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Physical therapy geriatrics

Olivier Bruyère, Etienne Cavalier, Fanny Buckinx, Jean-Yves Reginster
PURPOSE OF REVIEW: This article reviews recently published evidence regarding the role of vitamin D in the physiopathology of physical frailty in elderly populations and its role in the management of this geriatric condition. RECENT FINDINGS: Some recent studies have found a low level of 25-hydroxyvitamin D, considered the best marker of vitamin D status, in frail individuals. All prospective studies consistently report that low vitamin D status is associated with an increased risk of becoming frail...
October 1, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Meredith Greene, Amy C Justice, Kenneth E Covinsky
: As the number of older adults living with HIV continues to increase, understanding how to incorporate geriatric assessments within HIV care will be critical. Assessment of geriatric syndromes and physical function can be useful tools for HIV clinicians and researchers to help identify the most vulnerable older adults and to better understand the aging process in PLWH. This review focuses on the assessment of falls, frailty and physical function, first in the general population of older adults and includes a specific focus on use of these assessments in older adults living with HIV...
October 7, 2016: Virulence
Heidi D Klepin
Determining who is fit or unfit for standard treatments among older adults with acute myeloid leukemia (AML) remains a challenge. However, available evidence can provide guidance on strategies to assess and categorize fitness. Evidence is strongest to guide identification of "frail" older adults at the time of diagnosis based on performance status, physical function, and comorbidity. Many older adults, with adequate performance status and comorbidity burden, however, may be better characterized as "vulnerable"...
September 28, 2016: Current Hematologic Malignancy Reports
Nick W Bray, Rowan R Smart, Jennifer M Jakobi, Gareth R Jones
Frailty is a clinical geriatric syndrome caused by physiological deficits across multiple systems. These deficits make it challenging to sustain homeostasis required for the demands of everyday life. Exercise is likely the best therapy to reverse frailty status. Literature to date suggests that pre-frail older adults, those with 1-2 deficits on the Cardiovascular Health Study-Frailty Phenotype (CHS-frailty phenotype), should exercise 2-3 times a week, for 45-60 min. Aerobic, resistance, flexibility, and balance training components should be incorporated but resistance and balance activities should be emphasized...
October 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
John A Batsis, Lydia E Gill, Rebecca K Masutani, Anna M Adachi-Mejia, Heather B Blunt, Pamela J Bagley, Francisco Lopez-Jimenez, Stephen J Bartels
OBJECTIVES: To identify geriatric obesity interventions that can guide clinical recommendations. DESIGN: Systematic review using Medline (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, EMBASE (Ovid), and PsycINFO (Proquest) from January 1, 2005, to October 12, 2015, to identify English-language randomized controlled trials. PARTICIPANTS: Individuals aged 60 and older (mean age ≥65) and classified as having obesity (body mass index ≥30 kg/m(2) )...
September 19, 2016: Journal of the American Geriatrics Society
Isabel Montilla Padilla, Roberto Martín-Asenjo, Héctor Bueno
The mean age of patients presenting with acute coronary syndrome (ACS) has been increasing steadily in the last decades, so managing very old patients has become common practice. The oldest patients are under-represented in clinical trials, so specific evidence is scarce. Still, antithrombotic therapy and invasive strategy are the pillars of appropriate treatment even in the oldest patients. However, the elderly population is a heterogeneous group showing important divergences between chronological and biological age, which needs specific evaluation...
August 25, 2016: Heart, Lung & Circulation
Karla Bustamante Valles, Sandra Montes, Maria de Jesus Madrigal, Adan Burciaga, María Elena Martínez, Michelle J Johnson
BACKGROUND: Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation...
2016: Journal of Neuroengineering and Rehabilitation
Joanie Jackson, Amanda Clark, Lindsey Pearse, Elizabeth A Miller, Heather Stanfield, Christopher J L Cunningham
America's aging population needs interprofessional health care providers committed to providing high-quality, patient-centered care. Considering the often negative attitudes held by health care students about older adults and the impact that can have on their care, it is important to explore factors that influence student attitudes and desire to provide geriatric care. Five hundred seventy-two students pursuing nursing, physical therapy, athletic training, dietetics, and social work degrees were surveyed. Students reported demographic factors, amount of contact with older adults, how rewarding that contact had been, and confidence and interest in working with older adults...
