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Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = −0.27, p =.008), body mass index (β = −0.29, p =.002), Barthel Index (β = 0.24, p =.040), and hand grip strength (β = 0.30, p =.048). SB was significantly predicted by body mass index (β = 0.27, p =.008) and Barthel Index (β = −0.30, p =.012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB. [ABSTRACT FROM AUTHOR]

Background: Both pre-or post-COVID-19, older adults residing in nursing homes are at significant risk for social isolation, which is negatively associated with cognitive ability. Currently, the elderly aged 80 years and older are the fastest-growing age group globally. The extent of social isolation within this group post-COVID-19 and its impact on cognitive abilities remain inadequately explored. Objective: This research aimed to evaluate the prevalence of social isolation among the oldest old in Chinese nursing homes post-COVID-19 and to investigate the mediating and moderating roles of basic activities of daily living (BADL), depression, and subjective socioeconomic status in the relationship between social isolation and cognitive ability. Methods: This cross-sectional study included 453 participants aged 80 years and older from 11 nursing homes in Ningbo, Zhejiang Province, China. Social isolation was assessed using the Lubben Social Network Scale-6 (LSNS-6), cognitive ability using the Mini-Mental State Examination (MMSE), BADL using the Barthel Index (BI), and depression using the Patient Health Questionnaire-9 items (PHQ-9). Mediation and moderation effects were statistically analyzed using SPSS 23.0 and PROCESS 3.5. Results: The mean age of the study sample was 87.1 ± 3.8 years, among whom 60.3% (n = 273) were female, and 56.1% experienced social isolation, with 41.1% and 63.1% being isolated from family and friends, respectively. Social isolation indirectly affected cognitive ability through BADL and depression, respectively, and through the chain mediation effect of BADL and depression. Subjective socioeconomic status moderated the relationships between social isolation and BADL and between social isolation and depression. However, no moderating effect of subjective socioeconomic status was found between social isolation and cognitive ability. Conclusion: This study deepens our understanding of the current state of social isolation and its mechanisms of action in the oldest old post-COVID-19 and provides a new basis for future public health policy development and related research. [ABSTRACT FROM AUTHOR]

Background: Stroke patients often experience limb dysfunction, which can significantly impact their quality of life and daily living abilities. This study aimed to explore the effectiveness of nursing programs that incorporate multidisciplinary continuing care with the participation of nursing staff for patients with stroke and limb dysfunction. Methods: This was a randomized controlled trial (RCT) conducted from August 2021 to August 2023. Ninety stroke patients were randomly assigned to a control group (n = 45) and an observation group (n = 45). The control group received routine discharge care, while the observation group received multidisciplinary continuing care with the participation of nursing staff. Outcomes measured included Fugl-Meyer Assessment (FMA) scores for upper and lower limb function, quality of life, daily living ability (Barthel Index, MBI), and adverse reactions. Results: The FMA scores for upper and lower limbs were significantly higher in the observation group compared to the control group. The observation group also had significantly higher scores in all quality of life dimensions and MBI scores compared to the control group. There were 10 adverse reactions reported in the observation group and 22 in the control group. Conclusions: Implementing multidisciplinary continuing care with the participation of nursing staff for stroke patients with limb dysfunction has a positive effect on improving limb function, quality of life, and daily living abilities, while also being relatively safe. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to explore the feasibility of using machine learning approaches to objectively differentiate the mobilization patterns, measured via accelerometer sensors, of patients pre- and post-intervention. Methods: The intervention tested the implementation of a Frailty Care Bundle to improve mobilization, nutrition and cognition in older orthopedic patients. The study recruited 120 participants, a sub-group analysis was undertaken on 113 patients with accelerometer data (57 pre-intervention and 56 post-intervention), the median age was 78 years and the majority were female. Physical activity data from an ankle-worn accelerometer (StepWatch 4) was collected for each patient during their hospital stay. These data contained daily aggregated gait variables. Data preprocessing included the standardization of step counts and feature computation. Subsequently, a binary classification model was trained. A systematic hyperparameter optimization approach was applied, and feature selection was performed. Two classifier models, logistic regression and Random Forest, were investigated and Shapley values were used to explain model predictions. Results: The Random Forest classifier demonstrated an average balanced accuracy of 82.3% (± 1.7%) during training and 74.7% (± 8.2%) for the test set. In comparison, the logistic regression classifier achieved a training accuracy of 79.7% (± 1.9%) and a test accuracy of 77.6% (± 5.5%). The logistic regression model demonstrated less overfitting compared to the Random Forest model and better performance on the hold-out test set. Stride length was consistently chosen as a key feature in all iterations for both models, along with features related to stride velocity, gait speed, and Lyapunov exponent, indicating their significance in the classification. Conclusion: The best performing classifier was able to distinguish between patients pre- and post-intervention with greater than 75% accuracy. The intervention showed a correlation with higher gait speed and reduced stride length. However, the question of whether these alterations are part of an adaptive process that leads to improved outcomes over time remains. [ABSTRACT FROM AUTHOR]

Introduction/objectives: Primary health care visits post-discharge could potentially play an important role in efforts of reducing hospital readmission. Focusing on a single or a particular type of visit obscures nuances in types of primary care contacts over time and fails to quantify the intensity of primary health care visits during the follow-up period. The aim of this study was to explore associations between the number and type of primary health care visits post-discharge and the risk of hospital readmission within 30 days. Methods: A register-based closed cohort study. The study population of 6135 individuals were residents of Stockholm who were discharged home from any of the 3 geriatric inpatient departments, excluding those who were readmitted within the next 24 h. The dependent variable was hospital readmission within 30 days of discharge. The key independent variable was the number and type of primary health care visits in 30 days post-discharge. Cox-regression with time-varying covariates was employed for data analyses. Results: Approximately, 12% of the participants were readmitted to hospital within 30 days. There was no statistically significant association between number of primary care visits post-discharge and readmission (HR 1.00; 95% CI 1.00-1.01). Compared to no primary health care visit, no statistically significant association were found for administrative care related visits (HR 0.33, 95%CI 0.08-1.33), clinic visits (HR 0.93, 95%CI 0.71-1.21), home visits (HR 1.03, 95%CI 0.84-1.27), or team visits (HR 0.76, 95%CI 0.54-1.07). Conclusions: There were no associations between primary health care visits post-discharge and hospital readmission after geriatric inpatient care. Further studies using survey or qualitative approaches can provide insights into the factors that are relevant to post-discharge care but are unavailable in this type of register data studies. [ABSTRACT FROM AUTHOR]

