Medicine and Health Sciences Commons^™

Group Therapy For Adults With Hip Replacements, Riley Burford Mot/S, Hillary Talley Mot/S, Elizabeth Seals Mot/S, Alishah Pirwani Mot/S, Tylan Wakefield Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding the feasibility of group occupational therapy and outcomes related to ADL performance. The final portfolio contains a total of four research articles. Study designs include two randomized control trials, one cohort design, and one systematic review. All studies related directly to the PICO question and were used to determine best evidence for the feasibility of group therapy of the older adult population who have hip replacements in a rehabilitation setting.

Validity, Reliability, And Measurement Error Of A Sit-To-Stand Power Test In Older Adults: A Pre-Registered Study, Anoop T. Balachandran

Publications and Research

Objectives: Lower body power declines with age and is associated with decreased physical function in older adults. However, the majority of the tools available to measure power are expensive and require considerable space and expertise to operate. The purpose of this study was to assess the validity, reliability, and measurement error of a sit-to-stand power test (STSp) to assess lower body power. Methods: 51 community-dwelling adults, 65 years or older, completed a power test using a pneumatic leg press (LP), the Short Physical Performance Battery (SPPB) that includes a test of balance, usual walking speed, and chair stand tests; Timed …

Impact And Mortality Of Covid-19 On People Living With Dementia: Cross-Country Report, Aida Suárez-González, Gill Livingston, Lee Fay Low, Suzanne Cahill, Niamh Hennelly, Walter D. Dawson, Wendy Weidner, Martina Bocchetta, Cleusa P. Ferri, Jordi A. Matias-Guiu, Multiple Additional Authors

Institute on Aging Publications

This report brings together international evidence on the impact of the COVID-19 pandemic on people living with dementia and an overview of international policy and practice measures to mitigate the impact of COVID-19 among people living with dementia.

Key Findings

• We have collected data on impact and mortality of COVID-19 in people living with dementia in 9 countries: The United Kingdom (UK), Spain, Ireland, Italy, Australia, the United States (US), India, Kenya and Brazil.
• The share of people whose deaths were linked to COVID-19 in care homes who had dementia ranges from 29% to 75% across those countries. Within countries, …

Understanding The Context And Social Processes That Shape Person- And Family-Centered Culture In Long-Term Care: The Pivotal Role Of Personal Support Workers, Ellen Helena Melis

Antioch University Dissertations & Theses

This single, exemplar case study explored the context and social processes that shape person-and family-centered culture in a long-term care (LTC) home, using grounded theory and situational analysis for the data collection and analysis. Findings revealed one core dimension: needing to be heard, valued, and understood, and five key roles: personal support workers (PSWs), executive director (ED), senior leadership, nurse managers, and residents and families, which informed five dimensions, each focused on enhancing care for residents: (a) attending to residents’ daily care needs (PSWs), (b) advocating strategically (ED), (c) translating vision into programs and policies (senior leadership), (d) ensuring quality …

Is Technology The Key To Prevention Of Falls Among The Elderly In Rapidly Aging Societies? A Case Study Of Kunming, China, Phoebe Kiburi

Independent Study Project (ISP) Collection

As the aging society rapidly becomes more dominant in the world, there is a pressing need for different stakeholders to tend to the needs of the aging sufficiently. This is crucial in ensuring the robustness of the healthcare system as a whole; given that it can only be as strong as its weakest link. This study focuses on one of the areas of need of the ageing society: fall prevention.

Numerous studies have been done on interventions by the government, private entities, elderly people and their caregivers to prevent occurrence and recurrence of falls. However, most of these have been …

Strategies And Challenges Associated With Recruiting Retirement Village Communities And Residents Into A Group Exercise Intervention, Rachel L. Duckham, Jamie L. Tait, Caryl A. Nowson, Kerrie M. Sanders, Dennis R. Taaffe, Keith D. Hill, Robin M. Daly

Research outputs 2014 to 2021

BACKGROUND: Randomized controlled trials (RCTs) provide the highest level of scientific evidence, but successful participant recruitment is critical to ensure the external and internal validity of results. This study describes the strategies associated with recruiting older adults at increased falls risk residing in retirement villages into an 18-month cluster RCT designed to evaluate the effects of a dual-task exercise program on falls and physical and cognitive function.

