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Background: Stroke survivors and their caregivers have numerous and diverse educational needs, many of which are unmet because of inadequate training from healthcare professionals. As stroke recovery and rehabilitation can continue for years post-stroke, it is critical that stroke survivors are provided with and have access to a range of support options and evidence-based information. Website-based education programs (WEP) have been adopted in recent years to manage health problems. The present pilot study aims to evaluate the effect of WEP on activities of daily living (ADLs) and the fear of falls among sub-acute stroke survivors. Methods: A total of 16 eligible post-stroke survivors were recruited from multiple study settings across Surat City of Gujarat state in western India and were randomly assigned using a lottery method to either the experimental group (n = 8) receiving WEP or the control group (n = 8) receiving conventional physiotherapy for 4 weeks. Outcome measures were the Indian Stroke Scale (ISS), Modified Barthel Index (MBI), and Falls Efficacy Scale-International (FES-I). Results: Both groups showed statistically significant improvements in all outcomes but the experimental group showed more significant improvements in ADLs and fear of falls among sub-acute stroke survivors (p < 0.05). Conclusion: WEP for sub-acute stroke survivors is an effective intervention. It improves the performance of ADLs for stroke survivors and helps in better fall management indicating that web-based education programs shall be implemented on a regular basis to improve patient care. [ABSTRACT FROM AUTHOR]

Background: Stroke-associated pneumonia (SAP) is a common complication in stroke patients, and the Barthel Index (BI) is a well-established metric for assessing activities of daily living (ADL). However, the association between BI and SAP in acute ischemic stroke (AIS) patients remains unclear. This study aims to investigate the relationship between BI at admission and SAP, and explore the factors in AIS elderly patients. Method: Retrospective data were collected from ischemic stroke patients hospitalized at the Second Affiliated Hospital of Nanchang University between January 2018 and July 2021, including their basic demographic and laboratory test results. Restricted cubic spline regression, multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were employed to investigate the relationship between BI and SAP. Additionally, the Shapley Additive exPlanations (SHAP) method was used to identify the factors influencing SAP. Results: The study included 7,548 eligible stroke patients with a mean age of 75.1 ± 7.6 years, among which 41.14% were female. The SAP group demonstrated significantly lower BI compared to the non-SAP group (50.86 ± 35.60 vs. 75.27 ± 26.33, P < 0.001). Additionally, a conspicuous trend of decreasing SAP risk across the Q1-4 groups was observed (P < 0.001). The RCS analysis further confirmed a gradual reduction in SAP risk with increasing BI. Based on the clinical model, both the BI (NRI = 0.014, P = 0.005; IDI = 0.04, P < 0.001) and the NIHSS score (NRI = 0.09, P = 0.03; IDI = 0.025, P < 0.001) demonstrated additional predictive value for SAP. Multivariate logistic regression and SHAP analysis identified WBC, CONUT, TG, UA, and RBC levels, as well as the type of health insurance (urban employee basic medical insurance), as important independent predictors of SAP. Conclusion: BI at admission constitutes a risk factor for the onset of SAP in elderly patients with AIS, Compared to the NIHSS and mRS score, BI may be a more reliable and practical predictor of SAP. [ABSTRACT FROM AUTHOR]

The aim of this contribution is to present a segmentation method for the identification of voluntary movements from inertial data acquired through a single inertial measurement unit placed on the subject's wrist. Inertial data were recorded from 25 healthy subjects while performing 75 consecutive reach-to-grasp movements. The approach herein presented, called DynAMoS, is based on an adaptive thresholding step on the angular velocity norm, followed by a statistics-based post-processing on the movement duration distribution. Post-processing aims at reducing the number of erroneous transitions in the movement segmentation. We assessed the segmentation quality of this method using a stereophotogrammetric system as the gold standard. Two popular methods already presented in the literature were compared to DynAMoS in terms of the number of movements identified, onset and offset mean absolute errors, and movement duration. Moreover, we analyzed the sub-phase durations of the drinking movement to further characterize the task. The results show that the proposed method performs significantly better than the two state-of-the-art approaches (i.e., percentage of erroneous movements = 3%; onset and offset mean absolute error < 0.08 s), suggesting that DynAMoS could make more effective home monitoring applications for assessing the motion improvements of patients following domicile rehabilitation protocols. [ABSTRACT FROM AUTHOR]

Background India is progressing toward an increasing trend in of the geriatric population. By 2050, it is expected to double from 10.8% to 20%. A decrease in functional and locomotor activity among the geriatric population impairs the process of healthy aging. Methodology The study assessed the fall risk, frailty, and limitation in the activity of daily living among the individuals aged 60 years or more in rural area of Khordha district in Odisha. The cross-sectional study with 188 participants in a rural area assessed the functional ability of the elderly with Fall Risk Assessment Test Scale, Clinical Frailty Scale, and Katz Index. Results The study reported that 11.7% (confidence interval [CI] = 7%–17%) were medium to high risk of fall, 24% (CI = 18%–30%) were mildly frail, 29% (CI = 22%–36%) were vulnerable, and 10.6% (CI = 6%–15%) had limitation in the activity of daily living. Age, difficulty in vision, decreased sleep duration, and chronic disease were significant determinants of the limitation in the functional ability of the elderly. Conclusion Elderly population are at higher risk of fall, increased frailty, and limitation in activity of daily living. Comprehensive geriatric assessment, including the physical, psychological, and nutritional assessment, needs to be integrated to meet the health-care needs of the elderly in primary health care.

Abstract Background Stroke-associated pneumonia (SAP) is a common complication in stroke patients, and the Barthel Index (BI) is a well-established metric for assessing activities of daily living (ADL). However, the association between BI and SAP in acute ischemic stroke (AIS) patients remains unclear. This study aims to investigate the relationship between BI at admission and SAP, and explore the factors in AIS elderly patients. Method Retrospective data were collected from ischemic stroke patients hospitalized at the Second Affiliated Hospital of Nanchang University between January 2018 and July 2021, including their basic demographic and laboratory test results. Restricted cubic spline regression, multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were employed to investigate the relationship between BI and SAP. Additionally, the Shapley Additive exPlanations (SHAP) method was used to identify the factors influencing SAP. Results The study included 7,548 eligible stroke patients with a mean age of 75.1 ± 7.6 years, among which 41.14% were female. The SAP group demonstrated significantly lower BI compared to the non-SAP group (50.86 ± 35.60 vs. 75.27 ± 26.33, P

BackgroundHeavy metals may play an important role in environmental risk factors associated disorders of activities of daily living (ADL) in older adults. ObjectiveTo investigate the associations between plasma levels of six heavy metals (zinc, arsenic, cadmium, lead, manganese, and copper) and ADL disorders in older adults. MethodsA cross-sectional survey was conducted from 2018 to 2019 among 1412 rural elderly people in Gongcheng Yao Autonomous County, Guangxi Zhuang Autonomous Region. The plasma metal concentrations were detected by inductively coupled plasma mass spectrometry (ICP-MS), and subsequently classified into three groups (T1-T3) based on tertiles, with the T1 group as the reference. The samples were assessed for ADL disorders using the ADL scale. Logistic regression and restricted cubic spline model (RCS) were used to estimate the odds ratio (OR) and 95% confidence interval (CI) to assess the associations between heavy metals and the prevalence of reporting ADL disorders. ResultsThe mean age of the study population was (68.52 ± 5.92) years, 825 (58.4%) female and 587 (41.6%) male. Of these, 372 (26.34%) subjects reported ADL disorders, and most of them were female (74.30%). The results of logistic regression showed that the participants in the cadmium T2 group (0.15-0.25 µg·L−1) had a higher risk of ADL disorders compared to the T1 group (≤0.15 μg·L−1) (OR=1.552, 95%CI: 1.086, 2.134). After stratification by sex, the relative risk of ADL disorders was lower in the plasma copper T3 group (>1019.58 µg·L−1) compared to the T1 group (≤868.12 μg·L−1) in men (OR=0.481, 95%CI: 0.232, 0.998). The relative risk of ADL disorders was higher in the plasma cadmium T2 group (0.15-0.25 µg·L−1) compared to the T1 group (≤0.15 μg·L−1) in women (OR=1.758, 95%CI: 1.182, 2.616). The RCS results showed that the risk of ADL disorders in men was nonlinearly associated with copper (Pnonlinear=0.011, Poverall

Study Design A post-hoc analysis of a prospective cohort study. Purpose This study aimed to identify factors at the time of injury associated with declining activities of daily living (ADLs) in the chronic phase of osteoporotic vertebral fractures (OVFs) managed conservatively. Overview of Literature Although a conservative approach is the treatment of choice for OVFs, ADLs do not improve or eventually decrease in some cases. However, the risk factors for ADL decline after the occurrence of OVFs, particularly the difference between those with or without initial bed rest, are unknown. Methods A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline. Results In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2-weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09–16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32–11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively. Conclusions In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively.