Background: For patients with sepsis receiving non-invasive ventilation (NIV), early rehabilitation is crucial. The Sitting Baduanjin (SBE) is an efficient early rehabilitation exercise suitable for bed patients. There is no consensus about the effect of SBE on the early rehabilitation of septic patients with NIV. This study focused on how the SBE affected the early rehabilitation of sepsis patients with NIV. Methods: 96 sepsis patients with NIV were randomly assigned to either an Baduanjin group that received the SBE based on the routine rehabilitation exercise (n = 48) or a control group (n = 48) that received routine rehabilitation exercise. The primary outcome was the Medical Research Council(MRC)score, and the Barthel Index score, the duration of NIV, length of ICU stay, length of total stay, hospitalization expense as secondary outcomes. Results: A total of 245 sepsis patients were screened, with 96 randomly assigned. The study was completed by 90 patients out of the 96 participants.Results revealed that the MRC score increased in both groups, but the improvement of muscle strength in Baduanjin group was more obvious, with statistical significance (p < 0.001).There was statistically significantly difference between the two groups in Barthel Index at the day of transfer out of ICU(P = 0.028).The patients in the Baduanjin group had an average reduction of 24.09 h in the duration of NIV and 3.35 days in total length of hospital stay compared with the control group (p < 0.05).Of note, the Baduanjin group had significantly reduction the total hospitalization expense. No serious adverse events occurred during the intervention period. Conclusions: In patients with sepsis, the SBE appears to improve muscle strength and activities of daily living (ADL), and lowed the duration of NIV, the length of the total stay, and the hospitalization expense. Trial registration: The study registered on the Chinese Clinical Trial Registry (www.chictr.org.cn), Clinical Trials identifier ChiCTR1800015011 (28/02/2018). [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONDifferential Item Functioning (DIF), an item malfunctioning, causes Differential Test Functioning (DTF), thus biasing questionnaire measures. The current study evaluates the relationship between DIF and DTF for the Barthel Index and the Functional Independence Measure, likely the most used disability measures. The aim is to understand under which conditions DIF can be ignored as its DTF is negligible.A simulation study was run. Disability measures were obtained for the Barthel Index and FIM motor domain using Rasch analysis with previously published item calibrations. Several DIF scenarios have been assessed. DTF was tolerable if ≤0.50 logits.Simulations showed that the larger the DIF, the larger the DTF and that, keeping the overall DIF constant, the total number of items with DIF does not affect DTF. DIF of the items with the lowest or highest calibrations is the most dangerous. The DIF of central items should be so massive to matter in DTF terms that it is unlikely to happen in practice. The FIM robustness to DIF is better than that of the Barthel Index.The FIM and the Barthel Index show remarkable robustness to DIF. Thanks to this feature, sample invariant, generalisable disability measures are available.The Barthel Index and the Functional Independence Measure are two assessment procedures for evaluating disability.It is demonstrated that the Functional Independence Measure and the Barthel Index are remarkably resistant to Differential Item Functioning.As a result, these questionnaires yield very generalisable disability measures.The Barthel Index and the Functional Independence Measure are two assessment procedures for evaluating disability.It is demonstrated that the Functional Independence Measure and the Barthel Index are remarkably resistant to Differential Item Functioning.As a result, these questionnaires yield very generalisable disability measures. [ABSTRACT FROM AUTHOR]

Introduction: Early surgery for hip fracture, within 48 hours of hospital admission, is effective in reducing mortality. However, the average preoperative waiting time for hip fractures in Japan is 4.5 days and the 1-year mortality rate after a hip fracture is 10% in Japan. This study aimed to investigate whether early surgery, within 48 hours, could reduce the 1-year mortality rate in patients with hip fractures in Japan. Methods: This cohort study involved 402 consecutive patients with hip fractures who underwent surgical treatment between January 2013 and September 2019. The exclusion criteria were an age of <60 years and in-hospital injury. A total of 389 patients were included in this study. The patients were divided into two groups: those who underwent early surgery within 48 hours of admission (early group) and those who di not undergo early surgery (delayed group). We compared patient characteristics and treatment outcomes between the 2 groups. Results: A comparison of patient characteristics revealed that the early group had lower hemoglobin levels (P=0.046), lower C-reactive protein levels (P = 0.031), lower numbers of patients with weekend hospitalization, lower numbers of patients with a history of using medications that may cause bleeding (P < 0.01), and who received general anaesthesia (P < 0.01). However, there were no significant differences with regard to the other variables between the 2 groups. A treatment outcome analysis showed that the early group had shorter waiting times for surgery (P < 0.01) and shorter stays in acute-care wards (P < 0.01). However there were no differences in the total hospital stay, Barthel index at discharge, home discharge rates, in-hospital mortality rates, and 1-year mortality. Conclusion: Our findings indicate that early surgery did not reduce the 1-year mortality rate in older patients with hip fractures in Japan. [ABSTRACT FROM AUTHOR]

Background: Dependency is defined as a person's inability to meet basic human needs. In the context of aging, biopsychosocial changes compromise functionality, predisposing older adults to rely on others to perform daily activities. Fear of dependency describes the fear people have of appearing and/or being weak and/or reliant on others. The Fear of Dependency Scale (FDS), developed by Adams-Price and Ralston in 2016, aims to assess the fear of dependency by measuring an individual's attitudes toward being helped. Objective: This study presents a European Portuguese version of the FDS and examines its psychometric properties (internal consistency reliability and content validity). Methods: The translation and both cultural and linguistic adaptation of the FDS were performed by a panel of experts. A cross-sectional study was then performed to evaluate the psychometric properties (in terms of its reliability and validity) of the translated version of the FDS among a sample of 100 community-dwelling older adults. Results: The European Portuguese version of the FDS exhibited good psychometric properties. The scale's internal consistency was 0.84. Conclusions: The European Portuguese version of the FDS is a reliable, valid, and practical instrument for assessing the fear of dependency in older adults in the Portuguese population. It can be used in the context of health care provision and research. [ABSTRACT FROM AUTHOR]

Most research focuses around impairments in body function and structure, with relatively only a small number exploring their social impact. 1) compare characteristics for individuals who before stroke were blue collar vs. white collar workers 2) identify clinical, functional, and job-related factors associated with return to work within 1 year after discharge 3) identify specific ADL individual items (assessed at rehabilitation discharge) as return to work predictors and 4) identify return to work causal mediators. Retrospective observational cohort study, analyzing adult patients with stroke admitted to rehabilitation between 2007 and 2021, including baseline Barthel Index (BI) and return to work assessments between 2008 and 2022. Kaplan–Meier survival curves and Cox proportional hazards were applied. Causal mediation analyses using 1000-bootstrapped simulations were performed. A total of 802 individuals were included (14.6% returned to work), 53.6% blue-collar and 46.4% white-collar. Blue-collar workers showed significantly higher proportion of ischemic stroke, diabetes, dyslipidemia, and hypertension. Individuals not returning to work presented a higher proportion of blue collar, dominant side affected, aphasia, lower BI scores, and larger length of stay (LOS). Multivariable Cox proportional hazards identified age at injury, aphasia, hypertension, and total discharge BI score (C-Index = 0.74). Univariable Cox models identified three independent BI items at all levels of independence: bathing (C-Index = 0.58), grooming (C-Index = 0.56) and feeding (C-Index = 0.59). BI efficiency (gain/LOS) was a causal mediator. Blue collar workers showed higher proportion of risk factors and comorbidities. Novel factors, predictors, and a return to work mediator were identified. [ABSTRACT FROM AUTHOR]

determinants of access to rehabilitation professionals after stroke in middle-income countries, where the burden of this disease is higher, are little known. To identify the determinants of access to rehabilitation professionals by individuals with stroke at one, three, and six months after hospital discharge in Brazil and compare referral and access rates after discharge. Longitudinal and prospective study, with individuals with primary stroke, without previous disabilities. At hospital discharge, the number of rehabilitation professionals referred by the multidisciplinary team was recorded. The possible determinants of access, according to Andersen's model, were: a) predisposing factors: age, sex, education levels, and belief that they could improve with treatment; b) need factors: stroke severity, levels of disability; c) enabling factors: socioeconomic status, disposable income for health care, and quality of care provided by rehabilitation professionals. One, three, and six months after hospital discharge, individuals were contacted to identify which rehabilitation professionals were accessed. Multiple linear regression model and Wilcoxon tests were used (α=5%). 201 individuals were included. Disability levels and stroke severity explained 31%, 34%, and 39% (p<0.01) of access at one, three, and six months after hospital discharge, respectively. In all periods, there was less access than that recommended at the time of hospital discharge (p<0.01). Need factors (disability levels and stroke severity) were determinants of access in all assessed periods. In addition, in all periods, the comprehensiveness of care for individuals with stroke was compromised. [ABSTRACT FROM AUTHOR]

