scholarly journals Extended Exercise Rehabilitation After Hip Fracture Improves Patients' Physical Function: A Systematic Review and Meta-Analysis

2012 ◽  
Vol 92 (11) ◽  
pp. 1437-1451 ◽  
Author(s):  
Mohammad A. Auais ◽  
Owis Eilayyan ◽  
Nancy E. Mayo
Keyword(s):  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Physical Function ◽  
Hip Fractures ◽  
Gait Speed ◽  
Daily Living ◽  
Meta Analysis ◽  
Rehabilitation Program ◽  
Community Dwelling ◽  
Exercise Rehabilitation

BackgroundAlthough the principal goal of hip fracture management is a return to the pre-event functional level, most survivors fail to regain their former levels of autonomy. One of the most effective strategies to mitigate the fracture's consequences is therapeutic exercise.PurposeThe purpose of this study was to review and quantify the reported effects of an extended exercise rehabilitation program offered beyond the regular rehabilitation period on improving physical functioning for patients with hip fractures.SourcesThe Cochrane libraries, PubMed, CINAHL, PEDro, and EMBASE were searched to April 2012.Study SelectionAll randomized controlled trials comparing extended exercise programs with usual care for community-dwelling people after hip fracture were included in the review.Data Extraction and SynthesisTwo reviewers conducted each step independently. The data from the included studies were summarized, and pooled estimates were calculated for 11 functional outcomes.ResultsThirteen trials were included in the review and 11 in the meta-analysis. The extended exercise program showed modest effect sizes (ESs), which reached significance, under random theory, for knee extension strength for the affected and nonaffected sides (ES=0.47, 95% confidence interval [CI]=0.27–0.66, and ES=0.45, 95% CI=0.16–0.74, respectively), balance (ES=0.32, 95% CI=0.15–0.49), physical performance-based tests (ES=0.53, 95% CI=0.27–0.78), Timed “Up & Go” Test (ES=0.83, 95% CI=0.28–1.4), and fast gait speed (ES=0.42, 95% CI=0.11–0.73). Effects on normal gait speed, Six-Minute Walk Test, activities of daily living and instrumental activities of daily living, and physical function subscale of the 36-Item Short-Form Health Survey (SF-36-PF) did not reach significance. Community-based programs had larger ESs compared with home-based programs.ConclusionsTo the authors' knowledge, this is the first meta-analysis to provide evidence that an extended exercise rehabilitation program for patients with hip fractures has a significant impact on various functional abilities. The focus of future research should go beyond just effectiveness and study the cost-effectiveness of extended programs.

scholarly journals Identifying Early Decline of Physical Function in Community-Dwelling Older Women: Performance-Based and Self-Report Measures

2002 ◽  
Vol 82 (4) ◽  
pp. 320-328 ◽  
Author(s):  
Jennifer S Brach ◽  
Jessie M VanSwearingen ◽  
Anne B Newman ◽  
Andrea M Kriska
Keyword(s):  
Activities Of Daily Living ◽  
Physical Function ◽  
Older Women ◽  
Gait Speed ◽  
Daily Living ◽  
Performance Test ◽  
Social Activity ◽  
Community Dwelling ◽  
Self Report ◽  
Functional Status Questionnaire

Abstract Background and Purpose. The ability to identify early decline in physical function is important, but older people experiencing decline may fail to report the early changes in physical function. The purpose of this study was to compare the descriptions of physical function in community-dwelling older women obtained using performance-based and self-report measures. Subjects and Methods. One hundred seventy community-dwelling women with a mean age of 74.3 years (SD=4.3, range=56.6–83.6) completed the activities of daily living (ADL), instrumental activities of daily living (IADL), and social activity (SA) sections of the Functional Status Questionnaire (FSQ). They also completed performance-based measures of gait speed and the 7-item Physical Performance Test (PPT). Results. The majority of the women scored at the ceiling for the self-report measures of function (ADL=77%, IADL=61%, SA=94%), whereas only 7% scored at the ceiling for the PPT and 30% scored at the ceiling for gait speed (defined as >1.2 m/s). For 2 items of the FSQ, sensitivity was low (8% and 9%) and specificity was high (97% and 98%) compared with performance on the PPT. Discussion and Conclusion. In this sample of community-dwelling older women, performance-based measures identified more limitations in physical function than did self-report measures.