Abstract Background To examine the prevalence of toileting disability among older adults in India and its association with broad aspects of the physical and social environment. Methods We use data from the inaugural wave of the Longitudinal Ageing Study in India and focus on adults aged 65 and older (N = 20,789). We draw on the disablement process model and existing frameworks to identify environmental factors and other risk factors that may be associated with toileting disability. Hierarchical logistic regressions are implemented to analyze the health impacts from physical and social environment characteristics. Results One in five older Indian adults had difficulties with toileting, and the prevalence rate of this functional disability varied across sub-national regions. We find that low neighborhood trust was associated with an increased likelihood of toileting disability, as was the use of assistive mobility devices. The negative effects of these social and external environment characteristics hold when we stratified the sample by rural and urban residency. Also, older adults in urban areas without access to toilets and using shared latrines had higher odds of being disabled in terms of toileting. Other factors important in explaining toileting disability among older adults included poor self-rated health, arthritis, currently working, living in the East or West region, and having functional limitations. Conclusions Poor person-environment fit can compromise older adults’ ability to perform self-care tasks. Policymakers need to look beyond the physical environment (e.g., dedicating resources to construct toilet facilities) to adopt a more holistic, multi-faceted approach in their sanitation policies. Improving the safety of neighborhood surroundings in which shared latrines are located and the availability of accessible toilets that cater to those with mobility impairments can help improve independence in toileting among older adults.

Abstract Background The application of cerebellar transcranial magnetic stimulation (TMS) in stroke patients has received increasing attention due to its neuromodulation mechanisms. However, studies on the effect and safety of cerebellar TMS to improve balance capacity and activity of daily living (ADL) for stroke patients are limited. This systematic review and meta-analysis aimed to investigate the effect and safety of cerebellar TMS on balance capacity and ADL in stroke patients. Method A systematic search of seven electronic databases (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang and Chinese Scientific Journal) were conducted from their inception to October 20, 2023. The randomized controlled trials (RCTs) of cerebellar TMS on balance capacity and/or ADL in stroke patients were enrolled. The quality of included studies were assessed by Physiotherapy Evidence Database (PEDro) scale. Results A total of 13 studies involving 542 participants were eligible. The pooled results from 8 studies with 357 participants showed that cerebellar TMS could significantly improve the post-intervention Berg balance scale (BBS) score (MD = 4.24, 95%CI = 2.19 to 6.29, P

Abstract Objectives To assess the influence of loneliness on the healthy life expectancy of older adults in China and its gender disparities across different health indicators, in order to provide insights for enhancing the health status and subjective well-being of the older population. Method We conducted a cohort analysis using four waves of weighted samples (2008, 2011, 2014, and 2018) from the Chinese Longitudinal Healthy Longevity Survey, encompassing 15,507 respondents aged 65–99. Physical and subjective health were assessed through activity of daily living (ADL) and self-rated health (SRH), respectively. Utilizing loneliness status as a time-variant variable, we employed the multi-state interpolated Markov Chain to explore the associations between loneliness and age-specific life expectancy (LE), healthy life expectancy (HLE), and the proportion of healthy life expectancy in life expectancy (HLE/LE). Results Compared to the non-lonely population, both LE and HLE were lower among lonely individuals. Regarding gender differences, the HLE/LE for females in the lonely population was consistently lower than that for males. The impact of loneliness on the health of older adults varied by measurement indicators and gender. Specifically, based on ADL results, the decline in HLE/LE was greater for females, with a decline of 53.6% for lonely females compared to 51.7% for non-lonely females between the ages of 65 and 99. For males, the decline was 51.4% for lonely males and 51.5% for non-lonely males. According to SRH, the gender difference in the decline of HLE/LE due to loneliness was less apparent. For males, the change in HLE/LE for non-lonely individuals was 3.4%, compared to 4.2% for lonely individuals, whereas for females, the change was 3.7% for non-lonely individuals and 4.4% for lonely individuals. Conclusion Loneliness exerts varied effects on health across different measurement indicators and gender demographics. Targeted health promotion interventions are imperative to mitigate these negative impacts, particularly emphasizing the enhancement of subjective well-being and physical functioning, especially among older adult females.

This study employed a cross-sectional design to explore the impact of social support and self-efficacy on activity of daily living (ADL) among post-stroke patients in Saudi Arabia and investigate the mediating role of self-efficacy. Data were collected from 158 post-stroke patients across six healthcare facilities in three regions of Saudi Arabia using convenience sampling, between February 2023 and July 2023. The analysis included descriptive statistics, variance analysis, and linear regression using bootstrap methods. PROCESS Macro was used for the mediation model. This study revealed that most participants had high ADL, social support, and self-efficacy levels. Significant negative associations were found between ADL and age (p < 0.001), time since stroke (p = 0.009), and stroke history (p < 0.001), while significant positive associations were observed with educational background (p = 0.049), employment status (p < 0.001), and self-efficacy (p < 0.001). ADL in post-stroke patients was significantly influenced negatively by age (p = 0.025), time since stroke (p = 0.027), and stroke history (p < 0.001), while self-efficacy (p < 0.001) had a positive impact and moderated the relationship between social support and ADL. This study highlights the physical and psychosocial aspects affecting post-stroke patients, identifies key areas for enhancing their experiences, and informs the development of targeted interventions to address their comprehensive needs. [ABSTRACT FROM AUTHOR]

Study Design: A post-hoc analysis of a prospective cohort study. Purpose: This study aimed to identify factors at the time of injury associated with declining activities of daily living (ADLs) in the chronic phase of osteoporotic vertebral fractures (OVFs) managed conservatively. Overview of Literature: Although a conservative approach is the treatment of choice for OVFs, ADLs do not improve or eventually decrease in some cases. However, the risk factors for ADL decline after the occurrence of OVFs, particularly the difference between those with or without initial bed rest, are unknown. Methods: A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline. Results: In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2-weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09–16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32–11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively. Conclusions: In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively. [ABSTRACT FROM AUTHOR]

Associations between daily functional trajectories and new-onset all-cause dementia and Alzheimer's disease (AD) and the role of body weight are underexplored. Data were from the Health and Retirement Study (HRS) 1994–2020. Daily function was assessed using (instrumental) activities of daily living ([I]ADLs). All-cause dementia and AD were defined by self- or proxy-reported physician diagnoses. Body weight was assessed using body mass index (BMI) and categorized as normal (18.5 kg/m2 ≤ BMI < 30 kg/m2) and abnormal (BMI < 18.5 kg/m2 or ≥30 kg/m2). The group-based trajectory modeling and Cox proportional hazards regression were utilized. Of 18,763 adults included, 1236 developed new-onset dementia during a 10-year follow-up. The associations of ADL and IADL limitations at baseline with all-cause dementia and AD were much more pronounced in those with abnormal weight (P for interaction < 0.005). Five joint trajectories of ADL and IADL limitations were identified: No (72.7 %), Recovery (4.0 %), Recent emerging (16.4 %), Early emerging (4.8 %), and Severe (2.1 %). Furthermore, the 'Severe' joint trajectory (vs. 'No') was associated with 3.57- and 3.59-times higher risks of new-onset all-cause dementia and AD in participants with abnormal weight (P for interaction = 0.002 and 0.005). Notably, the Recovery joint trajectory (vs. No) was not associated with increased risks of all-cause dementia or AD. Self-/proxy-reported all-cause dementia and AD may introduce misclassification bias. Lifestyle factors were not quantified. BMI at baseline, but not its trajectory, was utilized. Potential reverse causation deserved attention. Body weight control can help reduce the risk of progression from functional limitations to all-cause dementia and AD. • Functional limitations were associated with increased risk of new-onset dementia. • Five 16-year joint trajectories of functional limitations were identified. • Recovery from functional limitations was not at increased risk of dementia. • Weight control can help prevent functional limitations from progressing to dementia. • The findings of new-onset all-cause dementia and Alzheimer's disease were similar. [ABSTRACT FROM AUTHOR]