Chronic back pain in adults is often a cause of absenteeism from work, limitations in social interactions, and difficulties in performing daily activities. This study aimed to check whether the functioning of everyday activities in elderly patients after neurosurgery improved over time compared to their condition before the procedure and whether there is a connection between fitness, self-esteem, and pain intensity. This was a cross-sectional study carried out using an anonymous survey. This study included patients over 60 years of age from the neurosurgical ward. The following scales were used to assess cognitive functioning, depression, functional status: basic and instrumental activities of daily living (IADL), back pain disability (QBPDS), pain intensity, and self-esteem. The level of independence in terms of IADL and QBPDS increased, and the intensity of pain decreased. Surgery reduced pain intensity from 8 ± 0.8 to 6.1 ± 1.4 points. The level of self-esteem (RSES) remained at a low level. The passage of time after neurosurgical treatment has a beneficial effect on reducing pain intensity and increasing independence in life activities. Daily physical activity and rehabilitation are important factors supporting the return to independence. [ABSTRACT FROM AUTHOR]

Background: Early nutrition after acute ischemic stroke is crucial. We explored early enteral nutrition for stroke patients and evaluated changes in blood indicators as a predictor of stroke prognosis. Methods: All hospitalized stroke patients receiving enteral nutrition were included in the study. We retrospectively collected the protein, energy, fat, and carbohydrate values for 7 days after admission. Serum albumin, total protein, and hemoglobin values were reviewed at admission and at one week. The main outcome indicators were the Modified Rankin Score, Barthel Index, and Quality of Life at 3 months. Results: A total of 354 patients (mean age, 70.7 years; 59.0% male) were included. The change in serum albumin at day 7 relative to at admission was positively correlated with the Quality of Life score (p = 0.001), the Barthel Index (p = 0.004), and the modified Rankin Score (p = 0.029). The change in total protein at day 7 relative to at admission was positively correlated with the Quality of Life score (p = 0.002), the Barthel Index (p = 0.001), and the modified Rankin score (p = 0.011). The change in hemoglobin values at day 7 relative to at admission was positively correlated with the Barthel Index (p = 0.037 but not with the Quality of Life score (p = 0.237) or the modified Rankin score (p = 0.730). Conclusions: Improved nutrition-related blood indicators one week after admission were independently associated with good stroke outcomes. Nutritional support for acute ischemic stroke patients during the early hospitalization stage appears to be advisable. Trial registration: This review was a retrospective cohort study. The study was retrospectively registered in the Chinese Clinical Trial Registry (No: ChiCTR2300077228). Registration date: 1/11/2023. Highlights: we explored the possible value of early enteral nutrition for stroke patients and evaluated changes in blood indicators as a predictor of stroke prognosis. we found that improved nutrition-related blood indicators at one week after admission were independently associated with good stroke outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Post-stroke depression (PSD) is an emotional disease characterized by loss of interest and depression after a stroke. Acupuncture, one of the most critical non-drug therapies for the treatment of PSD, has significant clinical efficacy, but the mechanism is not fully understood. Previous study has shown that acupuncture can reduce the level of proinflammatory cytokines and increase the level of anti-inflammatory cytokines, suggesting that regulating the dynamic balance of inflammatory cytokines may be the basis for acupuncture to improve PSD symptoms. Methods and analysis: A total of 84 patients with PSD will be recruited and randomly assigned to one of two groups at a 1:1 ratio. Based on the conventional stroke treatment, the control group will receive XingnaoKaiqiao (XNKQ) acupuncture, and the experimental group will receive antidepressant acupuncture at the same time as XNKQ acupuncture. The intervention will last four weeks, and data will be collected before and after treatment. The Hamilton depression scale (HAMD-17) is the primary outcome measure, and the secondary outcome measures include the Self-rating Depression Scale (SDS), the National Institute of Health stroke scale (NIHSS), and the Modified Barthel Index (MBI). Serum IL-1β, IL-4, 5-HT, and BDNF will be used as laboratory indicators. The scales will be assessed at baseline, two weeks, and four weeks, and serum items will be measured at baseline and four weeks after treatment. This study will observe the clinical effect of acupuncture on PSD and the changes in serum-related inflammatory cytokines and explore the possible mechanism of acupuncture against depression from the perspective of inflammatory response. Ethics and dissemination: This study protocol was approved by the Medical Ethics Committee of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (item number: TYLL2023[Z]004). Findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. [ABSTRACT FROM AUTHOR]

Background: A long-term assessment of stroke outcomes from the perspectives of patients and their caregivers is important for optimising long-term post-stroke care. The extended effects of stroke caregiving, particularly caregiver burden beyond 5 years since stroke, remain to be determined. Hence, this study aimed to determine caregiver burden at 10 years after stroke, compare the burden severity at 10 years with its levels at 5 years and 6 months after stroke, and identify predictors of the burden severity at 10 years post-stroke. Methods: A longitudinal follow-up study including a group of first-ever stroke patients/informal continuous caregivers pairs was followed for 10 years and interviewed face-to face at their home setting. Caregiver burden was evaluated with the Caregiver Burden Scale. Potential predictors were examined using standardised measures and identified by applying the Classification and Regression Tree. Results: A total of 40 caregiver/patient pairs participated in the study. At 10 years, 47.5% of the caregivers experienced a considerable burden. This was more than after 5 years (17.5%) and comparable to that after 6 months (37.5%), p < 0.003. Longer time spent caregiving, caregivers' weaker sense of coherence, more severe stroke, and caregivers' anxiety were the independent predictors of considerable burden 10 years after stroke. Conclusions: Caregivers' burden in the late chronic post-stroke phase is a significant problem, as nearly half of the caregivers experience a substantial burden. This problem mainly concerns individuals who spend at least 7 h daily caregiving and have a lower Sense of Coherence. The long-term evaluation of stroke consequences reported by stroke patients and their caregivers can be an important source of information for healthcare professionals in order to optimise the care and support they provide at various stages of life after stroke. [ABSTRACT FROM AUTHOR]

Injurious falls pose a significant threat to the safety of stroke patients, particularly among older adults. While the influence of activities of daily living (ADL) on falls is acknowledged, the precise connection between ADL ability and fall-related injuries in older stroke patients undergoing rehabilitation, particularly those with varying mobility levels, remains unclear. This multicenter cross-sectional study in China recruited 741 stroke patients aged 65 years and above, categorized into bedridden, domestic, and community groups based on their mobility levels using the Longshi Scale. ADL ability was assessed using the Barthel Index. Logistic regression models, generalized additive models, smoothed curve-fitting, and threshold effect analysis were employed to explore the relationship between ADL ability and injurious falls across the three mobility groups. Results revealed an inverted U-shaped relationship between ADL ability and injurious falls among patients in the domestic group (p = 0.011). Below the inflection point of 35 on the Barthel Index, the likelihood of injurious falls increased by 14% with each unit increase in ADL ability (OR = 1.14, 95% CI 1.010–1.29, p = 0.0331), while above the inflection point, it decreased by 3% per unit increase (OR = 0.97, 95% CI 0.95–0.99, p = 0.0013). However, no significant association between ADL ability and injurious falls was observed in either the bedridden or community groups (p > 0.05). These findings suggest that only older stroke patients capable of engaging in activities at home demonstrate a correlation between ADL ability and injurious falls. The identified inverted U-shaped relationship may aid in identifying fall injury risk in this population. [ABSTRACT FROM AUTHOR]