MO612THE ROLE OF MECHANICAL MUSCLE POWER IN PHYSICAL DYSFUNCTION: A MODEL FOR TAILORING RESISTANCE-BASED REHABILITATION IN CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Thomas Wilkinson ◽  
Eleanor Gore ◽  
Jared Palmer ◽  
Luke Baker ◽  
Emma Watson ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Strength Training ◽  
Physical Function ◽  
Muscle Mass ◽  
Gait Speed ◽  
Daily Living ◽  
Muscle Power ◽  
Mechanical Power ◽  
Relative Power

Abstract Background and Aims Individuals living with CKD are characterised by adverse changes in physical function. Knowledge of the factors that mediate impairments in physical functioning is crucial for developing effective interventions that preserve mobility and future independence. Mechanical muscle power describes the rate of performing work and is the product of muscular force and velocity of contraction. Muscle power has been shown to have stronger associations with functional limitations and mortality than sarcopenia in older adults. In CKD, the role of mechanical muscle power is poorly understood and is overlooked as a target in many rehabilitation programmes, often at the expense of muscle mass or strength. The aims of this study were to 1) explore the prevalence of low absolute mechanical power, low relative mechanical power, and low specific mechanical power in CKD; and 2) investigate the association of mechanical power with the ability to complete activities of daily living and physical performance. Method Mechanical muscle power (relative, allometric, specific) was calculated using the sit-to-stand-5 (STS5) test as per previously validated equations. Legs lean mass was derived from regional analyses conducted using bioelectrical impedance analysis (BIA). Physical performance was assessed using two objective tests: usual gait speed and the ‘time-up-and-go’ (TUAG) test. Self-reported activities of daily living (ADLs) were assessed via the Duke Activity Status Index (DASI). Balance and postural stability (postural sway and velocity) was assessed using a FysioMeter. Sex-specific tertiles were used to determine low, medium and high levels of relative STS power and its main components. Results 102 participants with non-dialysis CKD were included (mean age: 62.0 (±14.1) years, n=49 males (48%), mean eGFR: 38.0 (±21.5) ml.min.1.73m2). The mean estimated relative power was 3.1 (±1.5) W.kg in females and 3.3 (±1.3) W.kg in males. Low relative power was found in 35/102 (34%) patients. Relative power was a significant independent predictor of self-reported ADLs (via the DASI) (B=.413, P=.004), and performance on the TUAG (B=-.719, P<.001) and gait speed (B=.404, P=.003) tests. Skeletal muscle mass was not associated with the DASI or any of the objective function tests Conclusion Patients presenting with low muscle power would benefit from participation in appropriate interventions designed to improve the physiological components accounting for low relative muscle power. Assessment of power can be used to tailor renal rehabilitation programmes as shown in Figure 1. Incorporation of power-based training, a novel type of strength training, designed by manipulating traditional strength training variables and primarily movement velocity and training intensity may present the best strategy for improving physical function in CKD.

scholarly journals Developing an individualised cross-sectoral programme based on activities of daily living to support rehabilitation of older adults with hip fracture: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044539
Author(s):  
Alice Ropke ◽  
Karina Lund ◽  
Camilla Thrane ◽  
Carsten Juhl ◽  
Anne-Le Morville
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Qualitative Study ◽  
Activities Of Daily Living ◽  
Hip Fractures ◽  
Daily Living ◽  
Research Council ◽  
Healthcare Professionals ◽  
Rehabilitation Programme ◽  
Trial Registration