Background: To examine the prevalence of toileting disability among older adults in India and its association with broad aspects of the physical and social environment. Methods: We use data from the inaugural wave of the Longitudinal Ageing Study in India and focus on adults aged 65 and older (N = 20,789). We draw on the disablement process model and existing frameworks to identify environmental factors and other risk factors that may be associated with toileting disability. Hierarchical logistic regressions are implemented to analyze the health impacts from physical and social environment characteristics. Results: One in five older Indian adults had difficulties with toileting, and the prevalence rate of this functional disability varied across sub-national regions. We find that low neighborhood trust was associated with an increased likelihood of toileting disability, as was the use of assistive mobility devices. The negative effects of these social and external environment characteristics hold when we stratified the sample by rural and urban residency. Also, older adults in urban areas without access to toilets and using shared latrines had higher odds of being disabled in terms of toileting. Other factors important in explaining toileting disability among older adults included poor self-rated health, arthritis, currently working, living in the East or West region, and having functional limitations. Conclusions: Poor person-environment fit can compromise older adults' ability to perform self-care tasks. Policymakers need to look beyond the physical environment (e.g., dedicating resources to construct toilet facilities) to adopt a more holistic, multi-faceted approach in their sanitation policies. Improving the safety of neighborhood surroundings in which shared latrines are located and the availability of accessible toilets that cater to those with mobility impairments can help improve independence in toileting among older adults. [ABSTRACT FROM AUTHOR]

To explore the relationship between activity engagement and dyadic illness perceptions of community-dwelling individuals with stroke and their caregivers. We performed a secondary analysis on a cross-sectional study encompassing eight rehabilitation settings. Participants were recruited from June to December 2019 via the distribution of flyers, use of admission databases, and direct onsite interactions. Activity engagement of individuals with stroke was measured by the Assessment of Life Habits. Dyadic illness perceptions were measured using the Stroke-Specific Illness Perceptions Questionnaire-Revised. Data from 202 dyads of individuals with stroke (mean age 61.3 ± 8.3 years; 76.7% male; stroke duration 314.3 ± 170.5 days), and caregivers (mean age 52.6 ± 11.6 years; 73.3% female) were analyzed. Results show that individuals with stroke who shared similar optimistic illness perceptions with their caregivers concerning the consequences of stroke had a higher level of activity engagement (ΔR2 =.020, F(2,193) = 5.42, p =.005). Gender differences were found in the dyadic illness perception components concerning acute/chronic and cyclical timeline (ΔR2 =.017, F(2,191) = 4.72, p =.01; ΔR2 =.02, F(2,190) = 3.45, p =.034) and illness coherence (ΔR2 =.012, F(2,191) = 3.42, p =.035). Illness perceptions and post-stroke activity engagement with gender differences should be considered at a dyadic level, as the individuals with stroke and their caregivers influence each other's beliefs. Activity engagement in individuals with stroke is related to how their individual–caregiver dyads perceive their health condition. Clinicians should provide opportunities for individuals with stroke and caregivers to better understand the nature of stroke, and to develop positive outlooks for the future. This information includes, but is not limited to, the relevant sequelae, stroke development and prognosis, treatment and rehabilitation protocols, and the potential impact on daily living. Depending on their genders, individuals with stroke may require different approaches to facilitate community-dwelling activity engagement. Future research is needed to determine the effect of dyadic illness perceptions on post-stroke activity engagement among individuals of different genders. [ABSTRACT FROM AUTHOR]

Background Aim Methods Results Conclusion Cognitive impairment is one of the most common symptoms of Parkinson's disease (PD). In recent years, the effect of transcranial direct current stimulation (tDCS) have been investigated on various disabilities related to PD, including sensory and motor deficits and fatigue.To investigate effects of transcranial direct current stimulation (tDCS) along with cognitive training on attention, working memory, reaction time (RTI), response inhibition, and activities of daily living performance.This pilot randomized, single‐blinded, and sham‐controlled trial was performed on 32 people with PD who were blocked randomized equally into intervention and control groups. Intervention group received ten 20‐min sessions of tDCS during ten 45‐min sessions of cognitive training, while control group received ten 20‐min sessions of sham‐tDCS during ten 45‐min sessions of cognitive training. Anodal electrode of tDCS (2 mA) was placed over left dorsolateral prefrontal cortex (DLPFC), while cathode was over right supraorbital region. A blinded assessor performed pretest, posttest, and follow‐up assessments using the Unified Parkinson's Disease Rating Scale and four subtests of the CANTAB computer test including Match to Sample Visual Search, spatial span task, stop signal task, and RTI.The results showed significant differences within groups over time in the mean scores of attention (F = 24.73, p = 0.00), working memory (F = 19.06, p = 0.000), RTI (F = 8.63, p = 0.005), response inhibition (F = 15.75, p = 0.000), and activity of daily living performance (F = 6.73, p = 0.013).tDCS (anodal electrode over the left DLPFC and cathodal electrode over the right supraorbital region) along with cognitive training could facilitate improvement of cognitive functions and activities of daily living performance compared to routine cognitive exercises in people with PD. [ABSTRACT FROM AUTHOR]

The task of transporting objects is a fundamental part of daily living activities. Previous kinematic studies focusing on tasks such as pointing, reach-to-grasp, and drinking have not fully captured the motor behaviors involved in object transportation, including placing a cup on a table or storing items in specific places. Hence, this study aimed to analyze the motor behavior associated with transporting a mug using upper limb kinematic variables. Fifteen healthy adults were instructed to transport an open-handle mug across a table. The kinematic metrics evaluated included object end-error for accuracy, frontal and lateral end-range for precision, movement time, peak velocity, time to peak velocity for control strategy, object path ratio for efficiency, and interjoint coordination. The stability of motor behavior was assessed through a test-retest analysis. The mug transporting task achieved accuracy with a radius <10 mm around the target, a peak velocity of ∼0.4 m/s, a control strategy where acceleration time constituted about 30% of the movement time, and a slightly curved trajectory. The test-retest analysis confirmed stable motor behavior across all kinematic metrics (ICCs > 0.75). Thus, the mug transporting task exhibited unique and stable kinematic characteristics, distinguishing it from non-transport activities and effectively mirroring transporting activities of daily living. [ABSTRACT FROM AUTHOR]

Introduction: Spinal cord injuries (SCI) are a common medical and socioeconomic problem. Early, holistic care by a specialized medical team can improve the functional condition of patients, reduce the risk of complications and hasten their return to everyday activities. The described case presents the possibilities for cooperation between the members of an interdisciplinary team, and highlights the differences between interventions supporting the client's therapeutic successes. Materials and methods: A 39-year-old man with quadriparesis started rehabilitation three weeks after a cervical spine injury. Initially, he could not stabilize his trunk and head on his own (Barthel scale score 0). An individually-tailored program was planned, including cooperation with physiotherapists (PT), an occupational therapist (OT) and a psychologist. Results: After 15 weeks of the rehabilitation program, independence and functioning improved (Barthel scale - score 65). The client noticed improvement in transferring with assistance, eating meals independently and moving around the building using a wheelchair. He indicated that he was now less afraid of returning home due to his improved ability to perform everyday activities. Conclusions: To achieve the expected effects, physiotherapists and occupational therapists often use similar methods and techniques. Correct communication and cooperation between PT and OT not only allows for mutual complementation of activities, it is also necessary for achieving the intended therapeutic effects. [ABSTRACT FROM AUTHOR]