Background: Occupational therapy (OT) is an effective evidence-based intervention that positively influences stroke patients'independence recovery, leading to new opportunities for better quality of life outcomes. Objectives: To explore the effectiveness of an early OT intervention program (EOTIPS) in the process of hospital to home discharge after stroke in Spain. Material and methods: We conducted a prospective, randomized controlled clinical trial that included 60 adults who suffered a stroke and were discharged home. Participants assigned to the experimental group (n = 30) were included in EOTIPS and compared with a control group (n = 30). Evaluations assessed quality of life (Stroke and Aphasia Quality of Life Scale [SAQOL-39]), functional independence (Modified Rankin Scale [mRS], Barthel Index [BI] and Stroke Impact Scale-16 [SIS-16]), perceptual-cognitive skills (Montreal Cognitive Assessment [MoCA]), upper limb function (Fugl Meyer Assessment [FMA]), mobility (Berg Balance Scale [BBS] and Timed Up & Go [TUG]), communication skills (Communicative Activity Log [CAL]) and mood disorders (Beck Depression Inventory–II [BDI-II] and Hamilton Anxiety Scale [HAM-A]); they were completed within two weeks post-stroke and after three months follow-up. Statistical analysis included intent-to-treat analysis, considering all participants (dropouts as failures), and efficacy analysis, considering only end-of-treatment participants. Results: Participants in the intervention group showed a significant better evolution in the main outcome measure of quality of life (SAQOL-39 p =.029), as well as for independence (mRSp =.004), perceptual-cognitive skills (MoCA p =.012)and symptoms of depression (BDI-II p =.011) compared to the control group. Conclusions: EOTIPS was effective in improving quality of life, as well as enhancing perceptual-cognitive skills, independence and reducing levels of depression for patients who suffered a stroke in a Spanish cohort and could be considered as an applicable non-pharmacologic therapeutic tool that can lead to patients' positive outcomes after stroke. This study was registered on ClinicalTrials.gov with the identifier NCT04835363. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions To date, there is no reported effective biomarker that can predict which Alzheimer's disease (AD) patients will respond to donepezil and which will not. This study aimed to investigate whether baseline values of Aβ oligomers (AβOs), measured by the Multimer Detection System‐Oligomeric Aβ (MDS‐OAβ), can be used to predict responders after 6 months of donepezil medication.The study enrolled 104 patients diagnosed with probable AD. After 6 months of donepezil medication, the response to treatment was evaluated by re‐assessing the Korean version of the Mini‐Mental State Examination (K‐MMSE) and Clinical Dementia Rating scale‐Sum of Box (CDR‐SB) scales conducted at baseline. The patients were categorized into two groups according to the baseline MDS‐OAβ values known as the cut‐off for AD diagnosis: a group with values below 0.78 and another group with values equal to or above 0.78.After 6 months of medication, the number of responders was 50 (49.5%). Responders exhibited significantly worse baseline CDR, CDR‐SB, K‐MMSE, and Barthel index compared with non‐responders. There was a significantly higher number of responders among patients with MDS‐OAβ values below the cut‐off of 0.78 compared with those with values equal to or above this threshold. Furthermore, there was a significant improvement in the K‐MMSE and CDR‐SB after 6 months of donepezil medication in patients with MDS‐OAβ values below 0.78 compared with those with values equal to or above 0.78.Baseline MDS‐OAβ values might constitute a novel biochemical marker for the efficacy of 6 months of donepezil treatment in AD. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

Background: Delirium is a prevalent yet underdiagnosed disorder characterized by acute cognitive impairment. Various screening tools are available, including the Confusion Assessment Method (CAM) and 4 A's test (4AT). However, the results of these assessments may vary among raters. Therefore, we investigated the objective use of electroencephalography (EEG) in delirium and its clinical associations and predictive value. Method: This cross-sectional observational study was conducted at Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan, Malaysia, from April 2021 to April 2023. This study included patients aged ≥18 years with a preliminary diagnosis of delirium. Demographic and clinical data were collected along with EEG recordings evaluated by certified neurologists to classify abnormalities and compare the associated factors between patients with delirium with or without EEG abnormalities. Results: One hundred and twenty patients were recruited, with 80.0% displaying EEG abnormalities, mostly generalized slowing (moderate to severe) and primarily generalized slowing (mild to severe), and were characterized by theta activity. Age was significantly associated with EEG abnormalities, with patients aged 75 and older demonstrating the highest incidence (88.2%). The CAM scores were strongly correlated with EEG abnormalities (r = 0.639, P < 0.001) and was a predictor of EEG abnormalities (P < 0.012), indicating that EEG can complement clinical assessments for delirium. The Richmond Agitation and Sedation Scale (RASS) scores (r = −0.452, P < 0.001) and Barthel index (BI) (r = −0.582, P < 0.001) were negatively correlated with EEG abnormalities. Additionally, a longer hospitalization duration was associated with EEG abnormalities (r = 0.250, P = 0.006) and emerged as a predictor of such changes (P = 0.030). Conclusion: EEG abnormalities are prevalent in patients with delirium, particularly in elderly patients. CAM scores and the duration of hospitalization are valuable predictors of EEG abnormalities. EEG can be an objective tool for enhancing delirium diagnosis and prognosis, thereby facilitating timely interventions. Plain Language Summary: Why was the study done? Confusion is frequently observed among patients presenting with various medical issues. There are several tests available to assist in assessment of these patients to see if the symptoms present constitute delirium. However, there may be occasions where identifying delirium is difficult despite the tools available. Electroencephalography (EEG) may be another option to assist medical personnel in diagnosing delirium. In this study, we examine the use of EEG in identification of delirium and its clinical associations. What did the researchers do? Our team studied the use of EEG in patients admitted for various medical issues with symptoms suggestive of delirium over a 2-year period. We collected relevant clinical data and performed EEG for each participant. What did the researchers find? A total of 120 participants were involved in the study. We observe abnormal EEG findings in 80% of patients with the majority showing generalized slowing. The factors associated with EEG abnormalities are advancing age, positive Confusion Assessment Method (CAM), and duration of hospitalization. What do the findings mean? As the service is not widely available, it would not be practical to substitute existing clinical assessment tools with EEG. However, we cannot discount the importance of identifying delirium due to its association with poor clinical outcomes. Therefore, for centers that may perform EEG, it may be used as an adjunct in diagnosing delirium should any doubts arise. [ABSTRACT FROM AUTHOR]