ObjectivesTo develop an individualised rehabilitation programme for personal and instrumental activities of daily living (ADL) tasks, enabling older adults with hip fractures to perform ADL safely and independently.DesignQualitative study inspired by the complex intervention development (Medical Research Council framework phase I) using literature search and research circles.SettingsUniversity Hospital of Copenhagen, Herlev and Gentofte, and Herlev and Gentofte municipalities.ParticipantsOne research circle with seven older adults with hip fractures, and one with seven healthcare professionals (occupational therapists and physiotherapists).ResultsThree generic categories were identified: (1) ‘Challenge older adults with goal-oriented ADL tasks’, (2) ‘Implement strategies to enhance independent and safe performance of ADL tasks’, and (3) ‘Communicate the important information to the target group and across sectors’. A programme was developed and an intervention to enhance usual rehabilitation was designed comprising: an individualised intervention component consisting of five additional therapy sessions; one during hospitalisation, four in the municipality and a follow-up phone call.ConclusionsEngaging and integrating activities into rehabilitation treatment may support rehabilitation. Our study highlighted the need for setting individual goals and challenging older adults with hip fracture by providing guidance in strategies to enhance safe and independent performance of ADL tasks. Furthermore, the need for providing older adults with hip fracture and healthcare professionals with written and oral information about goal setting during the transitional rehabilitation phase was emphasised. Including the perspectives of older adults with hip fracture and healthcare professionals added value to the rehabilitation, and thus ensured an adequate, tangible and implementable rehabilitation programme.Trial registration numberThis article is the first of three articles inspired by Medicial Research Council guidelines. The next study is a feasibility study with the trial registration: ClinicalTrials.gov ID: NCT03828240. The results are right now being written in article. The third study is a randomised controlled trial with the trial registration: ClinicalTrials.gov ID: NCT04207788; Pre-results.

scholarly journals Physical Impairment and Disability: Relationship to Performance of Activities of Daily Living in Community-Dwelling Older Men

2002 ◽  
Vol 82 (8) ◽  
pp. 752-761 ◽  
Author(s):  
Jennifer S Brach ◽  
Jessie M VanSwearingen
Keyword(s):  
Activities Of Daily Living ◽  
Physical Function ◽  
Daily Living ◽  
Muscle Force ◽  
Older Men ◽  
Community Dwelling ◽  
Physical Impairment ◽  
Physical Impairments ◽  
Relationship Of ◽  
The Relationship

Abstract Background and Purpose. The decline of physical function of older adults, associated with loss of independent living status, is a major public health concern. The purpose of this study was to examine the relationship of physical impairment and disability to performance of activities of daily living (ADL) among community-dwelling older adults. Subjects and Methods. Eighty-three community-dwelling older men who were referred to a comprehensive outpatient geriatric evaluation program (mean age=75.5 years, SD=7.0, range=64–97) were examined. Measurements of physical impairment (muscle force production, flexibility, and fitness) and physical disability (gait speed, stride length, risk for recurrent falls, and physical function) were recorded. Results. A stepwise linear regression was used to determine the relationship of physical impairments and disability measures with ADL. The results indicated that walking speed, fall risk, and muscle force contributed independently to the characterization of the activities of daily living of the community-dwelling older men studied (adjusted R2=.68; F=56.81; df=3,80; P<.001). Using a principal components factor analysis, 4 domains were identified that explained 68.2% of the variance in performance of ADL: (1) mobility/fall risk=26.5%, (2) coordination=15%, (3) fitness=14.7%, and (4) flexibility=12.0%. Discussion and Conclusion. The identification of domains of physical function may be useful to physical therapists in the development of interventions targeted for physical impairments and disabilities that contribute to deficits in performance of ADL. Targeting interventions for physical impairments and disabilities related to function may improve the effectiveness of physical therapist interventions and reduce the loss of independence among community-dwelling older people.

Standardised Assessment: A Comparison of the Community Dependency Index and the Barthel Index with an Elderly Hip Fracture Population

1998 ◽  
Vol 61 (3) ◽  
pp. 121-126 ◽  
Author(s):  
Gillian Ward ◽  
Fiona Macaulay ◽  
Carol Jagger ◽  
William Harper
Keyword(s):  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Elderly People ◽  
Barthel Index ◽  
Daily Living ◽  
Outcome Measure ◽  
Community Dwelling ◽  
Fracture Population ◽  
Two Measures ◽  
Dependency Index

The Community Dependency Index (CDI) is a standardised outcome measure of independence in self-care activities, based upon the Barthel Index, for the assessment of disabled and elderly people living in the community. The operational definitions take account of the influence that the environment has on a person's ability to carry out activities of daily living. This paper reports the results of a longitudinal study of two groups of community-dwelling elderly people who had sustained a hip fracture. The inter-rater reliability of the CDI was assessed, the agreement between the CDI and the Barthel Index was assessed and the sensitivity to change over time of the two measures was compared. The CDI was found to be equally as sensitive to a change in overall scores as the Barthel Index but tended to give lower scores. This trend has important implications for its use as an outcome measure of independence in activities of daily living following trauma.