Background: The application of cerebellar transcranial magnetic stimulation (TMS) in stroke patients has received increasing attention due to its neuromodulation mechanisms. However, studies on the effect and safety of cerebellar TMS to improve balance capacity and activity of daily living (ADL) for stroke patients are limited. This systematic review and meta-analysis aimed to investigate the effect and safety of cerebellar TMS on balance capacity and ADL in stroke patients. Method: A systematic search of seven electronic databases (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang and Chinese Scientific Journal) were conducted from their inception to October 20, 2023. The randomized controlled trials (RCTs) of cerebellar TMS on balance capacity and/or ADL in stroke patients were enrolled. The quality of included studies were assessed by Physiotherapy Evidence Database (PEDro) scale. Results: A total of 13 studies involving 542 participants were eligible. The pooled results from 8 studies with 357 participants showed that cerebellar TMS could significantly improve the post-intervention Berg balance scale (BBS) score (MD = 4.24, 95%CI = 2.19 to 6.29, P < 0.00001; heterogeneity, I2 = 74%, P = 0.0003). The pooled results from 4 studies with 173 participants showed that cerebellar TMS could significantly improve the post-intervention Time Up and Go (TUG) (MD=-1.51, 95%CI=-2.8 to -0.22, P = 0.02; heterogeneity, I2 = 0%, P = 0.41). The pooled results from 6 studies with 280 participants showed that cerebellar TMS could significantly improve the post-intervention ADL (MD = 7.75, 95%CI = 4.33 to 11.17, P < 0.00001; heterogeneity, I2 = 56%, P = 0.04). The subgroup analysis showed that cerebellar TMS could improve BBS post-intervention and ADL post-intervention for both subacute and chronic stage stroke patients. Cerebellar high frequency TMS could improve BBS post-intervention and ADL post-intervention. Cerebellar TMS could still improve BBS post-intervention and ADL post-intervention despite of different cerebellar TMS sessions (less and more than 10 TMS sessions), different total cerebellar TMS pulse per week (less and more than 4500 pulse/week), and different cerebellar TMS modes (repetitive TMS and Theta Burst Stimulation). None of the studies reported severe adverse events except mild side effects in three studies. Conclusions: Cerebellar TMS is an effective and safe technique for improving balance capacity and ADL in stroke patients. Further larger-sample, higher-quality, and longer follow-up RCTs are needed to explore the more reliable evidence of cerebellar TMS in the balance capacity and ADL, and clarify potential mechanisms. [ABSTRACT FROM AUTHOR]

Literature suggests that dementia and, more generally, cognitive impairment affect the capacity to carry out activities of daily living (ADL) in aging. However, it is important to decipher the weight of specific cognitive domains and neurodegenerative profiles mainly related to ADL difficulties. A meta-analysis was conducted to investigate the nature and strength of the association between cognitive functioning and ADL in healthy older adults, mild cognitive impairment (MCI), and dementia. A comprehensive search of the PubMed, PsycINFO (PROQUEST), and Scopus databases for cross-sectional or longitudinal studies up until December 2022. Our meta-analytic results revealed that: overall, instrumental ADL (IADL) showed a significant association with executive functioning, in particular, abstraction ability/concept formation, set-shifting, and processing speed/complex attention/working memory, regardless of type of participants (i.e., healthy older adults, MCI, and dementia); whereas ADL (both basic ADL, BADL, and IADL) significantly correlated with global cognitive functioning and long-term verbal memory, with a moderator effect of clinical condition (e.g., increasing ES based on the level of cognitive impairment). Moreover, visuospatial and language abilities significantly correlated with ADL, mainly when performance-based tasks were used for ADL assessment. These findings emphasize the importance of neuropsychological assessment in aging to early identify people most at risk of functional decline and shed light on the need to consider specific cognitive abilities in rehabilitation programs. [ABSTRACT FROM AUTHOR]

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ObjectiveThis study aimed to assess the prevalence of physical activity and its association with the progression of difficulty performing activities of daily living among older adults in China.MethodsA population-based prospective cohort study based on China Family Panel Studies (CFPS) data was conducted in 2018 and 2020. This study used a logistic model to empirically estimate the effects on daily living activities among older adults.ResultsA total of 2073 older adults aged 60 years and above were included, 78.0% of whom did not exercise. The logistic regression model revealed several predictive factors for activity of daily living decline among older adults. These included residence status (OR = 0.672; 95% CI 0.519–0.869; p = 0.002), age (OR = 0.307; 95% CI 0.169–0.557; p

Background: Improving the quality of life for India's increasing senior population is a pressing public health issue. The proportion of seniors has risen from 5.6% in 1961 to 8.6% in 2011 and is projected to reach 12.5% by 2030, escalating further to 20% by 2050. The study aimed to explore how functional status relates to various HRQOL dimensions among urban elderly in Chengalpattu. Methodology: This cross-sectional study includes 260 elderly participants from Chengalpattu district, Tamil Nadu, India. The Short Form 36 (SF-36) assessed six domains of Health-Related Quality of Life (HRQOL), while the Barthel Activities of Daily Living (ADL) tool evaluated functional status. Results: Primary education stands out as the most common educational background at 49.2%, the majority of females at 55.4%. Daily living participants' activities fall into three categories: independent (n = 134; 51.5%), partially dependent (n = 111; 42.7%), and dependent (n = 15; 5.9%). The ADL and HRQOL ratings showed strong relationships Conclusion: The study underscores how declining ADL adversely affects multiple HRQOL aspects in the elderly, emphasizing the imperative of preserving functional health to enhance seniors' quality of life in India. Targeted interventions to maintain their independence and overall well-being are crucial amid the growing elderly population.

Abstract Background Intrinsic capacity (IC) is a comprehensive indicator of the overall well-being of older adults, and assessing of IC can help identify early stage of disability and tailor intervention to individual needs. However, there is a lack of effective and simple IC assessment tools. This study aimed to establish predictive scoring algorithms of IC to identify older adults at high risk of impaired functional ability. Methods We conducted a cross-sectional study in Southern Taiwan, measuring IC using 7 subitems: cognition, locomotion, vitality, vision, hearing, psychological well-being, and medication usage were measured. Functional ability outcomes included frailty, basic activities of daily living, and instrumental activities of daily living (IADL). The capability of 7 domains of IC in predicting functional ability was assessed by multivariable logistic regression. The prediction of capability of scoring algorithms was indicated by receiver operating characteristic (AUC) curves and measures of sensitivity and specificity. Results A total of 1,152 older adults were recruited and analyzed. Locomotion emerged as a significant predictor of IADL disability and worsening frailty. The IC-based weighted scoring algorism for predicting IADL demonstrated satisfactory capability (AUC: 0.80), as did the algorithm for predicting worsening frailty (AUC: 0.90). The optimal cutoff points for predicting IADL disability and frailty worse were estimated respectively at 13 and 16, with sensitivity/specificity values of 0.74/0.75 for the IADL prediction algorithm and 0.92/0.77 for the frailty prediction algorithm. Conclusion Our 7-domain IC screening tool proves to be sensitive and practical for early identification of functional disability and frailty among community-dwelling older adults in Taiwan.