Background/Objectives: Hospital-associated disability (HAD), a functional decline following acute hospitalization, is a common complication associated with mortality and unfavorable prognoses in patients admitted to acute care hospitals. However, few studies have investigated mortality and associated factors in patients with HAD and have been limited by inconsistent HAD assessment tools and criteria. This study investigated mortality and risk factors in patients with HAD using specific criteria. Methods: This retrospective study evaluated patients referred to the Department of Rehabilitation Medicine with suspected HAD between June 2022 and March 2023. The collected data included medical histories, diagnostic tests for HAD (including muscle strength, balance, and modified Barthel Index), and bioelectrical impedance analysis (BIA). Multivariate logistic regression analysis was conducted to identify factors associated with mortality. Kaplan–Meier survival curves were constructed for mortality at 3 and 7 months. Results: A total of 455 patients were identified, among which 206 patients diagnosed with HAD (73.1 ± 12.5 years) were included in the analysis. The 3-month mortality rate was 27.2%. In the multivariate analysis, male sex (odds ratio (OR), 3.23; p < 0.01), a history of cancer (OR, 2.18; p < 0.05), and a low phase angle (OR, 0.69; p < 0.05) were significantly associated with mortality. A phase angle < 2.9° on BIA was associated with a significant increase in 3-month (hazard ratio (HR), 1.85; 95% confidence interval (CI), 1.06–3.23) and 7-month (HR, 2.80; 95% CI, 1.75–4.98) mortality. Conclusions: Patients with HAD had a high mortality rate, with several factors, particularly low BIA phase angles, associated with increased mortality. [ABSTRACT FROM AUTHOR]

Purpose: When mobility deficits persist after stroke or spinal cord injury (SCI), outpatient neurorehabilitation services are required. This study aimed to explore the current practice of German outpatient neurorehabilitation services and identify factors associated to this practice. Methods: This was a qualitative observational study in which semi-structured interviews were conducted with professionals from outpatient neurorehabilitation services and mobility-impaired patients. A qualitative content analysis with a data-driven coding process was used. Results: Three general practitioners, five physical, five occupational, and one speech therapist, one neuropsychologist, two outpatient nurses, one rehabilitation technician, one social worker, two patient advocates (long-term survivors, each stroke and SCI), and 20 patients (10 after stroke, 10 after SCI, all first-ever affected since approximately one year) participated. The reported experiences ranged from high satisfaction to perceived deficits in participation-oriented, evidence-based, and coordinated care. Identified associated factors were: (a) availability of specialised therapists and professional education, (b) outpatient service catalogue, (c) cost coverage, (d) setting rehabilitation goals, and (e) physician as care coordinator. Conclusion: Areas of improvement identified focused on: setting rehabilitation goals towards participation, training therapists on evidence-based treatments and shared decision-making, updating the outpatient service catalogue, and implementing coordination actions. Implementation of these recommendations should be evaluated. IMPLICATIONS FOR REHABILITATION: Professionals need to be trained in setting rehabilitation goals and treatments. The continuing education should be based on current evidence and address interprofessionalism. Academization and continuing education in scientific work for therapists should be advanced. Professionals should educate patients about rehabilitation goals and set rehabilitation goals together, both interprofessional coordinated and with the patient (shared decision-making). Activity and participation should be the central aspects. Rehabilitation clinicians should give instructions to therapists on what to do if rehabilitation goals are not worked on. Rehabilitation clinicians should encourage interprofessional collaboration and information exchange where this is not the case. The exchange of information between outpatient professionals should be promoted through appropriate measures, that is, interprofessional meetings could be introduced. The outpatient service catalogue should be revised regarding evidence-based and participation-oriented treatments and enable appropriate cost coverage. [ABSTRACT FROM AUTHOR]

Background: Cancer is a leading cause of morbidity and mortality globally. Dyspnea, affecting up to 60% of cancer patients, exacerbates physical and psychological distress, reducing quality of life. This study aims to explore the relationship between dyspnea and factors such as age, sex, clinical diagnosis, and treatment lines in cancer patients, with the goal of improving understanding and management of this debilitating symptom to enhance patient care and quality of life. Methods: This study employed an observational, cross-sectional, and descriptive approach to investigate patients with oncological disease at the University Hospital of Salamanca between March 2021 and April 2024. A convenience sample was selected, including patients over 18 years old with a pathological diagnosis of cancer, experiencing any degree of dyspnea, and who consented to participate by signing the informed consent. Exclusion criteria included lack of consent and clinical conditions that prevented an interview. The studied variables encompass sociodemographic (age, gender, diagnosis, tumor stage, number of treatment lines) and clinical aspects (daily activities, degree of dyspnea, functional capacity, physical performance), evaluated using the Barthel Index, the mMRC Dyspnea Scale, the ECOG Scale, and the Short Physical Performance Battery (SPPB). Data were collected through semistructured interviews and medical records, and analyzed using specialized software. This research has ethical approval CEiM Code 2023 12 1472, Reference 2024/01. Results: The mean age was 66.82 years. Lung cancer was predominant (60.2%), with most patients in stage 3 (65.7%) and receiving three treatment lines (68.7%). Higher age, advanced disease stage, and more treatment lines correlated with lower Barthel and SPPB scores, and higher ECOG and mMRC scores, indicating worse functionality, physical performance, and greater dyspnea. No significant correlations were found between gender or pathological diagnosis and the studied variables. Conclusions: Advanced age, higher disease stage, and more treatment lines are associated with decreased functionality, poorer physical performance, and increased dyspnea in cancer patients. Gender and specific cancer diagnosis do not significantly affect these relationships. Addressing dyspnea is crucial to improving the quality of life and physical performance in this population. Future studies should explore additional factors like treatment types and nutritional status. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is a progressive obstruction of the airflow that is often fatal if not appropriately managed. COPD is prevalent among older adults worldwide, and diagnosis is often missed in comprehensive geriatric assessment. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, the management approach includes pharmacological, non-pharmacological treatment, and surgery in severe cases. This case report determines the effect of physiotherapy intervention (a non-pharmacological approach) on geriatric patients with COPD. Case presentation: This is a case report of a 72-year-old male patient who presented as an outpatient with COPD grade D (GOLD guidelines) with a forced expiratory volume in 1 s (FEV1) value of 52%. The patient had 3 acute episodes of exacerbation but was stabilized. The first episode of shortness of breath was 2 years ago while taking a brisk walk at home. He was immediately rushed to the hospital where he was placed on hospital admission and managed for about 2 weeks and was discharged but to continue physiotherapy on an outpatient basis due to the proximity of his home from the hospital. On physical examination with chronic obstructive pulmonary assessment test (CAT), 6-min walk test (6MWT), and functional assessment with the Barthel Index, the patient was easily fatigued and had challenges in performing basic activities of daily living (BADL). The patient had 72 sessions of physiotherapy interventions for 6 months which consisted of education, purse-lip breathing, active cycle of breathing technique, incentive spirometry exercise, aerobic exercise, and home exercise aimed at improving activity tolerance, encouraging diaphragmatic breathing, enhancing sputum clearance, improving function, and overall quality of life. Improvement was initially gradual and then significant in about the third month of the intervention. Activity tolerance improved with a 6MWT of 2 laps. The patient developed more confidence in performing ADL and leaving his home despite his lung condition as seen in CAT scores. Conclusions: Overall, results from this study showed that COPD is a treatable condition that is amenable to physiotherapy interventions in a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Motor impairment is a common issue in stroke patients, often affecting the upper limbs. To this standpoint, robotic neurorehabilitation has shown to be highly effective for motor function recovery. Notably, Machine learning (ML) may be a powerful technique able to identify the optimal kind and intensity of rehabilitation treatments to maximize the outcomes. This retrospective observational research aims to assess the efficacy of robotic devices in facilitating the functional rehabilitation of upper limbs in stroke patients through ML models. Specifically, clinical scales, such as the Fugl-Meyer Assessment (A-D) (FMA), the Frenchay Arm Test (FAT), and the Barthel Index (BI), were used to assess the patients' condition before and after robotic therapy. The values of these scales were predicted based on the patients' clinical and demographic data obtained before the treatment. The findings showed that ML models have high accuracy in predicting the FMA, FAT, and BI, with R-squared (R2) values of 0.79, 0.57, and 0.74, respectively. The findings of this study suggest that integrating ML into robotic therapy may have the capacity to establish a personalized and streamlined clinical practice, leading to significant improvements in patients' quality of life and the long-term sustainability of the healthcare system. [ABSTRACT FROM AUTHOR]