scholarly journals อุปกรณ์ช่วยสำหรับกิจวัตรประจำวันในผู้สูงอายุหลังกระดูกสะโพกหัก

2021 ◽  
Vol 14 (4) ◽  
pp. 74-80
Author(s):  
Panintorn Konggateyai ◽  
Vipavee Thanapatiwat ◽  
Piyapat Dajpratham ◽  
Wasana Anuja
Keyword(s):  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Hip Fractures ◽  
Daily Living ◽  
The Elderly ◽  
Electrical Control ◽  
Self Confidence ◽  
Control Devices

Hip fractures are more common in the elderly.  After surgery,  the elderly have limitations in doing various activities, especially Activities of Daily Living (ADLs). Adaptive devices are used to assist in completing ADLs after surgery such as a long sponge stick used to prevent bending over while showering, dressing stick, shoehorn, etc. Besides, adaptive devices can increase self-confidence, safety and reduce anxiety among patients and caregivers. Nowadays, adaptive devices are easy to buy at an inexpensive price. Also, there are the innovations of adaptive devices that facilitate the patient to do the activities of daily living such as home electrical control devices, and the proactive innovation that reduces the incidence of hip fracture.

scholarly journals Impacts of stroke and cognitive impairment on activities of daily living in the Taiwan longitudinal study on aging

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pi-Hsia Lee ◽  
Ting-Ting Yeh ◽  
Hsin-Yen Yen ◽  
Wan-Ling Hsu ◽  
Valeria Jia-Yi Chiu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Longitudinal Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Skill Training ◽  
Community Dwelling ◽  
Combined Effects ◽  
Stroke Group ◽  
The Individual ◽  
Community Dwelling Older Adults

AbstractStroke and cognitive impairment are common in older population. They often occur together and their combined effects significantly increase disability in both basic (BADLs) and instrumental (IADLs) activities of daily living. We investigated the individual and combined impacts of stroke and cognitive impairment on BADLs and IADLs. A total of 3331 community-dwelling older adults were enrolled from the Taiwan longitudinal study on aging in 2011. Both BADLs and IADLs were analyzed. Combination of stroke and cognitive impairment increased severity of ADL disabilities, but similar prevalence, similar numbers of summed BADL and IADL tasks with disability, and similar levels of difficulty for each BADL and IADL task were found between the stroke group and cognitive impairment group. The former had more difficult in dressing while the latter had more difficult in using the telephone, transport, and managing finances. A hierarchy of ADLs was also observed in all groups. ADL skill training supplemented with cognitive and physical interventions should focus on secondary prevention of dementia and improve motor functional capacity to reduce loss of ADLs.

scholarly journals Technology Used to Recognize Activities of Daily Living in Community-Dwelling Older Adults

2020 ◽  
Vol 18 (1) ◽  
pp. 163
Author(s):  
Nicola Camp ◽  
Martin Lewis ◽  
Kirsty Hunter ◽  
Julie Johnston ◽  
Massimiliano Zecca ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Wearable Technology ◽  
Community Dwelling ◽  
Use Of Technology ◽  
Key Stakeholders ◽  
Environmental Technologies ◽  
Current Monitoring ◽  
Future Work

The use of technology has been suggested as a means of allowing continued autonomous living for older adults, while reducing the burden on caregivers and aiding decision-making relating to healthcare. However, more clarity is needed relating to the Activities of Daily Living (ADL) recognised, and the types of technology included within current monitoring approaches. This review aims to identify these differences and highlight the current gaps in these systems. A scoping review was conducted in accordance with PRISMA-ScR, drawing on PubMed, Scopus, and Google Scholar. Articles and commercially available systems were selected if they focused on ADL recognition of older adults within their home environment. Thirty-nine ADL recognition systems were identified, nine of which were commercially available. One system incorporated environmental and wearable technology, two used only wearable technology, and 34 used only environmental technologies. Overall, 14 ADL were identified but there was variation in the specific ADL recognised by each system. Although the use of technology to monitor ADL of older adults is becoming more prevalent, there is a large variation in the ADL recognised, how ADL are defined, and the types of technology used within monitoring systems. Key stakeholders, such as older adults and healthcare workers, should be consulted in future work to ensure that future developments are functional and useable.

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