METHODS: Recruitment of adults aged ≥65 at increased falls risk residing within retirement villages (size 60-350 residents) was initially designed to occur over 12 months using two distinct cohorts (C). Recruitment occurred via …

Frailty Screening And Case-Finding For Complex Chronic Conditions In Older Adults In Primary Care, Linda Lee, Tejal Patel, Loretta M. Hillier, Jason Locklin, James Milligan, John Pefanis, Andrew Costa, Joseph Lee, Karen Slonim, Lora Giangregorio, Susan Hunter, Heather Keller, Veronique Boscart

Publications and Scholarship

With the aging population, escalating demand for seniors’ care and limited specialist resources, new care delivery models are needed to improve capacity for primary health care for older adults. This paper describes the “C5-75” (Case-finding for Complex Chronic Conditions in Seniors 75+) program, an innovative care model aimed at identifying frailty and commonly associated geriatric conditions among older adults within a Canadian family practice setting and targeting interventions for identified conditions using a feasible, systematic, evidence-informed multi-disciplinary approach. We screen annually for frailty using gait speed and handgrip strength, screen for previously undiagnosed comorbid conditions, and offer frail older adults …

Frailty Screening And Case-Finding For Complex Chronic Conditions In Older Adults In Primary Care, Linda Lee, Tejal Patel, Loretta M. Hillier, Jason Locklin, James Milligan, John Pefanis, Andrew Costa, Joseph Lee, Karen Slonim, Lora Giangregorio, Susan Hunter, Heather Keller, Veronique Boscart

Publications and Scholarship

With the aging population, escalating demand for seniors’ care and limited specialist resources, new care delivery models are needed to improve capacity for primary health care for older adults. This paper describes the “C5-75” (Case-finding for Complex Chronic Conditions in Seniors 75+) program, an innovative care model aimed at identifying frailty and commonly associated geriatric conditions among older adults within a Canadian family practice setting and targeting interventions for identified conditions using a feasible, systematic, evidence-informed multi-disciplinary approach. We screen annually for frailty using gait speed and handgrip strength, screen for previously undiagnosed comorbid conditions, and offer frail older adults …

The Impact Of Sarcopenic Obesity On Inflammation, Lean Body Mass, And Muscle Strength In Elderly Women, Dahan Da Cunha Nascimento, Samuel Da Cunha Oliveira, Denis Cesar Leite Vieira, Silvana Schwerz Funghetto, Alessandro Oliveira Silva, Renato Valduga, Brad J. Schoenfeld, Jonato Prestes

Publications and Research

Objective: The objective of this study was to apply the newly standardized definition for sarcopenia from the Foundation for the National Institutes of Health (FNIH) and the current definition for obesity to 1) determine the prevalence of sarcopenic obesity (SO) in obese elderly women; 2) compare the muscle strength, lean body mass, and markers of inflammation between obese elderly women with SO and nonsarcopenic obesity (NSO), and 3) elucidate the relation- ship between appendicular lean mass adjusted for body mass index (aLM/BMI) with muscle strength, lean body mass, and obesity indices.

Methods: A total of 64 elderly obese women (age: …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Walking-Induced Fatigue Leads To Increased Risk In Older Adults, S. Morrison, S. R. Colberg, H. K. Parson, S. Neumann, R. Handel, E. J. Vinik, J. Paulson, A. I. Vinik

Rehabilitation Sciences Faculty Publications

Background- For older adults, falls are a serious health problem, with more than 30% of people older than 65 suffering a fall at least once a year. One element often overlooked in the assessment of falls is whether a person's balance, walking ability, and overall falls risk is affected by performing activities of daily living such as walking.