September 6, 2016: Journal of Gerontological Nursing
Hoda Butrous, Scott L Hummel
Heart failure (HF) is a leading cause of morbidity, hospitalization, and mortality in older adults and a growing public health problem placing a huge financial burden on the health care system. Many challenges exist in the assessment and management of HF in geriatric patients, who often have coexisting multimorbidity, polypharmacy, cognitive impairment, and frailty. These complex "geriatric domains" greatly affect physical and functional status as well as long-term clinical outcomes. Geriatric patients have been under-represented in major HF clinical trials...
September 2016: Canadian Journal of Cardiology
Thuy Koll, Mackenzi Pergolotti, Holly M Holmes, Huibrie C Pieters, G J van Londen, Zachary A Marcum, Amy R MacKenzie, Christopher B Steer
Supportive care is an essential component of anticancer treatment regardless of age or treatment intent. As the number of older adults with cancer increases, and supportive care strategies enable more patients to undergo treatment, greater numbers of older patients will become cancer survivors. These patients may have lingering adverse effects from treatment and will need continued supportive care interventions. Older adults with cancer benefit from geriatric assessment (GA)-guided supportive care interventions...
August 2016: Current Oncology Reports
Tanya M Wildes, Brittany Depp, Graham Colditz, Susan Stark
Falls in older adults with cancer are more common than in noncancer controls, yet no fall-risk screening tool has been validated in this population. We undertook a cross-sectional pilot study of the Falls Risk Questionnaire (FRQ) in 21 adults aged ≥65 receiving systemic cancer therapy. Participants completed the FRQ, geriatric assessment measures, and a measure of fear-of-falling. The recruitment rate was 87.5 %, with 95.2 % completion of the FRQ and additional geriatric assessment and quality of life measures...
September 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Alexander Pantelyat, Candace Syres, Suzanne Reichwein, Allison Willis
BACKGROUND: Physical therapy can improve motor function in patients with PD. Music performance may be used to improve motor skills by rhythmic entrainment. Drumming has long been a part of traditional healing rituals worldwide, and is increasingly being utilized as a therapeutic strategy. METHODS: This pilot controlled prospective cohort trial assessed feasibility and effects of twice-weekly group West African drum circle classes for 6 weeks on PD patients' quality of life, symptoms, motor findings, cognition, and mood...
May 2016: Movement Disorders Clinical Practice
Tomasz Gołębiowski, Hanna Augustyniak-Bartosik, Wacław Weyde, Marian Klinger
The recent epidemiologic data pointed out, that the general number of patients on hemodialysis is steadily increasing, especially in group of elderly patients over 75 years old. The geriatric syndromes are a multietiological disorder related to physiological aging and partly associated with comorbid conditions. Frailty, falls, functional decline and disability, cognitive impairment and depression are main geriatric syndromes and occurs in patients with impaired renal function more often than among general population...
2016: Postȩpy Higieny i Medycyny Doświadczalnej
Neil H Penny, Samantha J Bires, Elizabeth A Bonn, Alisha N Dockery, Nicole L Pettit
OBJECTIVE: We describe the development of an instrument to measure moral distress experienced by occupational therapists and show how its content validity was established. METHOD: Written comments (n = 78) from a previous survey using the Moral Distress Scale-Revised-Other Health Provider Adult were used to modify that instrument and create the Moral Distress Scale-Revised-Occupational Therapy-Adult Settings (MDS-R-OT[A]). The MDS-R-OT[A] was distributed to a nationwide random sample of 400 occupational therapists who rated the relevance of each item to their clinical practice...