Background: Knee osteoarthritis is the most prevalent type of osteoarthritis. Patients frequently encounter pain triggered by movement that evolves into impaired joint function. Needing persistent rest or having night-time pain signifies advanced disease. Qualitative research is considered the most effective method for comprehending patients' needs and contexts. Methods: This study employed a qualitative research design, allowing the researchers to acquire insights into the patients' beliefs and values, and the contextual factors influencing the formation and expression of these beliefs and values. Results: A cohort of nine patients awaiting total knee replacement (TKR) surgery was included and they were interviewed until data saturation was achieved. The results of the phenomenological analysis resulted in the identification of three themes: "The existence of pain impedes the capacity to participate in daily life activities"; "TKR induced fears and uncertainties regarding the progression of the disease"; "Severe nighttime pain compromising sleep quality". Conclusions: This study analyzes the experiences of people awaiting TKR surgery, emphasizing the importance of addressing their unique needs to improve preoperative education and rehabilitation. In this way, patients' recovery during the postoperative phase can be improved. [ABSTRACT FROM AUTHOR]

Background: Intrinsic capacity (IC) is a comprehensive indicator of the overall well-being of older adults, and assessing of IC can help identify early stage of disability and tailor intervention to individual needs. However, there is a lack of effective and simple IC assessment tools. This study aimed to establish predictive scoring algorithms of IC to identify older adults at high risk of impaired functional ability. Methods: We conducted a cross-sectional study in Southern Taiwan, measuring IC using 7 subitems: cognition, locomotion, vitality, vision, hearing, psychological well-being, and medication usage were measured. Functional ability outcomes included frailty, basic activities of daily living, and instrumental activities of daily living (IADL). The capability of 7 domains of IC in predicting functional ability was assessed by multivariable logistic regression. The prediction of capability of scoring algorithms was indicated by receiver operating characteristic (AUC) curves and measures of sensitivity and specificity. Results: A total of 1,152 older adults were recruited and analyzed. Locomotion emerged as a significant predictor of IADL disability and worsening frailty. The IC-based weighted scoring algorism for predicting IADL demonstrated satisfactory capability (AUC: 0.80), as did the algorithm for predicting worsening frailty (AUC: 0.90). The optimal cutoff points for predicting IADL disability and frailty worse were estimated respectively at 13 and 16, with sensitivity/specificity values of 0.74/0.75 for the IADL prediction algorithm and 0.92/0.77 for the frailty prediction algorithm. Conclusion: Our 7-domain IC screening tool proves to be sensitive and practical for early identification of functional disability and frailty among community-dwelling older adults in Taiwan. [ABSTRACT FROM AUTHOR]

The preventive effects of chronic physical exercise (CPE) on Alzheimer's disease (AD) are now admitted by the scientific community. Curative effects of CPE are more disputed, but they deserve to be investigated, since CPE is a natural non-pharmacological alternative for the treatment of AD. In this perspective, the authors discuss the impact of CPE on AD based on an exhaustive literature search using the electronic databases PubMed, ScienceDirect and Google Scholar. Aerobic exercise alone is probably not the unique solution and needs to be complemented by other exercises (physical activities) to optimize the slowing down of AD. Anaerobic, muscle strength and power, balance/coordination and meditative exercises may also help to slow down the AD progression. However, the scientific evidence does not allow a precise description of the best training program for patients with AD. Influential environmental conditions (e.g. social relations, outdoor or indoor exercise) should also be studied to optimize training programs aimed at slowing down the AD progression. [ABSTRACT FROM AUTHOR]

Background: Cognitive decline is a major reason for dependence and resource use in long-term care. Objective: We explored whether social activities may prevent cognitive decline of older residents of long-term care facilities. Methods: In a routine care cohort, 3,603 residents of long-term care facilities were assessed on average 4.4 times using the interRAI-Long-Term-Care-Facilities instrument which includes frequency of participation in social activities of long standing interest over the last 30 days and the Cognitive Performance Scale. Linear mixed models repeated measures analyses were performed corrected for age, sex, physical activity, Activities of Daily Living, mood, and health indicators. Results: Social activity was associated with cognitive preservation over time. This association was stronger in those with no or mild cognitive impairment at baseline, relative to those with moderate to severe impairment. Participation in specific social activities such as conversing and helping others showed a similar positive association. The relation between social activity and cognitive impairment appeared to be bi-directional. Conclusions: The protective effects of social activity offer a window of opportunity to preserve cognitive functioning in long-term care residents. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to clarify the relationship between high or low blood pressure (BP) and cognitive function in elderly outpatients with cardiometabolic diseases. Methods: We evaluated the association between BP and the Dementia Assessment Sheet for Community‐based Integrated Care System‐21 items (DASC‐21), Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment Tool (MoCA) (N = 677). Results: The patients' mean age was 79.2 ± 6.3 years (male 35.3%), and BP was 132.1 ± 18.1/73.5 ± 12.2 mmHg. Systolic BP (SBP) was linearly related to the DASC‐21 score (r = −0.122, P = 0.004), but not to the MMSE score (P = 0.101) or MoCA score (P = 0.802). Multiple linear regression analysis showed that lower SBP was significantly related to the DASC‐21 score, even after controlling for confounding factors (B = −0.411 per 10 mmHg; 95% confidence interval [CI], −0.673 to −0.149; P = 0.002). Moreover, logistic regression analysis showed that lower SBP was associated with DASC‐21 ≥ 31 (odds ratio = 0.838 per 10 mmHg, P = 0.048). An MMSE score ≤23 was significantly associated with higher SBP in patients without a history of hypertension but with lower SBP in those with hypertension, those on hypertensive medication, and those with dyslipidemia. Conclusion: Higher BP was associated with a higher prevalence of probable dementia in those without a history of hypertension, even in late life. In those with hypertension and those taking antihypertensives with comorbidities of stroke or heart failure, lower BP was associated with probable dementia, which was largely dependent on reduced activities of daily living, as measured by the DASC‐21 score. Geriatr Gerontol Int 2024; 24: 110–117. [ABSTRACT FROM AUTHOR]

Purpose: Immobilization, especially of the lower extremity, after orthopaedic surgery has been associated with reduced physical activity. Previous interventions from our study group showed even in young, healthy people reduced activity levels after immobilization of the shoulder. Therefore, this study investigates the change in physical activity due to shoulder immobilization after a reconstructive surgery. Methods: This prospective study includes 40 patients undergoing surgery from May 2019 to December 2020. Daily activity was measured before surgery, after discharge and three weeks postoperatively each time for six days. Activity including step counts and active time were measured by Fitbit™ inspire. Range of motion before and after surgery as well as Pain (VAS) were documented. Results: Steps became significantly less immediately postoperatively with an immobilized shoulder joint than before surgery (9728.8 vs. 6022.6, p < 0.05). At follow-up, the number of steps increased again, but still showed a significantly lower number of steps (mean 8833.2) compared to preoperative. Patients preoperatively showed mostly an "active" activity pattern, whereas postoperatively a "low active" behaviour predominated. The proportion of sedentary behaviour ("basal activity" and "limited activity") was almost three times higher postoperatively (12.5% vs. 30%). Conclusion: General physical activity is restricted during upper limb immobilization in adults. Therefore, activity-enhancing measures should be implemented in the early phase of rehabilitation after upper extremity surgery. [ABSTRACT FROM AUTHOR]

Objectives: Examining the health of COVID-19 patients after hospitalization, with a focus on monitoring common and incapacitating symptoms at four weeks and a year after discharge, is a seldom investigated topic that may yield important information about long-term consequences. Methods: Patients who had been admitted for treatment after exhibiting COVID-19 symptoms underwent multiple choice semi-structured interviews in April 2021, followed by a follow-up interview in May 2022. We intended to look into the levels of recovery, the effect on functional abilities, quality of life, fatigue scores, mental health, activity of daily living, and an overall spectrum of symptoms. Results: Out of 350 participants, 148 respondents (42.3 %) recovered after 1 year of illness and 202 (57.7 %) were still experiencing symptoms at the time of survey completion. In our survey, fatigue (97.1 %), dyspnoea (86.6 %), dry cough (83.4 %), joint pain (83.4 %), tingling in limbs (74.6 %), myalgia (59.1 %) and were visible even after 1 year but with reduced severity. Statistically significant change was noticed in fatigue scores, quality of life, mental health and activity of daily living among long COVID survivors at baseline and after 1 year. Conclusions: The frequency of symptoms in our study fits within this fairly broad range noted in literature. Nonetheless, our data do not appear to support the hypothesis that symptoms that linger following COVID-19 are self-limiting: the prevalence of persisting symptoms in our study did not decrease with time.