The Oxford Digital Multiple Errands Test (OxMET) is a brief computer-tablet based cognitive screen, intended as an ecologically valid assessment of executive dysfunction. We examined aspects of predictive validity in relation to functional outcomes. Participants (≤ 2 months post-stroke) were recruited from an English-speaking stroke rehabilitation in-patient setting. Participants completed OxMET. The Barthel Index, Therapy Outcome Measure (TOMS), and modified Rankin Scale (mRS) were collected from medical notes. Participants were followed up after 6-months and completed the Nottingham Extended Activities of Daily Living (NEADL) scale. 117 participants were recruited (M = 26.18 days post-stroke (SD = 25.16), mean 74.44yrs (SD = 12.88), median NIHSS 8.32 (IQR = 5-11)). Sixty-six completed a follow-up (M = 73.94yrs (SD = 12.68), median NIHSS 8 (IQR = 4-11)). Significant associations were found between TOMS and mRS. At 6-month follow up, we found a moderate predictive relationship between the OxMET accuracy and NEADL (R2 =.29, p <.001), and we did not find this prediction with MoCA taken at 6-months. The subacute OxMET associated with measures of functionality and disability in a rehabilitation context, and in activities of daily living. The OxMET is an assessment of executive function with good predictive validity on clinically relevant functional outcome measures that may be more predictive than other cognitive tests. [ABSTRACT FROM AUTHOR]

This study aimed to examine the impact of accelerated rehabilitation surgical nursing combined with enteral nutrition on the postoperative recovery of patients undergoing total hip arthroplasty. We enrolled 100 patients admitted to Ankang People's Hospital between January 2021 and December 2022. The patients were randomly divided into a control group and a treatment group. Patients in the control group received routine nursing and targeted dietary guidance, while those in the treatment group received accelerated rehabilitation surgical nursing and enteral nutrition. Patients in the treatment group exhibited lower intraoperative blood loss, postoperative time of getting out of bed, postoperative hospital stays, visual analog scale scores, and incidence of complications than those in the control group. Additionally, patients in the treatment group exhibited higher Harris scores, Barthel indexes, and higher prealbumin, hemoglobin, transferrin, albumin, immunoglobulins G, A, and M levels, and nursing satisfaction than those in the control group. Accelerated rehabilitation surgical nursing combined with enteral nutrition for patients undergoing total hip arthroplasty can effectively improve hip function and life ability recovery, shorten the rehabilitation time, lower the complication rate, promote the nutritional status and immune function and improve the nursing satisfaction rate of patients. [ABSTRACT FROM AUTHOR]

Chronic subdural hematoma (CSDH) is a common neurological condition, especially in the elderly population. Atorvastatin has shown the potential to reduce the recurrence of CSDH and improve overall outcomes. New studies have emerged since the last meta-analysis, increasing the sample size and the variety of outcomes analyzed. We searched PubMed , Embase , and the Cochrane Central Register of Controlled Trials for studies comparing the use of atorvastatin in CSDH patients with a control group or placebo. The primary outcome was the recurrence of CSDH. Secondary outcomes of interest were hematoma volume, composite adverse effects, mortality, and neurological function, measured by the Glasgow Outcome Scale and Barthel index for activities of daily living. Seven studies, of which 2 were randomized controlled trials, were included, containing 1192 patients. Overall recurrence significantly decreased compared to the control group (risk ratio [RR] 0.46; 95% confidence interval [CI] 0.25–0.83; P = 0.009). The benefits of atorvastatin were sustained in the subgroup analysis of patients who underwent initial conservative therapy (RR 0.40; 95% CI 0.22–0.70; P = 0.001). However, there was no significant difference when atorvastatin was combined with surgical intervention (RR 0.53; 95% CI 0.21–1.32; P = 0.17). Adverse effects were not increased by atorvastatin (RR 0.82; 95% CI 0.51–1.34; P = 0.44). Atorvastatin might be beneficial in reducing CSDH recurrence, especially in conservative treatment patients. Atorvastatin was not significantly associated with adverse effects. Larger, higher-quality randomized studies are needed to adequately evaluate the efficacy, safety, and optimal dose of atorvastatin in CSDH patients. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the predictive factors of transfer of glioblastoma multiforme (GBM) patients who underwent rehabilitation in acute care hospitals. We retrospectively identified 85 patients with GBM who underwent rehabilitation at our hospital. Multivariable logistic regression analysis showed that age and Barthel index (BI) at rehabilitation initiation significantly influenced the discharge destination. Cut-off values for these factors were 76 years of age and 30 BI points. These findings could help predict the discharge destination and the choice of rehabilitation strategies of newly diagnosed patients with GBM admitted to an acute care hospital. [ABSTRACT FROM AUTHOR]

Objective: To determine the normative values of the Korean version of the Modified Barthel Index (K-MBI) score for typically developing children in Korea and assess its suitability for use in children. Methods: Rehabilitation physicians and occupational therapists with children were invited through an online platform to participate in a survey assessing their children's performance of activity of daily living (ADL) using the K-MBI. The questionnaire encompassed queries on sociodemographic information of children and the assessment criteria outlined in the K-MBI. The standardized K-MBI scores by age were estimated using the nonlinear least squares method. Results: The analysis incorporated responses from a total of 206 individuals. K-MBI total scores showed a rapid increase over the first 8 years of life, with 99% of children achieving a score of 90 or higher by age 8. Mobility scores exhibited a swift increase during early childhood, surpassing 90% of the maximum score at 3 years of age and nearing 100% at 7 years of age. In contrast, self-care scores demonstrated a more gradual advancement, achieving approximately 100% of the maximum score by the age of 10 years. Conclusion: Age-specific normative values for K-MBI scores of typically developing children were established, which can be used as a reference in clinical care. While the K-MBI captured the overall trajectory of children's ADL development, it did not discern subtle differences across various developmental stages. There is a need for the development of more refined assessment tools tailored specifically to children. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective study of data abstracted from the Diagnosis Procedure Combination (DPC) database. Purpose: This study aimed to investigate the effects of surgery in the early phase. Overview of Literature: The optimal timing of surgery for cervical fracture dislocation (CFD) remains unclear because only a few clinical studies with approximately 100 patients have been published. Methods: This study included 4,653 adult patients with a definitive diagnosis of CFD from the DPC database. The database contains nationwide inpatient data collected from >1,000 acute care hospitals in Japan. The DPC database contains information regarding hospitalization, such as diagnosis, treatment, medical history, complications, and hospitalization outcomes. This study identified 460 pairs of patients after one-to-one propensity-score matching (PSM). Treatment outcomes were compared between patients who underwent surgery for CFD within 72 hours (early group) and later (delayed group) after admission. The main outcomes included 30-day mortality, in-hospital death, and major complications. The secondary outcomes were improvement in the Barthel index, length of hospital stay, and discharged home rate. Results: After adjusting for PSM, the early group had a significantly higher 30-day mortality rates than the delayed group (3.0% vs. 0.4%, p=0.006). In the multivariate logistic regression analysis after PSM, the early group was associated with an increased risk of 30-day mortality (odds ratio, 8.05; 95% confidence interval, 2.15–5.26; p=0.007). Conclusions: This study indicated that early surgery for CFD resulted in increased 30-day mortality. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the postoperative period, patients mainly rely on caregivers, who experience their own physical and mental fatigue. Caregiver fatigue may affect patient outcomes. OBJECTIVES: This study explored the fatigue status and influencing factors of primary caregivers of patients after liver cancer surgery. METHODS: A baseline information questionnaire, the Fatigue Scale-14, and the Barthel Index were used to investigate the self-care ability and fatigue status of 191 primary caregivers of patients with hepatic carcinoma who had had surgery. FINDINGS: The postoperative hospitalization time and self-care level of patients, whether the primary caregiver had health insurance, subjective feelings of fatigue, the perception that health was affected, and the patients' desired level of postoperative care were correlated with the occurrence of primary caregiver fatigue. [ABSTRACT FROM AUTHOR]

