-
Archives of Physical Medicine and... May 2023
Topics: Humans; Aged; Mobility Limitation; Cross-Sectional Studies
PubMed: 36724836
DOI: 10.1016/j.apmr.2023.01.006 -
International Journal of Older People... Sep 2018The aim of this integrative review of the literature was to evaluate and summarise current research about how nurses maintain and improve hospitalised older peoples'... (Review)
Review
AIM
The aim of this integrative review of the literature was to evaluate and summarise current research about how nurses maintain and improve hospitalised older peoples' mobility levels.
BACKGROUND
Older persons make up the majority of healthcare recipients, and they are at risk to experience significant decline in their mobility once hospitalised. This can result in longer hospitalisations or nursing home admissions. Currently, it is not well understood how nurses maintain and restore mobility of hospitalised older persons.
DESIGN
An integrative literature review using key concepts related to hospitalised older people, mobility and nursing care was conducted. Whittemore and Khalf's five-stage methodological framework for integrative reviews was utilised.
METHODS
Two reviewers screened 1640 resources from four computerised databases published in English during 2000-2017. Reviewers used the Mixed Methods Appraisal Tool (MMAT) and CASP quality appraisal tools to assess the thirteen included articles.
RESULTS
The findings of this review reveal that little is known about how frequently nurses are mobilising, that many nurses perceive mobilising older patients to be physiotherapy's responsibility and that education about mobilisation can improve nurses' willingness to mobilise people.
CONCLUSION
By investing in education and training programmes targeted for nurses, nurses can feel empowered in their ability to mobilise patients and are encouraged to take ownership of their patient's functional needs. In order to facilitate mobility, adequate staffing levels are necessary for transferring and ambulation, mobility assistive devices such as walkers and canes and environments with adequate space to mobilise. More research is needed to better understand and overcome barriers that nurses face in mobilised older people in acute care.
IMPLICATIONS FOR PRACTICE
The nursing team can work together to prioritise mobilisation to assist in restoring and maintaining the function of hospitalised older people. Educators could review their mobility programmes to increase graduate nurses' confidence and self-efficacy in mobility assessments and thus prepare graduate nurses for the realities of practice.
Topics: Hospitalization; Humans; Mobility Limitation; Nurse's Role; Nursing Staff, Hospital; Orthopedic Equipment; Walking
PubMed: 29770560
DOI: 10.1111/opn.12200 -
PM & R : the Journal of Injury,... Jan 2017Individuals with central nervous system injuries are a large and apparently rapidly expanding population-as suggested by 2013 statistics from the American Heart... (Review)
Review
Individuals with central nervous system injuries are a large and apparently rapidly expanding population-as suggested by 2013 statistics from the American Heart Association. Increasing survival rates and lifespans emphasize the need to improve the quality of life for this population. In persons with central nervous system injuries, mobility limitations are among the most important factors contributing to reduced life satisfaction. Decreased mobility and subsequently reduced overall activity levels also contribute to lower levels of physical health. Braces to assist walking are options for greater-functioning individuals but still limit overall mobility as the result of increased energy expenditure and difficulty of use. For individuals with greater levels of mobility impairment, wheelchairs remain the preferred mobility aid yet still fall considerably short compared with upright bipedal walking. Furthermore, the promise of functional electrical stimulation as a means to achieve walking has yet to materialize. None of these options allow individuals to achieve walking at speeds or levels comparable with those seen in individuals with unimpaired gait. Medical exoskeletons hold much promise to fulfill this unmet need and have advanced as a viable option in both therapeutic and personal mobility state, particularly during the past decade. The present review highlights the major developments in this technology, with a focus on exoskeletons for lower limb that may encompass the spine and that aim to allow independent upright walking for those who otherwise do not have this option. Specifically reviewed are powered exoskeletons that are either commercially available or have the potential to restore upright walking function. This paper includes a basic description of how each exoskeleton device works, a summation of key features, their known limitations, and a discussion of current and future clinical applicability.
Topics: Energy Metabolism; Exoskeleton Device; Humans; Lower Extremity; Mobility Limitation; Quality of Life; Trauma, Nervous System; Walking
PubMed: 27565639
DOI: 10.1016/j.pmrj.2016.07.534 -
Zeitschrift Fur Gerontologie Und... Feb 2019
Topics: Aged; Aged, 80 and over; Humans; Mobility Limitation; Range of Motion, Articular; Walking
PubMed: 30701296
DOI: 10.1007/s00391-018-01490-3 -
Physiotherapy Research International :... Jan 2018Since physical inactivity is the major risk factor for recurrent stroke, it is important to understand how level of disability impacts oxygen uptake by people after...