Objective- This study assessed the immediate impact of incline walking at a moderate pace on falls risk, leg strength, reaction time, gait, and balance in 75 healthy adults from 30 to 79 years of age. Subjects were subdivided into 5 equal groups …

The Effect Of Thermacare Heat Wraps On Balance And Mobility In Seniors With Impaired Gait - A Cross Over Study, Jerrold S. Petrofsky, Michael S. Laymon, Iman Akef Khowailed, Haneul Lee

College of Health & Human Services (TUN) Publications and Research

To examine if the use of heat at home can result in better quality and safer mobility in the elderly with gait and balance impairments.

Setting: Randomized longitudinal cross over study design in a clinical setting.

Methods: 20 people with impaired mobility (assessed as a score of more than 4 on the Stepping On questionnaire) were tested with a multi-camera gait analysis system, a treadmill with pressure sensors, a balance platform and the timed up and go and walking speed tests before and after using ThermaCare continuous heat wraps on their legs and knees for 6 days at 4 hours …

Identification Of Functional Parameters For The Classification Of Older Female Fallers And Prediction Of ‘First-Time’ Fallers, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Falls remain a challenge for ageing societies. Strong evidence indicates that a previous fall is the strongest single screening indicator for a subsequent fall and the need for assessing fall risk without accounting for fall history is therefore imperative. Testing in three functional domains (using a total 92 measures) were completed in 84 older women (60–85 years of age), including muscular control, standing balance, and mean and variability of gait. Participants were retrospectively classified as fallers (n = 38) or non-fallers (n = 42) and additionally in a prospective manner to identify first-time fallers (FTFs) (n = 6) within a …

Care In Specialist Medical And Mental Health Unit Compared With Standard Care For Older People With Cognitive Impairment Admitted To General Hospital: Randomised Controlled Trial (Nihr Team Trial), Sarah E. Goldberg, Lucy E. Bradshaw, Fiona C. Kearney, Catherine Russell, Kathy H. Whittamore, Pippa E R Foster, Jil Mamza, John R F Gladman, Rob G. Jones, Sarah A. Lewis, Davina Porock, Rowan H. Harwood

Publications and Research

Objective To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment.

Design Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system.

Setting Large acute general hospital in the United Kingdom.

Participants 600 patients aged over 65 admitted for acute medical care, identified as “confused” on admission.

Interventions Participants were randomised to a specialist medical and mental health unit, designed to deliver best practice care for people with delirium or dementia, or to standard care (acute geriatric or general medical wards). Features of …

Evaluation Of A Medical And Mental Health Unit Compared With Standard Care For Older People Whose Emergency Admission To An Acute General Hospital Is Complicated By Concurrent ‘Confusion’: A Controlled Clinical Trial. Acronym: Team: Trial Of An Elderly Acute Care Medical And Mental Health Unit, Rowan H. Harwood, Sarah E. Goldberg, Kathy H. Whittamore, Catherine Russell, John Rf Gladman, Rob G. Jones, Davina Porock, Sarah A. Lewis, Lucy E. Bradshaw, Rachel A. Elliot

Publications and Research

Background: Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences. We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period. Additional specialist mental health staff were employed, other staff were trained in the ‘person-centred’ dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers. We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and …

The Mds Mortality Risk Index: The Evolution Of A Method For Predicting 6-Month Mortality In Nursing Home Residents, Davina Porock, Debra Parker-Oliver, Gregory F. Petroski, Marilyn Rantz

Publications and Research

Background: Accurate prognosis is vital to the initiation of advance care planning particularly in a vulnerable, at risk population such as care home residents. The aim of this paper is to report on the revision and simplification of the MDS Mortality Rating Index (MMRI) for use in clinical practice to predict the probability of death in six months for care home residents.

Methods: The design was a secondary analysis of a US Minimum Data Set (MDS) for long term care residents using regression analysis to identify predictors of mortality within six months.

Results: Using twelve easy to collect …

Determinants Of Balance Confidence In Community-Dwelling Elderly People, Janine Hatch, Kathleen M. Gill-Body, Leslie G. Portney

All PTHMS Faculty Publications

Background and Purpose. The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study.

Subjects. The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (X̄=81.7, SD=6.7).

Methods. Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up & …