Background: This study aims to analyze the nursing literature and examine the extent of older people's independence in fulfilling daily living activities. Main body: A study was conducted with bibliometric analysis of research papers published between 2000 and 2022, which focused on the elderly's level of independence in performing daily living activities. The analysis aimed to identify trends in publications in the fields of nursing, health science, clinical science, and public health. VOSviewer was used to analyze the data and review the results for co-authors and co-occurrence. There were 8,209 articles obtained from 2000 to 2022 in the health sciences and nursing research fields. The country that conducted the highest amount of research on activities of daily living (ADLs) was China, with topics such as intervention, outcome, improvement, elderly population, prevalence, and proportion being explored. In intervention research, common points of discussion include systematic reviews, measurements, improvements, outcomes, elderly individuals, and patients. The variable of daily activity with the least description pertains to a decrease in ADL, functional disability, and risk factors. Conclusion: In many nations, particularly developing nations, ADL become concerned about the level of independence of the elderly.

Abstract Objective This study, based on the China Hainan Centenarians Cohort Study (CHCCS), aims to comprehensively describe the characteristic of daytime, night and total sleep duration, sleep quality and different sleep mode of Hainan centenarians and their associations with activity of daily living (ADL) functions. Method The baseline data of CHCCS was used. ADL function was evaluated the Bathel index, sleep quality was evaluated by Pittsburgh sleep quality index (PSQI), sleep status including daytime, night and total sleep duration as well as sleep quality and sleep mode. Multivariate logistic regression model was used to explore the association between sleep status and ADL disability and ADL moderate & severe disability. Results A total of 994 centenarians were included in this study with the age range 100–116 years old. Compared with the centenarians who sleep 6–9 h at night and 9 h at night and sleep ≥ 2 h in the daytime and ADL disability was 2.93 (95% CI: 1.02–8.44), and adjusted OR of ADL moderate & severe disability was 2.75 (95% CI: 1.56–4.83). Compared with centenarians who sleep for 7–9 h and have good sleep quality, centenarians who sleep for > 9 h and have poor sleep quality have an increased risk of ADL moderate & severe disability (OR = 3.72, 95% CI: 1.54–9.00). Conclusion Relation between sleep duration and ADL disability was more significant compared with sleep quality in Hainan centenarians. Poor sleep quality can aggravate the relationship between sleep duration and ADL moderate & severe disability.

The aim of this contribution is to present a segmentation method for the identification of voluntary movements from inertial data acquired through a single inertial measurement unit placed on the subject’s wrist. Inertial data were recorded from 25 healthy subjects while performing 75 consecutive reach-to-grasp movements. The approach herein presented, called DynAMoS, is based on an adaptive thresholding step on the angular velocity norm, followed by a statistics-based post-processing on the movement duration distribution. Post-processing aims at reducing the number of erroneous transitions in the movement segmentation. We assessed the segmentation quality of this method using a stereophotogrammetric system as the gold standard. Two popular methods already presented in the literature were compared to DynAMoS in terms of the number of movements identified, onset and offset mean absolute errors, and movement duration. Moreover, we analyzed the sub-phase durations of the drinking movement to further characterize the task. The results show that the proposed method performs significantly better than the two state-of-the-art approaches (i.e., percentage of erroneous movements = 3%; onset and offset mean absolute error < 0.08 s), suggesting that DynAMoS could make more effective home monitoring applications for assessing the motion improvements of patients following domicile rehabilitation protocols.

In the SARS‐CoV‐2 Omicron period, the pattern of pneumonia changed from primarily viral pneumonia to pneumonia mixed with bacteria in the elderly. We investigated functional outcomes at 1 year after hospital discharge in patients with primary Omicron pneumonia and pneumonia mixed with bacteria, mainly aspiration pneumonia. Functional decline rates calculated using the Barthel Index at 1 year after hospital discharge were significantly higher in the pneumonia mixed with bacteria group than the primary viral pneumonia group (42.6% vs. 20.5%, p < 0.0001). It is necessary to consider early rehabilitation and treatment in elderly patients even when the predominant strain is the Omicron variant. [ABSTRACT FROM AUTHOR]

Background: Post-stroke depression (PSD) is the most common mental complication after stroke and has a serious impact on functional outcomes and quality of life for stroke patients. Antidepressants are the first-line treatment for PSD; however, many reported side effects remain. Clinical research and practice guidelines have shown that electro-acupuncture (EA) or rTMS have a positive effect on PSD. However, there are few clinical studies on EA and MRI-navigated rTMS for PSD that explore the fMRI-based central mechanism in depression. Methods: In this randomized, controlled, open-label trial, 64 patients with PSD will be randomly allocated into the experiment group (n = 32) or control group (n = 32). The experiment group will receive EA and MRI-navigated rTMS and the control group will receive MRI-navigated rTMS treatment, in 12-20 sessions over 4 weeks. In addition, 10 healthy people for fMRI scanning will be recruited as a healthy control group without any intervention. The primary outcome will be the change from baseline in the Hamilton Depression Scale-24 item (HAMD-24) scores at week 4. The primary analysis of the central mechanism will mainly involve cortical morphology, local spontaneous brain activity, and the default mode network (DMN) functional connectivity based on fMRI at 0 and 4 weeks. Secondary outcomes will include the neuro-patho-physiological and quality of life changes in cortical excitability, determined using the motor evoked potential test (MEP), National Institutes of Health Stroke Scale (NIHSS), EuroQol Five Dimensions Questionnaire (EQ-5D) Scale, Modified Barthel Index (MBI) Scale, and Health Scale of Traditional Chinese Medicine (HSTCM). Additional indicators will include the Acceptability Questionnaire and Health Economics Evaluation (cost-effectiveness analysis) to assess the acceptability and economic practicality of the treatment under study. Outcomes will be assessed at baseline and post intervention. Discussion: EA and MRI-navigated rTMS therapy could become an alternative treatment for PSD, and it is expected that this trial will provide reliable clinical evidence and a potential central mechanism for the future use of EA and MRInavigated rTMS for PSD. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis is a chronic knee disease that is caused due to wear and tear injury or inflammation in the joint causing pain and limiting ROM. The condition leads to joint stiffness which causes joint weakness and loss of stability and balance. The purpose of this study is to determine whether ASE or CE is effective in reducing pain and improving balance in an OA knee subject. Purpose: To find out the effect of aerobic strengthening exercise and conventional exercise in reducing pain and improving balance in osteoarthritis knee. Materials and Methods: 198 individuals aged from 55 to 70 of both genders suffering from pain and reduced balance in OA knee participated in the study taken from Dynamics physiotherapy and rehabilitation centre. The individuals were randomly assigned into two groups. Group A received ASE; Group B received CE for 4 weeks. The functional state of the subjects was evaluated pre and post using the NPRS and TUG test. The entire process was conducted from November 2022 to March 2023. Results: Aerobic strengthening exercise was found to be effective compared to conventional exercise in improving balance and reducing pain in OA knee subjects. Conclusion: Group A had better balance and seemed to have reduced pain in OA knee during ADL compared to Group B. It is concluded that ASE provides balance and reduces pain and is seen as an effective treatment in OA knee. [ABSTRACT FROM AUTHOR]

• Refractures have a negative impact on the elderly. • Nutritional status associated with osteoporotic refractures in older people. • Geriatric nutritional risk index can predict the occurrence of refractures. This paper focuses on revealing the relationship between the Geriatric Nutritional Risk Index (GNRI) and Activity of Daily Living (ADL) with osteoporotic refracture. Data from 1068 inpatients with osteoporotic fractures were analyzed. Binary logistic regression, Cox proportional hazard regression and Kaplan-Meier curves were performed for osteoporosis characteristics and its risk factors. Receiver operating characteristic (ROC) curve was developed to predict the cut-off value. The study showed that older age, lower ADL and lower GNRI were independent risk factors for osteoporotic fracture with OR of 1.039, 0.946, 0.892 and HR of 1.033, 0.967, 0.947 respectively. According to the results of ROC, the predictive accuracy of GNRI was high with an area under ROC (AUC) of 0.715, sensitivity of 76.6%, specificity of 53.5% and a threshold value of 99.65. Older age, lower ADL and lower GNRI were independent risk factors for osteoporotic refracture. [ABSTRACT FROM AUTHOR]

