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Background and Purpose Following hospitalization, seniors are at risk of impaired mobility and increased risk of falling, which can lead to injuries and re-admission. The primary purpose of this paper was to evaluate the ability of hospitalized seniors to use vestibular inputs for balance control. The secondary purpose was to examine the influence of vestibular function and lower limb muscle strength on mobility. Methods Experimental and correlation designs were used. Patients (aged 65-90 years), preparing for discharge from an inpatient geriatric rehabilitation unit, were recruited. Vestibular control of standing balance was measured using the Clinical Test of Sensory Interaction for Balance (CTSIB). Mobility was measured with the Timed Up and Go (TUG) Test. Lower limb muscle maximum voluntary isometric contraction (MVIC) strength was tested with portable dynamometry. Wilcoxon signed rank test, with alpha adjusted for multiple comparisons ( p ≤ 0.017), was used to compare relevant components of the CTSIB. Stepwise regression was used to assess the influence of vestibular impairment on TUG score. Results CTSIBTest6 (median = 7.1 seconds, range = 0.0-30.0) was less than CTSIBTest1 (30.0 seconds, 30.0-30.0) and CTSIBTest4 (30.0 seconds, 10.5-30.0) (W = 136, p < 0.017). MVIC scores (Nm·kg−1, mean ± SD) included hip abduction 0.38 ± 0.2, hip flexion 0.32 ± 0.1, hip extension 0.44 ± 0.2, knee flexion 0.31 ± 0.1, knee extension 0.33 ± 0.2, ankle dorsiflexion 0.12 ± 0.1 and ankle plantarflexion 0.23 ± 0.1. Mean TUG score was 26.1 ± 6.0 seconds. Performance on CTSIBTest6 explained 55% of the variance in TUG scores, whereas hip extension strength explained an additional 6%. Conclusions Seniors awaiting discharge from hospital had impaired vestibular control of balance that was systematically associated with impaired mobility. Evaluating vestibular function prior to discharge from hospital could improve discharge planning with respect to management of impairments that threaten balance and safe mobility. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a serious medical condition that may cause blindness, renal failure and amputation of the lower limbs, stroke and myocardial infarction. The global incidence of diabetes increases continuously. The self‐management of diabetes can be problematic and burdensome, especially if employed individuals choose not to reveal their illness. The workplace has been highlighted as an important element that may impact how employed individuals, diagnosed with diabetes and managed their illness. Aim: To describe the influence of diabetes disclosure on the cognitive, physical ability and diabetes self‐management of employed adults with diabetes in Saudi Arabia. Design: A descriptive correlational study. Methods: This study used a self‐administered questionnaire, including the Checklist Individual Strength and Perceived Diabetes Self‐Management Scale, for data collection. The sample size was 250 employed adults with diabetes. The data were analysed using descriptive statistics, Spearman's correlation coefficient and bivariate analysis. Results: A significant correlation was found between diabetes self‐management and support from co‐workers (r =.55, p <.05), and the employees who received more support from their co‐workers were able to perform diabetes self‐management. The results also indicate that employees who received support at their workplace reported improved concentration, motivation and activity (r =.41, p <.05). Conclusion: It is essential for top management and policymakers to implement supportive programmes in the workplace, and considering a constant, not rotating, work schedule. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the experience of HCAs encouraging residents living in residential care to complete the sit‐to‐stand activity and to identify the strategies HCAs used to integrate the activity into their daily work routines. Background: Decreased mobility in advanced ageing is further reduced when entering a residential care facility. Interventions such as the sit‐to‐stand activity have been shown to have a positive effect on the mobility of older people. There is evidence to suggest that healthcare aides are able to support residents to complete the sit‐to‐stand activity as part of their daily work routines; however, little is known about how healthcare aides actually do this with residents living in residential care. Design: A qualitative interview study included seven purposively sampled HCAs working in residential care facilities. Semistructured interviews were analysed using inductive qualitative content analysis. Results: The HCAs’ experience with the sit‐to‐stand activity was represented by the following four categories: Resident participation, Feeling misunderstood and disrespected, Time and workload, and Management involvement. HCAs identified three strategies to help them support residents to complete the sit‐to‐stand activity: Motivating residents, Completing activity in a group and Using time management skills. Conclusions: HCAs reported some encouragement from managers and cooperation from residents to complete the sit‐to‐stand activity with residents; however, they also felt constrained by time limitations and workload demands and they felt misunderstood and disrespected. HCAs were able to identify several strategies that helped them to integrate the sit‐to‐stand activity into their daily routines. Implications for practice: This study highlights the challenges and supportive factors of implementing the sit‐to‐stand activity into the daily work routine of HCAs. The study also identifies the strategic role of nurse managers when implementing interventions in residential care facilities. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Performing routine pain assessments with all intensive care unit ( ICU) patients is strongly recommended in clinical practice guidelines. As many ICU patients are unable to self-report, the Critical-Care Pain Observation Tool ( CPOT) is one of the two behavioural pain scales suggested for clinical use. Still, no study has described the evaluations of its use in ICU daily practice. Objective To describe the nurses' evaluation of the feasibility, clinical relevance and satisfaction with the CPOT use 12 months after its implementation in the ICU. Method A descriptive design was used. It was conducted in the medical-surgical ICU of a university affiliated setting at Greenfield Park (Québec, Canada). A self-administered evaluation questionnaire including four sections (i.e. feasibility, clinical relevance, satisfaction and socio-demographic information) was completed by ICU nurses who were all trained to use the CPOT. The questionnaires were completed anonymously. Results A total of 38 ICU nurses returned their completed questionnaire (63% participation rate). Regarding its feasibility, the majority rated the CPOT as quick to use, simple to understand and easy to complete (92-100%). According to clinical relevance, close to 70% of ICU nurses acknowledged that the CPOT had influenced their practice, but lower results (<50%) were found for effective communication of pain assessment findings with the physicians and other health professionals. More than 80% of ICU nurses were satisfied with its daily use. Conclusion The CPOT use was deemed feasible and relevant in daily practice as per the nurses' evaluations but did not allow an effective communication with other ICU care team members. Relevance to clinical practice Training should be offered to all members of the ICU care team, and other implementation strategies should be explored as well to ensure optimal uptake of a pain assessment approach which impacts on their decision-making process for pain management. [ABSTRACT FROM AUTHOR]