BACKGROUND AND PURPOSE
Since physical inactivity is the major risk factor for recurrent stroke, it is important to understand how level of disability impacts oxygen uptake by people after stroke. This study investigated the nature of the relationship between level of disability and oxygen cost in people with chronic stroke.
METHODS
Level of walking disability was measured as comfortable walking speed using the 10-m Walk Test reported in m/s with 55 ambulatory people 2 years after stroke. Oxygen cost was measured during 3 walking tasks: overground walking at comfortable speed, overground walking at fast speed, and stair walking at comfortable speed. Oxygen cost was calculated from oxygen uptake divided by distance covered during walking and reported in ml∙kg ∙m .
RESULTS
The relationship between level of walking disability and oxygen cost was curvilinear for all 3 walking tasks. One quadratic model accounted for 81% (95% CI [74, 88]) of the variance in oxygen cost during the 3 walking tasks: [Formula: see text] DISCUSSION: The oxygen cost of walking was related the level of walking disability in people with chronic stroke, such that the more disabled the individual, the higher the oxygen cost of walking; with oxygen cost rising sharply as disability became severe. An equation that relates oxygen cost during different walking tasks according to the level of walking disability allows clinicians to determine oxygen cost indirectly without the difficulty of measuring oxygen uptake directly.
Topics: Aged; Energy Metabolism; Female; Humans; Male; Middle Aged; Mobility Limitation; Oxygen; Oxygen Consumption; Stroke; Walk Test; Walking
PubMed: 28671315
DOI: 10.1002/pri.1688 -
The Gerontologist Dec 2015Optimal mobility is an important element of healthy aging. Yet, older adults' perceptions of mobility and mobility preservation are not well understood. The purposes of... (Meta-Analysis)
Meta-Analysis Review
PURPOSE OF THE STUDY
Optimal mobility is an important element of healthy aging. Yet, older adults' perceptions of mobility and mobility preservation are not well understood. The purposes of our study were to (a) identify studies that report older adults' perceptions of mobility, (b) conduct a standardized methodological quality assessment, and (c) conduct a metasynthesis of the identified studies.
DESIGN AND METHODS
We included studies with community-dwelling adults aged ≥65 years, focused on perceptions of mobility pertaining to everyday functioning, used qualitative methods, and were cited in PubMed, Embase, CINAHLPlus, or Geobase databases. Study quality was appraised using the McMaster University Tool.
RESULTS
Out of 748 studies identified, 12 met inclusion criteria. Overall quality of the studies was variable. Metasynthesis produced 3 overarching themes: (a) mobility is part of sense of self and feeling whole, (b) assisted mobility is fundamental to living, and (c) adaptability is key to moving forward.
IMPLICATIONS
Older adults' perceptions of mobility can inform interventions that would involve actively planning for future mobility needs and enhance the acceptance of the changes, both to the older adult and the perceived response to changes by those around them.
Topics: Aged; Aging; Health Status; Humans; Mobility Limitation; Perception; Qualitative Research
PubMed: 24637252
DOI: 10.1093/geront/gnu014 -
International Journal of Environmental... Feb 2023The phenomenon of ageing may contribute to the rise of the dependent population. Due to the obstacles and difficulties they confront, the elderly's mobility decreases... (Review)
Review
The phenomenon of ageing may contribute to the rise of the dependent population. Due to the obstacles and difficulties they confront, the elderly's mobility decreases significantly. The aim of this article is to identify factors associated with mobility barriers in older adults. The method employed is an examination of articles published between 2011 and 2022 to identify common themes in previous studies. Four search engines were being used, and 32 articles have been included. This study demonstrated that health is a major factor associated with decreased mobility. This review identified four types of barriers which are health, built environment, socio-economic background and social relation change. This review could help policy makers and gerontologist in identifying solutions to resolve the mobility issues in older people.
Topics: Aged; Humans; Aging; Mobility Limitation
PubMed: 36901256
DOI: 10.3390/ijerph20054243 -
Nursing Open Apr 2023Analysis of the concepts and development of a conceptual definition of being wheelchair-bound and being bedridden.