Objective: This study, based on the China Hainan Centenarians Cohort Study (CHCCS), aims to comprehensively describe the characteristic of daytime, night and total sleep duration, sleep quality and different sleep mode of Hainan centenarians and their associations with activity of daily living (ADL) functions. Method: The baseline data of CHCCS was used. ADL function was evaluated the Bathel index, sleep quality was evaluated by Pittsburgh sleep quality index (PSQI), sleep status including daytime, night and total sleep duration as well as sleep quality and sleep mode. Multivariate logistic regression model was used to explore the association between sleep status and ADL disability and ADL moderate & severe disability. Results: A total of 994 centenarians were included in this study with the age range 100–116 years old. Compared with the centenarians who sleep 6–9 h at night and < 2 h in the daytime, the adjusted OR between sleep > 9 h at night and sleep ≥ 2 h in the daytime and ADL disability was 2.93 (95% CI: 1.02–8.44), and adjusted OR of ADL moderate & severe disability was 2.75 (95% CI: 1.56–4.83). Compared with centenarians who sleep for 7–9 h and have good sleep quality, centenarians who sleep for > 9 h and have poor sleep quality have an increased risk of ADL moderate & severe disability (OR = 3.72, 95% CI: 1.54–9.00). Conclusion: Relation between sleep duration and ADL disability was more significant compared with sleep quality in Hainan centenarians. Poor sleep quality can aggravate the relationship between sleep duration and ADL moderate & severe disability. Key points: 1. The median duration of daytime sleep (Q1, Q3) was 1.00 (0.50,1.50) hour, while those of night sleep and total sleep (Q1, Q3) were 8.00 (7.00,9.00) hours and 9.00 (8.00,10.50) hours in the centenarians, respectively. And 35.5% of them had poor sleep quality. 2. Compared with sleep quality, the relationship between sleep duration and activity of daily living (ADL) disability was more significant. 3.Centenarians with long sleep duration both at night and in the daytime have high risk of ADL disability and ADL moderate & severe disability. 4. Poor sleep quality could aggravate the relationship between sleep duration on ADL moderate & severe disability. [ABSTRACT FROM AUTHOR]

Abstract Objective There are several meta-analyses of randomized controlled trials (RCTs) demonstrating the benefits of virtual reality (VR) training as an intervention for motor performance, activity of daily living (ADL) and quality of life (QoL) outcomes in patients with Parkinson's disease (PD). However, the aggregate evidence collected to date has not been thoroughly evaluated for strength, quality, and reproducibility. An umbrella review from published meta-analyses of RCTs was conducted to evaluate the strength and quality of existing evidence regarding the efficacy of VR training in improving the motor performance, ADL and QoL outcomes of patients with PD. Methods PubMed, PsychInfo, Web of Science, and Scopus were searched to identify relevant meta-analysis of RCTs examining the effects of VR training on motor performance and quality of life outcomes in PD patients. We recalculated the effect sizes (Hedges’g) for VR training using DerSimonian and Laird (DL) random effects models. We further assessed between-study heterogeneity, prediction interval (PI), publication bias, small-size studies, and whether the results of the observed positive studies were better than would be expected by chance. Based on these calculations, the quality of evidence for each outcome was assessed by using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. Results Four meta-analysis with eight outcomes included in the umbrella review was recalculated effect size. Pooled results found VR training can large improve the basic balance ability, moderate improve the overall balance capacity and moderate improve the stride length in PD patients. For ADL and QoL, the effect sizes were pooled that suggested VR training can moderate improve ADL and QoL for PD patients. However, no statistically clear evidence was found in walking speed, motor function and gait function during VR training. The analyzed meta-analyses showed low-to-moderate methodological quality (AMSTAR2) as well as presented evidence of moderate-to-very low quality (GRADE). Tow adverse reactions were reported in the included meta-analyses. Conclusions In this umbrella review, a beneficial correlation between VR and balance ability, stride length, ADL and QoL in PD patients was discovered, especially for the very positive effect of VR on balance because of two of the eight outcomes related to balance ability showed large effect size. The observations were accompanied by moderate- to very low-quality rating evidence, supporting VR training as a practical approach to rehabilitation.

Much interest in lonely death and activity of daily living (ADL) monitoring services through analysis from household power consumption data is increasing. For this, anomaly detection and power disaggregation are needed, respectively. However, the existing technologies suffer from inaccuracy problem, so they are not widely used. In this study, activity perception-based anomaly detection and appliance activation profile-based disaggregation methods are newly presented to improve accuracy. According to the experimental results, the proposed methods showed better performance than the existing methods.

Abstract Background Stroke is the leading cause of mortality. This study aimed to investigate the association between stroke, comorbidities, and activity of daily living (ADL) among older adults in the United States. Methods Participants were 1165 older adults aged 60 and older from two waves (2016 and 2018) of the Health and Retirement Study who had a stroke. Descriptive statistics were used to describe demographic information and comorbidities. Logistic regressions and multiple regression analyses were used to determine associations between stroke, comorbidities, and ADL. Results The mean age was 75.32 ± 9.5 years, and 55.6% were female. An adjusted analysis shows that older stroke adults living with diabetes as comorbidity are significantly associated with difficulty in dressing, walking, bedding, and toileting. Moreover, depression was significantly associated with difficulty in dressing, walking, bathing, eating, and bedding. At the same time, heart conditions and hypertension as comorbidity were rarely associated with difficulty in ADL. After adjusting for age and sex, heart condition and depression are significantly associated with seeing a doctor for stroke (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.49–0.91; p = 0.01) and stroke therapy (OR: 0.46; 95% CI: 0.25–0.84; p = 0.01). Finally, stroke problem (unstandardized β [B] = 0.58, p = 0.017) and stroke therapy (B = 1.42, p

Background: Total hip arthroplasty (THA) is an orthopaedic procedure that improves the quality of life in patients suffering from hip pain related to osteoarthritis, fractures, and avascular osteonecrosis of the femoral head. Different surgical approaches can be used for THA leading to different recovery times. Because of the lowering medium age of people undergoing THA, it is important to focus on the earlier return of physiological activity after surgery. Aim: To evaluate the best approach for THA in terms of earlier return to activity. Method: Studies comparing the postoperative outcomes in patients who underwent THA through different approaches were analysed focusing on patients' self-reported outcomes, ADL score and UCLA activity score with a short follow-up. Results: A total of 1990 articles were identified in the search, and 14 met the inclusion criteria. The Review Manager software version 5.4 was used to conduct a meta-analysis to compare the direct anterior (DAA) and posterior (PA) approaches, which are the most adopted approaches. An earlier return to walk without aids and to independent ADLs were reported with DAA, but without statistical significance (respectively p = 0.06 and p = 0.10). The time to return to drive was similar among the 2 groups (p = 0.88). The return to work was faster with PA, but no statistical significance was reported (p = 0.47). Conclusions: Further studies are needed with a larger number of patients, that present homogeneous outcomes, follow-ups and rehabilitation programmes, and that compare similar surgical approaches to assess the early return to activity of daily living after THA. [ABSTRACT FROM AUTHOR]

The integration of information and communication technologies (ICT) can be of great utility in monitoring and evaluating the elderly's health condition and its behavior in performing Activities of Daily Living (ADL) in the perspective to avoid, as long as possible, the delays of recourse to health care institutions (e.g., nursing homes and hospitals). In this research, we propose a predictive model for detecting behavioral and health-related changes in a patient who is monitored continuously in an assisted living environment. We focus on keeping track of the dependency level evolution and detecting the loss of autonomy for an elderly person using a Hidden Markov Model based approach. In this predictive process, we were interested in including the correlation between cardiovascular history and hypertension as it is considered the primary risk factor for cardiovascular diseases, stroke, kidney failure and many other diseases. Our simulation was applied to an empirical dataset that concerned 3046 elderly persons monitored over 9 years. The results show that our model accurately evaluates person's dependency, follows his autonomy evolution over time and thus predicts moments of important changes. [ABSTRACT FROM AUTHOR]

