ~ 191

Author(s):

Anne Shumway-Cook ◽

Aftab E Patla ◽

Anita Stewart ◽

Luigi Ferrucci ◽

Marcia A Ciol ◽

...

Keyword(s):

Older Adults ◽

Weather Conditions ◽

Grocery Store ◽

Fisher Exact Test ◽

Ambient Conditions ◽

Mobility Disability ◽

Exact Test ◽

Mobility Function ◽

Community Mobility ◽

Trip Frequency

Abstract Background and Purpose. In this study, the influence of 8 dimensions of the physical environment on mobility in older adults with and without mobility disability was measured. This was done in order to identify environmental factors that contribute to mobility disability. Subjects. Subjects were 36 older adults (≥70 years of age) who were recruited from 2 geographic sites (Seattle, Wash, and Waterloo, Ontario, Canada) and were grouped according to level of mobility function (physically able [ability to walk ½ mile (0.8 km) or climb stairs without assistance], physically disabled). Methods. Subjects were observed and videotaped during 3 trips into the community (trip to grocery store, physician visit, recreational trip). Frequency of encounters with environmental features within each of the 8 dimensions was recorded. Differences in baseline characteristics and environmental encounters were analyzed using an analysis of variance or the Fisher exact test, as appropriate. Results. Mobility disability among older adults was not associated with a uniform decrease in encounters with environmental challenges across all dimensions. Environmental dimensions that differed between subjects who were physically able and those with physical disability included temporal factors, physical load, terrain, and postural transition. Dimensions that were not different included distance, density, ambient conditions (eg, light levels and weather conditions), and attentional demands. Discussion and Conclusion. Understanding the relationship of the environment to mobility is crucial to both prevention and rehabilitation of mobility disability in older adults. Among older adults, certain dimensions of the environment may disable community mobility more than others.

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A mixed reality cognitive orthosis to support older adults in achieving their daily living activities: perspective from stakeholders (Preprint)

10.2196/preprints.34983 ◽

2021 ◽

Author(s):

Amel Yaddaden ◽

Guillaume Spalla ◽

Charles Gouin-Vallerand ◽

Patty Semeniuk ◽

Nathalie Bier

Keyword(s):

Older Adults ◽

Focus Groups ◽

Neurodegenerative Disorders ◽

Daily Living ◽

Mixed Reality ◽

Daily Life ◽

User Centered Design ◽

Daily Living Activities ◽

Effective Interventions ◽

Head Mounted Displays

BACKGROUND Mixed reality is an emerging technology allowing to "blend" virtual objects in the actual user's environment. A way to realize this is by using head-mounted displays. Many recent studies have suggested the possibility of using this technology to support the cognition of people with neurodegenerative disorders. However, most studies explored improvements in cognition rather than in independence and safety during the accomplishment of daily living activities. It is therefore crucial to document the possibility of using mixed reality to support the independence of older adults in their daily life. OBJECTIVE This study is part of a larger user-centered design study of a cognitive orthosis using pure mixed reality to support independence of people living with neurodegenerative disorders (NDs). The objectives were to explore: (1) What are the main difficulties encountered by older adults with NDs in their daily life to ensure that the pure mixed reality meets their needs; (2) What are the most effective interventions with this population in order to determine what types of assistance should be given by the pure mixed reality technology; (3) How should the pure mixed reality technology provide assistance to promote safety and independence at home; and (4) What are the main facilitators and barriers for the use of this technology. METHODS We conducted a descriptive qualitative study with 5 focus groups with experts of the disease and its functional impacts (n = 29) to gather information. Qualitative data from the focus groups was analyzed through an inductive thematic analysis. RESULTS The themes emerging from the analysis will provide clear guidelines to the development team prototyping a first version of a cognitive orthosis based on pure mixed reality. CONCLUSIONS The cognitive orthosis that will be developed in the light of this study will act as a proof of concept of the possibility of supporting people with neurodegenerative disorders using pure mixed reality.

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