Background/aim: Efficient discharge for stroke patients is crucial but challenging. The study aimed to develop early predictive models to explore which patient characteristics and variables significantly influence the discharge planning of patients, based on the data available within 24 h of admission. Design: Prospective observational study. Methods: A prospective cohort was conducted at a university hospital with 523 patients hospitalised for stroke. We built and trained six different machine learning (ML) models, followed by testing and tuning those models to find the best‐suited predictor for discharge disposition, dichotomized into home and non‐home. To evaluate the accuracy, reliability and interpretability of the best‐performing models, we identified and analysed the features that had the greatest impact on the predictions. Results: In total, 523 patients met the inclusion criteria, with a mean age of 61 years. Of the patients with stroke, 30.01% had non‐home discharge. Our model predicting non‐home discharge achieved an area under the receiver operating characteristic curve of 0.95 and a precision of 0.776. After threshold was moved, the model had a recall of 0.809. Top 10 variables by importance were National Institutes of Health Stroke Scale (NIHSS) score, family income, Barthel index (BI) score, FRAIL score, fall risk, pressure injury risk, feeding method, depression, age and dysphagia. Conclusion: The ML model identified higher NIHSS, BI, and FRAIL, family income, higher fall risk, pressure injury risk, older age, tube feeding, depression and dysphagia as the top 10 strongest risk predictors in identifying patients who required non‐home discharge to higher levels of care. Modern ML techniques can support timely and appropriate clinical decision‐making. Relevance to Clinical Practice: This study illustrates the characteristics and risk factors of non‐home discharge in patients with stroke, potentially contributing to the improvement of the discharge process. Reporting Method: STROBE guidelines. [ABSTRACT FROM AUTHOR]

Background: Traditional meta-analysis offers only direct comparative evidence. The optimal cognitive training for poststroke cognitive impairment (PSCI) remains largely undetermined. Objectives: This study aims to assess and compare the effectiveness of selected cognitive training methods for PSCI patients and to identify and rank the most effective intervention programs. Methods: Searches were conducted in PubMed, Embase, Cochrane Library, Web of science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biomedical Database for randomized controlled trials up to September 30, 2023. Two researchers independently performed literature screening, data extraction, and quality assessment. Network meta-analysis was utilized to synthesize the main findings. The primary outcome focused on the intervention's impact on subjective cognitive function, with secondary outcomes including effects on activities of daily living, motor function, and functional independence. This study is registered with PROSPERO (CRD42023463282). Results: Fifty eligible randomized controlled trials were identified, revealing eight distinct interventions. These interventions collectively demonstrate efficacy in enhancing cognition. Traditional cognitive training significantly improves overall cognitive function, daily living function, motor function, and functional independence. In Loewenstein Occupational Therapy Cognitive Assessment, Barthel Index, Fugl-Meyer Assessment, and Functional Independence Measure scales, a combination of computer-based and traditional cognitive training outperformed the conventional control group MD = 29.97 (95%CI: 16.3, 44.2), MD = 18.67 (95%CI: 9.78, 27.45), MD = 28.76 (95%CI: 5.46, 51.79) and MD = 42.2 (95%CI: 5.25, 78.99). In the MMSE scale, virtual reality cognitive training combined with traditional training was most effective MD = 8.01 (95%CI: 3.6, 12.4). On the MoCA scale, the combination of exercise and cognitive training showed superior results MD = 6.68 (95%CI: 2.55, 10.78). Only the combined computer-based and traditional cognitive training, as well as traditional cognitive training alone, significantly enhanced functional independence, with no notable differences in other pairwise interventions. Conclusion: The network meta-analysis suggests that augmenting traditional training with other modalities may enhance overall effectiveness. Specifically, interventions incorporating computer-based cognitive training appear to surpass other methods in improving cognition, daily living function, motor skills, and functional independence. The findings of this network meta-analysis provide evidence-based guidance for clinical decision-making. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the association between the time to first post-extubation oral intake, barriers to oral intake, and the rate of activities of daily living (ADL) independence at discharge (Barthel Index score <70). Method: Consecutive patients admitted to the intensive care unit, aged ≥18 years, and mechanically ventilated for ≥48 hr were retrospectively enrolled. The time to first oral intake, barriers to oral intake, daily changes, and clinical outcomes were assessed. Multiple logistic regression analysis adjusted for baseline characteristics was used to determine the association between time to first post-extubation oral intake and ADL independence. Result: Among the 136 patients, 74 were assigned to the ADL independence group and 62 to the dependence group. The time to first post-extubation oral intake was significantly associated with ADL independence (adjusted p = < 0.001) and was a predictor of ADL independence at discharge. Respiratory and dysphagia-related factors (odds ratio [OR] 0.35; 95% confidence interval [CI] 0.15–0.82, p = 0.015 and OR 0.07; CI 0.01–0.68, p = 0.021, respectively) were significantly associated with the ADL independence at discharge. Conclusion: Respiratory and dysphagia-related factors, as barriers to the initiation of oral intake after extubation, were significantly associated with ADL independence at discharge. [ABSTRACT FROM AUTHOR]

Objectives: To identify the prevalence and associated factors of cognitive dysfunction, 1 year after ICU discharge, among adult patients, and it´s relation with quality of life. Methods: Multicenter, prospective cohort study including ICUs of 10 tertiary hospitals in Brazil, between May 2014 and December 2018. The patients included were 452 adult ICU survivors (median age 60; 47.6% women) with an ICU stay greater than 72 h. Results: At 12 months after ICU discharge, a Montreal Cognitive Assessment (tMOCA) telephone score of less than 12 was defined as cognitive dysfunction. At 12 months, of the 452 ICU survivors who completed the cognitive evaluation 216 (47.8%) had cognitive dysfunction. In multivariable analyses, the factors associated with long-term (1-year) cognitive dysfunction were older age (Prevalence Ratio–PR = 1.44, P < 0.001), absence of higher education (PR = 2.81, P = 0.005), higher comorbidities on admission (PR = 1.089; P = 0.004) and delirium (PR = 1.13, P < 0.001). Health-related Quality of life (HRQoL), assessed by the mental and physical dimensions of the SF-12v2, was significantly better in patients without cognitive dysfunction (Mental SF-12v2 Mean difference = 2.54; CI 95%, − 4.80/− 0.28; p = 0.028 and Physical SF-12v2 Mean difference = − 2.85; CI 95%, − 5.20/− 0.50; P = 0.018). Conclusions: Delirium was found to be the main modifiable predictor of long-term cognitive dysfunction in ICU survivors. Higher education consistently reduced the probability of having long-term cognitive dysfunction. Cognitive dysfunction significantly influenced patients' quality of life, leading us to emphasize the importance of cognitive reserve for long-term prognosis after ICU discharge. [ABSTRACT FROM AUTHOR]

