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JAMA Jun 2022
Topics: Aged; Frail Elderly; Geriatric Assessment; Humans; Life Style; Mobility Limitation
PubMed: 35762997
DOI: 10.1001/jama.2022.10376 -
Pediatric Physical Therapy : the... Jan 2018To summarize and critically appraise the existing evidence related to power mobility training methods used in research studies conducted with children 21 years or... (Review)
Review
PURPOSE
To summarize and critically appraise the existing evidence related to power mobility training methods used in research studies conducted with children 21 years or younger.
METHODS
A systematic review was conducted using 16 electronic databases to identify primary source quantitative studies published in peer-reviewed journals. Data extraction, determination of level of evidence, evaluation of methodological rigor, and assessment of the risk of bias were completed. The Evidence Alert Traffic Light Grading System (EATLS) was used.
RESULTS
Twenty-seven studies were included in the review. Levels of evidence were II to V; scientific rigor scores were 2 to 7.
CONCLUSIONS
An overall Yellow EATLS level of evidence was found indicating that therapists should use caution when providing power mobility training interventions and measure outcomes related to established goals in areas such as development, functional skills, or use of a power mobility device.
Topics: Adolescent; Child; Child, Preschool; Disabled Children; Humans; Mobility Limitation; Outcome Assessment, Health Care; Physical Therapy Modalities
PubMed: 29252826
DOI: 10.1097/PEP.0000000000000458 -
Journal of Geriatric Physical Therapy... 2018The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the... (Randomized Controlled Trial)
Randomized Controlled Trial
Determining Whether a Dosage-Specific and Individualized Home Exercise Program With Consults Reduces Fall Risk and Falls in Community-Dwelling Older Adults With Difficulty Walking: A Randomized Control Trial.
BACKGROUND AND PURPOSE
The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the efficacy of a new practice model, incorporating Shubert's evidence-based fall prevention recommendations, with the usual ambulatory physical therapy (PT) at Rusk Rehabilitation, to decrease fall risk among older adults living in the community. The hypotheses were (1) the proposed program would decrease participants' fall risk, (2) it would be more effective than our usual PT, and (3) the addition of 4 consults after discharge would improve compliance with a home exercise program.
METHODS
This was a randomized controlled trial. Sixty-nine participants who were independent community dwellers, were 65 years or older, had difficulty walking or complaints of instability, and had 1 or more risk of falls were randomly assigned into a usual care group (UCG, n = 43) or an experimental group (EG, n = 26). Both groups received PT 2 times per week for 30 minutes for 10 to 32 visits. The UCG received the usual PT delivered at Rusk. The EG was instructed in a moderate- to high-intensity home exercise program designed after completing the mini-Balance Evaluation Systems Test to assist with exercise prescription. The EG was educated on performing a recommended dosage of exercise over 6 months using a diary. The EG received 4 additional 30-minute consults every 2 to 4 weeks postdischarge to reinforce compliance. Self-report of number of falls, number of minutes of exercise per week, and performance on outcome measures (Timed Up and Go, 5-times sit-to-stand, Berg Balance Scale, and Activity Balance Confidence Scale) were monitored at evaluation, 2, 4, and 6 months.
RESULTS AND DISCUSSION
Thirty-five participants completed the study (UCG n = 22; EG n = 13). Both groups were similar at baseline on outcome measures and number of visits. Random effect model analyses demonstrated that both groups made significant reductions in fall risk over 6 months as identified by performance on outcome measures. However, the EG improved significantly more compared with the UCG over time (P < .05). Linear regression analyses showed that the EG exercised significantly more compared with the UCG at all times (P < .05). The EG exceeded the target of 115 min/wk of exercise (154 minutes, standard deviation [SD] 68.5; 170 minutes, SD 96.8; and 143 minutes, SD 68.5) at 2, 4, and 6 months, respectively. This study demonstrated that the experimental program is effective in decreasing fall risk in community-dwelling older adults and is more effective than our usual care. Moreover, it suggests that the overall experimental protocol may offer an effective strategy to foster adherence to an exercise program without the increasing number of visits.
CONCLUSION
This study supports the efficacy of the experimental program in decreasing fall risk and being more effective than our usual care, as well as fostering greater compliance with an exercise regimen. It provides some preliminary evidence to support Shubert's recommendation on exercise prescription for fall prevention.
Topics: Accidental Falls; Aged; Aged, 80 and over; Exercise Therapy; Female; Geriatric Assessment; Humans; Independent Living; Male; Mobility Limitation; Patient Discharge; Patient Education as Topic; Physical Therapy Modalities; Postural Balance; Referral and Consultation
PubMed: 27893567
DOI: 10.1519/JPT.0000000000000114 -
Geriatric Nursing (New York, N.Y.) 2023To describe and analyze the current research status of life-space mobility of the older persons in community. The literature in PubMed, Web of Science, Cochrane Library,... (Review)
Review
To describe and analyze the current research status of life-space mobility of the older persons in community. The literature in PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, Scopus, OpenGrey, SinoMed, CNKI, WanFang, and VIP databases was computer searched, and the time frame was build to May 23, 2023. A total of 42 literatures were included, including 35 in English and 7 in Chinese, 30 of which were cross-sectional studies. Theoretical models related to spatial mobility included the "concentric circles" model and the "cone" model. 33 literatures reported the prevalence or level of spatial mobility limitations, and 9 assessment instruments were used, The influencing factors can be divided into four categories. 9 literatures reported on the adverse effects, and 9 literatures reported on the prevention and intervention. The limitation of life-space mobility is a common and under-recognized phenomenon among the older persons in the community,with serious adverse effects, complex and diverse influencing factors.