This article describes the aims, development, and testing of the Mobility Assessment Schedule ( MAS), an instrument assessing the ability of students with intellectual disability ( ID), to function effectively as pedestrians in normal traffic. The MAS provides information about individual mobility skills of school-age children with ID and measures the child's traffic skills congruent with safely and independently functioning in traffic situations. Mobility skills are measured in eight areas: visual perception, auditory perception, reaction, memory, attention, motor skills, social skills, and communication. The MAS was tested with 128 students at one school for children with ID in Germany. The internal consistencies of the scale and subscales were reasonable to good. Baseline results showed that the students already possessed-even before mobility training-many skills that are necessary for participation in traffic situations. The MAS is applicable and valid to assess traffic functioning skills of children with ID and can be an important tool for mobility training because it delivers information on various skills, which are necessary to function independently in traffic situations. This inventory can be part of the school's individual educational plans. [ABSTRACT FROM AUTHOR]

Objective The objective of this research was to identify the risk factors for musculoskeletal disorders present when mothers lift normally developing children weighing between 20 and 31 lbs (9-14 kg) in the home. Method Twenty five mothers aged 28-40 years completed Sanders and Morse's (2005) self-report survey of pain and high-risk practices. In addition, the OMLITH, a structured checklist for observing mothers lifting children in the home, was developed. Criteria to rate variables relating to the load (child), environment, person (mother) and task as low, moderate or high risk were developed, on the basis of published manual handling assessments. The mothers were observed performing 87 lifts, and risk factors were rated. Results The majority of participants reported low back pain (64%). They self-rated bending while carrying a child as most stressful, and various other tasks involving carrying; prolonged bending, squatting or stooping; and lifting a child as physically stressful. At least one risk factor related to the load was recorded in all 87 observations, with moderate to high risk most frequently related to the child's weight (73.6%) or the mother's grip on the child (93.1%). Common environmental factors presenting a moderate to high risk related to space constraints (59.7% of tasks) and equipment (58.6%). Factors related to the mothers' strength and fitness (57.5% of tasks) commonly posed moderate to high risk, as did horizontal reach distances (82.8%), vertical lift distances (78.2%) and reaches above shoulder height or below mid thigh level (88.5%). Trunk rotation greater than 45° or combining rotation and side bending while lifting resulted in a moderate to high risk rating in 72.4% of tasks. The developmental age of the child interacted with weight to increase or decrease the requirement for lifting. Conclusion Risk factors for musculoskeletal disorders are present to a significant degree, and further research in this area is warranted. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We applied a meta-analytical approach to derive a robust estimate of the acute effects of pre-exercise static stretching ( SS) on strength, power, and explosive muscular performance. A computerized search of articles published between 1966 and December 2010 was performed using PubMed, SCOPUS, and Web of Science databases. A total of 104 studies yielding 61 data points for strength, 12 data points for power, and 57 data points for explosive performance met our inclusion criteria. The pooled estimate of the acute effects of SS on strength, power, and explosive performance, expressed in standardized units as well as in percentages, were −0.10 [95% confidence interval ( CI): −0.15 to −0.04], −0.04 (95% CI: −0.16 to 0.08), and −0.03 (95% CI: −0.07 to 0.01), or −5.4% (95% CI: −6.6% to −4.2%), −1.9% (95% CI: −4.0% to 0.2%), and −2.0% (95% CI: −2.8% to −1.3%). These effects were not related to subject's age, gender, or fitness level; however, they were more pronounced in isometric vs dynamic tests, and were related to the total duration of stretch, with the smallest negative acute effects being observed with stretch duration of ≤45 s. We conclude that the usage of SS as the sole activity during warm-up routine should generally be avoided. [ABSTRACT FROM AUTHOR]

Background and Purpose The aims of this study were to develop a clinical assessment scale to measure functional ability in ambulant boys with Duchenne muscular dystrophy and to determine the reliability of the scale in multiple centres in the UK. Methods Focus groups and workshops were held with experienced paediatric neuromuscular physiotherapists to determine scale content. A manual was prepared with accompanying videos, and training sessions were conducted. A total of 17 physiotherapists from participating centres used the videos to determine inter-rater reliability. Five determined the intra-rater reliability. Results Strength of agreement for these groups based on total subject scores was very good (0.95 and ≥0.93 for consistency and absolute agreement, respectively). Test-retest ability was high, with perfect agreement between occasions for all but two items of the scale. Conclusions Our study indicates that the North Star Ambulatory Assessment is practical and reliable. It takes only 10 minutes to perform and incorporates both universally used timed tests as well as levels of activities, which allow assessment of high-functioning boys with Duchenne muscular dystrophy. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]