Aims: The aging population in the Netherlands is increasing, with 4.7 million people aged 65+ expected by 2040. Many older people experience difficulties maintaining Functional Independence (FI), which is essential for aging in place. This study examined the feasibility of a decision support tool to promote FI through integrated assessment and personalized advice. Methods: A mixed-methods feasibility study focused on demand, acceptability, and implementation. Quantitative data were collected from physical therapists and older persons using the Acceptability of Intervention Measure, Intervention Appropriateness Measure, Motivation and Intention to Use Measure, and the Client Satisfaction Questionnaire, and analyzed descriptively. Semi-structured interviews were thematically analyzed. Results: Fifteen physical therapists and fourteen older persons participated. Both groups valued the tool. Physical therapists reported concerns regarding time, workflow integration, and interpretation. Older people reported increased awareness and supported shared decision-making. Conclusion: The DST-FI tool shows potential but requires refinement for implementation in physical therapist practice.
Objectives The purpose of this study was to investigate the effects of gradual speed robot-assisted gait training on lower extremity strength and balance in stroke patients. Methods All subjects were randomly divided into three groups based on the speed of robotic application: Gradual speed increase Robot-assisted gait training Group (GRG, n = 27), Comfortable speed Robot-assisted gait training Group (CRG, n = 26), and control group (n = 28). Participants received 30-minutes robot-assisted gait training thrice weekly for 8 weeks, with pre- and post-assessments of strength and balance. Results The study results showed that all subjects showed significant differences in all measurements post-intervention (p < 0.05). Additionally, GRG was found to significantly improve in Medical Research Council (MRC), Berg Balance Scale (BBS) and Activities-specific Balance Confidence (ABC) compared to CRG (p < 0.05). Conclusions Progressive speed robot-assisted gait training is more effective than constant speed or conventional therapy for improving strength and balance in chronic stroke method (KCT0002552).
AimsTremor Dominant (TD) and Postural Instability/Gait Difficulty (PIGD) are clinical subtypes of Parkinson disease (PD). The purpose of this study was to determine if the instrumented Timed-Up-and-Go (iTUG) and Timed-Up-and-Go Cognitive (iTUGc) differed between TD and PIGD subtypes.MethodsTurn velocity, sit to and from stand duration, sit to and from stand lean angles, trunk rotation, turning duration, and total duration were captured during the iTUG and iTUGc. Independent t-tests, Cohen's d, Mann-Whitney U and effect size r were used.ResultsPIGD group (n = 19) had significantly slower turning velocity (p = 0.048, d = 0.52) during iTUGc compared to TD group (n = 24). Moderate effect sizes were found between groups for trunk rotation during iTUG (p = 0.271, r = 0.17) and iTUGc (p = 0.092, r = 0.26).ConclusionsAssessing turning during the iTUGc may be useful in detecting important movement difficulties in people living with PD classified in the PIGD subtype.
BackgroundFalls are a major problem in long-term care health facilities (LTCHFs). This study investigated fall incidence and risk factors during the first three months of admission.MethodsThis retrospective study at a Japanese LTCHF included 69 residents (mean age 85.7 +/- 6.3 years). Admission data on demographics, physical and cognitive function, and Activities of Daily Living (ADL) were collected. Falls were tracked for three months using the facility's incident reporting system.ResultsWithin three months, 31.9% of residents fell at least once (n = 22). GEE analysis identified toileting dependence as significantly associated with falls (p = 0.026). Logistic regression adjusted for sex confirmed it as an independent predictor (OR = 8.850, 95% CI: 1.067-73.370, p = 0.043), with a sensitivity of 95.5% (AUC = 0.680).ConclusionToileting dependence at admission is a key predictor of falls among new LTCHF residents. These findings highlight the importance of ADL assessment, particularly toileting ability, to enable early, targeted fall prevention.
AimsTo ascertain whether hip flexor explosive strength, agility, and functional mobility tests can discriminate between multiple-step (MS) and single-step (SS) fall avoidance strategies.MethodsThirty-six community-dwelling older women (79.6 +/- 5.9 years) were evaluated using a tether-release method to induce forward balance recovery and were classified into MS (n = 17) and SS (n = 19) groups. Hip flexor isometric maximum strength, peak normalized rate of force development (NRFD), time-to-peak RFD, five-times sit-to-stand (FSST), two-square agility test, ten-step test (TST), 20-s open-close stepping, and walking speed were assessed. Discriminant analysis was performed to identify the factors differentiating the MS and SS groups.ResultsThe MS group showed lower NRFD, slower time-to-peak RFD, and worse performance in the FSST and TST. A model combining NRFD and TST achieved a 91.6% discrimination rate.ConclusionHip flexor explosive strength and agility, particularly rapid alternate foot placement, may help distinguish fall avoidance strategies in older women.