AIM
Analysis of the concepts and development of a conceptual definition of being wheelchair-bound and being bedridden.
DESIGN
Concept analysis.
METHODS
Walker and Avant´s concept analysis method was used. A thematic analysis guided the determination of the attributes, antecedents and consequences.
RESULTS
Being wheelchair-bound and being bedridden are defined as permanent states in which people are bound to an object. Being passively bound to a wheelchair and being bedridden both mean an increasing restriction of the life-space. Being passive wheelchair-bound often represents a preliminary stage to being bedridden. Both concepts have six attributes: in need of help, powerlessness, life-space confinement, mobility limitation, endurance and weakness. They differ in the main feature maintaining an independent sitting position. Physical immobility and physiological instability are antecedents with the following influencing factors: illness, complexity, burden, endogenous/exogenous booster. The consequences are the progression of inactivity and all related physical and psycho-social problems.
Topics: Humans; Wheelchairs; Mobility Limitation; Frailty; Nutritional Status
PubMed: 36336822
DOI: 10.1002/nop2.1455 -
The Journals of Gerontology. Series A,... Aug 2023Early change in function in older adults has been termed preclinical disability (PCD). PCD has been understudied compared to other stages of disability because it is... (Review)
Review
BACKGROUND
Early change in function in older adults has been termed preclinical disability (PCD). PCD has been understudied compared to other stages of disability because it is unlikely to receive comparative priority in clinical settings. It has major implications for prevention and population health as it may be the optimal time to intervene to prevent further decline. A standardized approach to research in PCD, including a common definition and measurement approaches, is needed to advance this work.
METHODS
The process to establish how PCD should be defined and measured was undertaken in 2 stages: (1) a scoping review of the literature, which was used to inform (2) a web-enabled consensus meeting with content experts.
RESULTS
The scoping review and the consensus meeting support the use of the term preclinical mobility limitation (PCML) and that it should be measured using both patient-reported and performance-based measures. It was agreed that the definition of PCML should include modification of frequency and/or method of task completion, without overt disability, and that requisite mobility tasks include walking (distance and speed), stairs, and transfers.
CONCLUSIONS
Currently, there are few standardized assessments that can identify PCML. PCML is the term that most clearly describes the stage where people experience a change in routine mobility tasks, without a perception of disability. Further evaluation into the reliability, validity, and responsiveness of outcome measures is needed to advance research on PCML.
Topics: Humans; Aged; Reproducibility of Results; Consensus; Exercise; Activities of Daily Living; Mobility Limitation
PubMed: 37300461
DOI: 10.1093/gerona/glad143 -
Journal of Cardiopulmonary... May 2022Despite known health benefits of cardiac rehabilitation (CR) for patients with cardiovascular disease (CVD), only a quarter of eligible patients attend. Among CR...
PURPOSE
Despite known health benefits of cardiac rehabilitation (CR) for patients with cardiovascular disease (CVD), only a quarter of eligible patients attend. Among CR barriers are physical (eg, walking) and in-person attendance limitations. The purpose of this study was to determine the prevalence of difficulty walking and dependence on another person to attend medical appointments among people with and without CVD using national survey data.
METHODS
We compared the prevalence of difficulty walking and difficulty attending medical appointments alone among adults with and without CVD using national survey data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2015-2019. We used logistic regression and Rao-Scott χ2 analysis while controlling for several social determinants of health as covariates.
RESULTS
Of 2 212 973 respondents, 200 087 (9.04%) had CVD. The odds of individuals with CVD experiencing either difficulty walking or difficulty attending medical appointments alone were >3 times greater than the odds for individuals without CVD. In all adults with CVD, 42% reported difficulty walking and 20% reported dependence on another person to attend medical appointments. In all adults with CVD, 46% reported difficulty with one or both difficulties compared with 14% of adults without CVD.
CONCLUSIONS
We estimate that 11.9 million Americans with self-reported CVD have difficulty walking, or are dependent on another person to attend medical appointments, or both. Alternative models of CR that adapt to these limitations are needed to increase attendance of CR so that all adults with CVD can improve their health outcomes.
Topics: Adult; Cardiac Rehabilitation; Cardiovascular Diseases; Humans; Mobility Limitation; Office Visits; Prevalence; United States
PubMed: 35135965
DOI: 10.1097/HCR.0000000000000669