Topics: Humans; Aged; Aged, 80 and over; Independent Living; Mobility Limitation
PubMed: 37722235
DOI: 10.1016/j.gerinurse.2023.08.021 -
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 -
Journal of Neuroengineering and... Apr 2012Loss of physical mobility makes maximal participation in desired activities more difficult and in the worst case fully prevents participation. This paper surveys recent... (Review)
Review
Loss of physical mobility makes maximal participation in desired activities more difficult and in the worst case fully prevents participation. This paper surveys recent work in assistive technology to improve mobility for persons with a disability, drawing on examples observed during a tour of academic and industrial research sites in Europe. The underlying theme of this recent work is a more seamless integration of the capabilities of the user and the assistive technology. This improved integration spans diverse technologies, including powered wheelchairs, prosthetic limbs, functional electrical stimulation, and wearable exoskeletons. Improved integration is being accomplished in three ways: 1) improving the assistive technology mechanics; 2) improving the user-technology physical interface; and 3) sharing of control between the user and the technology. We provide an overview of these improvements in user-technology integration and discuss whether such improvements have the potential to be transformative for people with mobility impairments.
Topics: Disabled Persons; Europe; Humans; Mobility Limitation; Self-Help Devices
PubMed: 22520500
DOI: 10.1186/1743-0003-9-20 -
The Lancet. Diabetes & Endocrinology Nov 2018
Topics: Aged; Humans; Male; Mobility Limitation; Muscle Strength; Muscle, Skeletal; Testosterone
PubMed: 30366565
DOI: 10.1016/S2213-8587(18)30202-X -
The Journals of Gerontology. Series A,... Aug 2022Motor function affects ability to perform daily activities and maintain independence. Yet, the interrelatedness of upper and lower extremity motor impairments and the...
BACKGROUND
Motor function affects ability to perform daily activities and maintain independence. Yet, the interrelatedness of upper and lower extremity motor impairments and the magnitude of their contribution to slow gait and mobility difficulty are not well investigated.
METHODS
Participants in the Baltimore Longitudinal Study of Aging (N = 728, aged 50-99) completed motor and physical function tests including grip and knee extension strength, pegboard, finger tapping, standing balance, chair stands, fast-paced 400-m walk, and usual gait speed. Slow gait was defined as usual gait speed <1.0 m/s. Mobility difficulty was defined as self-reported difficulty walking ΒΌ mile or climbing stairs. Structural equation modeling examined the interrelationships of motor measures and their contributions to slow gait and mobility difficulty, adjusting for demographics and comorbidities.
RESULTS
Poorer manual dexterity (-0.571 standard deviation [SD] units, p < .001) and lower muscle strength (upper and lower extremity; -0.447 SD units, p = .014) were most strongly associated with slow gait speed, followed by slower chair stand pace (-0.195 SD units, p = .002) and greater lap time variation (0.102 SD units, p = .028). Lower muscle strength (-0.582 SD units, p = .001) was most strongly associated with mobility difficulty, followed by slower chair stand pace (-0.322 SD units, p < .001), slower gait speed (-0.247 SD units, p < .001), and poorer standing balance (-0.190 SD units, p = .043).
CONCLUSIONS
Components of manual dexterity and strength were the strongest correlates of slow gait and mobility difficulty in mid-to-late life. Longitudinal studies examining relationships between changes in these motor parameters and mobility are needed to elucidate possible causal effects.
Topics: Aged; Aging; Gait; Humans; Longitudinal Studies; Middle Aged; Mobility Limitation; Walking; Walking Speed
PubMed: 34984437
DOI: 10.1093/gerona/glac001 -
Obesity (Silver Spring, Md.) Apr 2007To study whether walking limitation at old age is determined by obesity history.
OBJECTIVE
To study whether walking limitation at old age is determined by obesity history.
RESEARCH METHODS AND PROCEDURES
In a retrospective longitudinal study based on a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, body mass, and body height were measured in a health examination. Walking limitation was defined as walking speed<1.2 m/s or difficulty in walking 0.5 km. Recalled height at 20 years of age and recalled weight at 20, 30, 40, and 50 years of age were recorded.
RESULTS
Subjects who had been obese at the age of 30, 40, or 50 years had almost a 4-fold higher risk of walking limitation compared to non-obese. Obesity duration increased the age- and gender-adjusted risk of walking limitation among those who had been obese since the age of 50 (odds ratio, 4.33; 95% confidence interval, 2.59 to 7.23, n=114), among the obese since the age of 40 [6.01 (2.55 to 14.14), n=39], and among the obese since the age of 30 [8.97 (3.06 to 26.29), n=14]. The risk remained elevated even among those who had previously been obese but lost weight during their midlife or late adulthood [3.15 (1.63 to 6.11), n=71].
DISCUSSION
Early onset of obesity and obesity duration increased the risk of walking limitation, and the effect was only partially mediated through current BMI and higher risk of obesity-related diseases. Preventing excess weight gain throughout one's life course is an important goal in order to promote good health and functioning in older age.
Topics: Age Factors; Aged; Aged, 80 and over; Body Mass Index; Female; Humans; Longitudinal Studies; Male; Middle Aged; Mobility Limitation; Obesity; Retrospective Studies; Sex Factors; Walking; Weight Gain
PubMed: 17426328
DOI: 10.1038/oby.2007.583 -
Journal of the American Medical... Oct 2011
Topics: Cholinergic Antagonists; Hospitalization; Humans; Mobility Limitation
PubMed: 21856240
DOI: 10.1016/j.jamda.2011.07.008