Objective: There are several meta-analyses of randomized controlled trials (RCTs) demonstrating the benefits of virtual reality (VR) training as an intervention for motor performance, activity of daily living (ADL) and quality of life (QoL) outcomes in patients with Parkinson's disease (PD). However, the aggregate evidence collected to date has not been thoroughly evaluated for strength, quality, and reproducibility. An umbrella review from published meta-analyses of RCTs was conducted to evaluate the strength and quality of existing evidence regarding the efficacy of VR training in improving the motor performance, ADL and QoL outcomes of patients with PD. Methods: PubMed, PsychInfo, Web of Science, and Scopus were searched to identify relevant meta-analysis of RCTs examining the effects of VR training on motor performance and quality of life outcomes in PD patients. We recalculated the effect sizes (Hedges'g) for VR training using DerSimonian and Laird (DL) random effects models. We further assessed between-study heterogeneity, prediction interval (PI), publication bias, small-size studies, and whether the results of the observed positive studies were better than would be expected by chance. Based on these calculations, the quality of evidence for each outcome was assessed by using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. Results: Four meta-analysis with eight outcomes included in the umbrella review was recalculated effect size. Pooled results found VR training can large improve the basic balance ability, moderate improve the overall balance capacity and moderate improve the stride length in PD patients. For ADL and QoL, the effect sizes were pooled that suggested VR training can moderate improve ADL and QoL for PD patients. However, no statistically clear evidence was found in walking speed, motor function and gait function during VR training. The analyzed meta-analyses showed low-to-moderate methodological quality (AMSTAR2) as well as presented evidence of moderate-to-very low quality (GRADE). Tow adverse reactions were reported in the included meta-analyses. Conclusions: In this umbrella review, a beneficial correlation between VR and balance ability, stride length, ADL and QoL in PD patients was discovered, especially for the very positive effect of VR on balance because of two of the eight outcomes related to balance ability showed large effect size. The observations were accompanied by moderate- to very low-quality rating evidence, supporting VR training as a practical approach to rehabilitation. [ABSTRACT FROM AUTHOR]

This study aimed to assess the predominant predictors of functional disability in terms of involvement of activity of daily living (ADL) of urban geriatric subjects of Varanasi, India. This community-based cross-sectional study was undertaken on 616 urban geriatric subjects, selected through a multistage sampling procedure. The functional disability of subjects was assessed by using Barthel's Index of ADL. Statistical analysis was done using Statistical Package for Social Sciences. Chi-square test and logistic regression analysis were done. Among all sociodemographic variables, age and marital status of subjects were significantly associated with their ADL status. In logistic regression, only age was a significant predictor of ADL involvement. Adjusted odds ratio for functional disability in the age group ≥80 years and 70-79 years were 19.82 [95% confidence interval (CI): 4.5-86.58] and 2.86 (95% CI: 1.91-4.28), respectively. Despite the several influencing factors, ageing and functional ability of geriatric subjects share an unbreakable bond. [ABSTRACT FROM AUTHOR]

Background: Life expectancy (LE) is increasing worldwide, while there is lack of information on how this affects older individuals' use of formal home care services. Aim: We aimed to decompose LE into years with and without home care services and estimate projected number of users towards 2050 in Norway for people 70 years or older. Methods: This study is based on a sample of 25,536 participants aged 70 years and older in the Trøndelag Health Study (HUNT) survey 2 (1995–1997), 3 (2006–2008), or 4 (2017–2019) linked with national data on mortality. Prevalence of home care services was standardised to the Norwegian population by age and sex. The Sullivan method was used to estimate expected years with and without home help services and nursing services for the years 1995, 2006 and 2016. Data from HUNT4 and Statistics Norway were used to estimate projected use of these services between 2020 and 2050. Results: During 1995–2017, the use of home help services decreased from 22.6% to 6.2% (p < 0.001), and from 6.4% to 5.5% (p = 0.004) for home nursing services. Adjusted for age and sex, the use of home help services decreased significantly over time (p < 0.001), while home nursing services were stable (p = 0.69). LE at age 70 increased from 11.9 to 15.3 years in men (p < 0.05) during 1995–2017, and from 14.7 to 17.1 in women (p < 0.05). In the same period, the expected years receiving home help decreased from 2.6 to 1.1 in men (p < 0.05), and from 4.4 to 2.1 in women (p < 0.05). The expected years receiving home nursing increased from 0.6 to 0.9 in men (p < 0.05), and from 1.3 to 1.7 in women (p < 0.05). Projected numbers of people 70+ in Norway in need of either of these services were estimated to rise from 64,000 in 2020 to 160,000 in 2050. Conclusion: While overall life expectancy increased, the expected years receiving home help have decreased and home nursing slightly increased among the Norwegian population aged 70 years and older during 1995–2017. However, the substantial increase in the projected number of older adults using home care services in the future is an alert for the current health care planners. [ABSTRACT FROM AUTHOR]

Functional internal rotation (fIR) motion remains a concern after reverse shoulder arthroplasty (RSA). The extreme variability of the coracoid morphometry together with the gain in tension of the conjoint tendon could impact internal rotation (IR) after RSA. Our aim was to evaluate the relationship between postoperative IR outcome and coracoid morphometry, evaluated as anteroposterior (AP) and mediolateral (ML) glenocoracoid distances in a 3-dimensional preoperative computed tomography scans, in a consecutive series of patients undergoing the same RSA implant. A retrospective analysis of a prospectively collected series of 40 patients (18 male, 22 female; mean age (standard deviation [SD]), 73.4 years [4.1]) submitted to RSA for cuff tear arthropathy was performed. fIR function was measured as the highest midline segment of the back that can be reached and converted into 5 range segments of motion. Participants were divided into 2 groups according to the fIR (group A, ≤6; group B, >6). Passive IR was also measured. The AP and ML glenocoracoid distances were measured, in millimeters, on the preoperative 3-dimensional computed tomography scans. Statistics were performed. The mean follow-up was 29 months (range, 24-39). The mean score for fIR was 6.45 (SD: 1.81) while the mean score for passive IR was 6.84 (SD: 1.75). No difference was found between fIR and passive IR (P =.328). No statistical difference was found between fIR and glenosphere size (P =.562) and fIR and size of the liner (P =.429). Significant statistical correlations have been found between AP and ML coracoid distances and the two groups (AP in group A: 28.50 and B: 31.265, P =.034; ML in group A: 23.053 and B: 14.27, P <.001). Our study demonstrated that coracoid morphometry, evaluated as glenocoracoid distance, significantly impact IR outcomes in a 145° neck shaft angle RSA; in particular, a high ML glenocoracoid distance (>23 mm) was found to be determinant. This anatomical parameter should be considered in the preoperative planning of RSA and additional surgical strategies addressed in order to gain satisfactory fIR. [ABSTRACT FROM AUTHOR]

Aging affects fatigability and is a risk factor for incurring a fatigue-related injury in the neck/shoulder region. Age-related changes in the electromyographical features of motor control may be partly responsible. Young (N = 17) and older (N = 13) adults completed a reach-and-lift task at their self-selected speed, before and after a fatiguing task targeting the neck/shoulder. Electromyography amplitude (root mean square), amplitude variability (root mean square coefficient of variation [CV]), functional connectivity (normalized mutual information [NMI]), and functional connectivity variability (NMI CV) were extracted from several muscles and analyzed for effects and interactions of age using general estimating equation models. Root mean square CV and deltoid NMI CV increased from pre- to postfatigue (ps <.05). Upper trapezius–deltoid NMI decreased for young, but increased for older adults, while the opposite response was found for lower trapezius–deltoid NMI (ps <.05). Older adults seem to adapt to fatigue in reach-and-lift movement with a cranial shift in control of the scapula. [ABSTRACT FROM AUTHOR]