July 2016: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
Anna Giardini, Antonia Pierobon, Simona Callegari, Gabriella Bertotti, Marina Maffoni, Giuseppe Frazzitta
BACKGROUND: Non-pharmacological approaches to PD disease management seems to be a growing and promising field of investigation. Indeed interesting new perspectives are forthcoming from studies on physical rehabilitation and on physical exercise. AIM: To qualitatively describe the rehabilitation experience of Parkinson Disease patients taking part in a Multidisciplinary Intensive Rehabilitation Treatment (MIRT) consisting of four weeks of physical therapy and exercise, with three daily sessions, five days a week...
June 1, 2016: European Journal of Physical and Rehabilitation Medicine
Suzanne Timmons, Emma O'Shea, Desmond O'Neill, Paul Gallagher, Anna de Siún, Denise McArdle, Patricia Gibbons, Sean Kennelly
BACKGROUND: Admission to an acute hospital can be distressing and disorientating for a person with dementia, and is associated with decline in cognitive and functional ability. The objective of this audit was to assess the quality of dementia care in acute hospitals in the Republic of Ireland. METHODS: Across all 35 acute public hospitals, data was collected on care from admission through discharge using a retrospective chart review (n = 660), hospital organisation interview with senior management (n = 35), and ward level organisation interview with ward managers (n = 76)...
2016: BMC Geriatrics
Zhiyuan Shen, Qingwei Ruan, Zhuowei Yu, Zhongquan Sun
AIM: The objective of this review was to assess chronic kidney disease-related frailty and cognitive impairment, as well as their probable causes, mechanisms and the interventions. METHODS: Studies from 1990 to 2015 were reviewed to evaluate the relationship between chronic kidney disease and physical frailty and cognitive impairment. Of the 1694 studies from the initial search, longitudinal studies (n = 22) with the keywords "Cognitive and CKD" and longitudinal or cross-sectional studies (n = 5) with the keywords "Frailty and CKD" were included in final analysis...
May 31, 2016: Geriatrics & Gerontology International
Yuma Sonoda, Shinichiro Sawano, Yuka Kojima, Masato Kugo, Masashi Taniguchi, Shoji Maegawa, Taku Kawasaki
[Purpose] This study was performed to examine the effects of subacute physical therapy (PT) on activities of daily living (ADL), quality of life, and geriatric aspects of patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA). [Subjects] The subjects were TKA (n=56) and THA (n=39) patients who received PT on the first day of independent ADL (up to 2 weeks) and just prior to discharge (4 weeks). [Methods] The functional independence measure (FIM), grip strength, knee extension strength (KES), timed up and go (TUG) test, mini-mental state examination (MMSE), geriatric depression scale short form (GDS-15), fall efficacy scale (FES), and medical outcome study 8-item short-form health survey (SF-8) were used as outcome measure, and comorbidity involvement was also investigated...
April 2016: Journal of Physical Therapy Science
Rachel R Deer, Jared M Dickinson, Steve R Fisher, Hyunsu Ju, Elena Volpi
Hospitalization induces functional decline in older adults. Many geriatric patients fail to fully recover physical function after hospitalization, which increases the risk of frailty, disability, dependence, re-hospitalization, and mortality. There is a lack of evidence-based therapies that can be implemented following hospitalization to accelerate functional improvements. The aims of this Phase I clinical trial are to determine 1) the effect size and variability of targeted interventions in accelerating functional recovery from hospitalization and 2) the feasibility of implementing such interventions in community-dwelling older adults...
July 2016: Contemporary Clinical Trials
Elena Puin Costescu, Aliona Dronic, Loana Dana Alexa, O Alexa
Frailty fractures encompass pelvic ring fractures in the elderly--a condition more frequently encountered in women, usually with pre-existing osteoporosis. The incidence of these fractures is increasing, following the increase in average life expectancy. Most of the times, they are the result of a minor injury, of which the patient has little or no recollection; the clinical signs and symptoms, radiological changes and the degree of fracture stability vary greatly. As such, there is a wide range of therapeutic options and one of the most important decisions for the physician is choosing between surgery and conservative treatment...
January 2016: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
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