Background: Hip fracture (HF) in older adults is strongly associated with a greater decline in their activities of daily living (ADLs) and health-related (HRQoL). The present study aimed to evaluate the effects of a family-based care transition program (FBCTP) on ADLs, HRQoL and social support in this age group after HF surgery. Methods: A quasi-experimental design was conducted on 100 older adults who had undergone HFS and were selected by convenience sampling and allocated to the IG (n = 50) and the CG (n = 50). Data were collected utilizing the Barthel Index, the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support. The FBCTP was delivered in-hospital education sessions, home visit, and a follow-up and telephone counselling session. The data were collected at three stages, including the baseline, four weeks after discharge, and eight weeks later. The level of statistical significance was set at 0.05. Results: The results of the study indicated that the effects of time and group on the increase in ADLs were 15.2 and 36.69 (p < 0.000), respectively, following the completion of the FBCTP. Furthermore, time and group were found to have a positive effect on HRQoL, with an increase of 2.82 and 5.60 units, respectively (p < 0.000). In this context, time and group also interacted in the IG compared to the CG, with scores increasing by 1.86 units over time (p < 0.000). Although the study results indicated that social support improved by 1.98 units over time (p < 0.000), the effects of group alone and the time × group interaction were not statistically significant. This indicates that the program was not effective in accelerating social support. Conclusion: Consequently, nurses, policymakers, and planners engaged in geriatric healthcare may utilize these results to enhance the health status of this age group following HFS. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of iTBS stimulation on walking function in patients with stroke. Methods Fifty patients with post-stroke walking dysfunction who met the inclusion criteria were selected for 3-week rehabilitation treatment, and were randomly divided into iTBS group) n = 25) and sham group) n = 25). The iTBS group was treated with conventional rehabilitation therapy combined with iTBS stimulation of contralesional cerebellum, and the sham group was treated with conventional rehabilitation therapy plus iTBS stimulation of contralesional cerebellum. Relevant indicators were analyzed before treatment and at 21 days of treatment. Lower limb motor function scores of the two groups were compared before and after treatment. Fugl-Meyer motor function lower limb activity score, Berg Balance Scale score, Brunnstrom stage) lower limb), hamstring/quadriceps) H/Q) on the affected side, Modified Barthel index ) MBI), gait analysis parameters, and TMS-MEP were used to evaluate the effectiveness of cerebellar iTBS in the rehabilitation of walking dysfunction after stroke. Results After 21 days of treatment, the improvements of Brunnstrom stage, Holden grade, Berg score, FMA score, 6-minute walking distance, NIHSS score and MBI score in iTBS group were significantly better than those in sham group) P < 0.05). After treatment, the H/Q in iTBS group was significantly higher thanbefore) P < 0.05), but there was no significant difference between the two groups) P > 0.05). Stride speed, stride frequency, stride width, single support phase on the affected side and GDI score in iTBS group were significantly improved compared with sham group) P < 0.05), and there was no significant difference in stride length between the two groups after treatment) P > 0.05). The Conclusion Contralesional cerebellar iTBS combined with routine rehabilitation could improve lower limb walking function and daily living ability of stroke patients. [ABSTRACT FROM AUTHOR]

Background: Post-stroke psychosis (PSP) is a rare but serious neuropsychiatric condition characterized by delusions and/or hallucinations following a stroke. Despite its impact on prognosis and quality of life, PSP remains underdiagnosed and undertreated, with limited data on its prevalence and risk factors. The purpose of this study is to assess the prevalence and determinants of post-stroke psychosis (PSP), as well as to compare PSP and non-PSP patients in terms of improvement and daily living outcomes. This nested case–control study included 2,624 acute stroke patients from a university hospital between May 2017 and April 2022. Patients who developed PSP within 6 months post-stroke were identified as cases (n = 108), and 119 patients without PSP were randomly selected as controls. Comprehensive assessments included clinical, laboratory, and imaging evaluations at baseline. After 6 months, follow-up evaluations were conducted, including neurological examinations, psychiatric assessments, and stroke severity assessments using the Barthel index (BI). The psychiatric assessments included the Hamilton Depression Rating Scale for depression and the Mini-Mental State Examination for cognitive status. Results: The prevalence of PSP was 5.4%. risk factors significantly associated with PSP included older age, male patients, lower education level (≤ 5 years), hemiplegia, sphincter affection, cortical lesion, brain atrophy, small vessel disease, ischemic stroke, post-stroke dementia, and seizures. Non-specified psychosis and delusional disorder were the most common psychosis subtypes. There was a significantly higher percentage of excellent patients in the non-PSP group compared to those who had PSP regarding the observed improvement in the patient's condition. Also, there is a higher percentage of deteriorated patients in the PSP group (46.6%) compared to another group (18.9%) regarding BI. Conclusion: PSP is a prevalent post-stroke complication associated with distinct risk factors and poor functional outcomes. Early screening and identification of high-risk patients, along with multidisciplinary management strategies, are crucial for optimizing recovery and quality of life in stroke survivors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite the promising effects of robot-assisted gait training (RAGT) on balance and gait in post-stroke rehabilitation, the optimal predictors of fall-related balance and effective RAGT attributes remain unclear in post-stroke patients at a high risk of fall. OBJECTIVE: We aimed to determine the most accurate clinical machine learning (ML) algorithm for predicting fall-related balance factors and identifying RAGT attributes. METHODS: We applied five ML algorithms— logistic regression, random forest, decision tree, support vector machine (SVM), and extreme gradient boosting (XGboost)— to a dataset of 105 post-stroke patients undergoing RAGT. The variables included the Berg Balance Scale score, walking speed, steps, hip and knee active torques, functional ambulation categories, Fugl– Meyer assessment (FMA), the Korean version of the Modified Barthel Index, and fall history. RESULTS: The random forest algorithm excelled (receiver operating characteristic area under the curve; AUC = 0.91) in predicting balance improvement, outperforming the SVM (AUC = 0.76) and XGboost (AUC = 0.71). Key determinants identified were knee active torque, age, step count, number of RAGT sessions, FMA, and hip torque. CONCLUSION: The random forest algorithm was the best prediction model for identifying fall-related balance and RAGT determinants, highlighting the importance of key factors for successful RAGT outcome performance in fall-related balance improvement. [ABSTRACT FROM AUTHOR]

BACKGROUND: The traditional method of post-hospital intervention and guidance of stroke patients has some limitations. OBJECTIVE: To investigate the effects of Internet + wearable device training on limb function recovery and the levels of serum neurocytokines (BDNF, NT-3, and NGF) in stroke patients. METHODS: 80 stroke patients with hemiplegia were randomly selected from the Department of Neurorehabilitation, Affiliated Rehabilitation Hospital of Chongqing Medical University. They were divided into a control group and an observation group, with 40 patients in each group. The control group received routine post-hospital follow-up guidance, while the observation group received Internet remote home rehabilitation guidance combined with wearable device training. The interventions were compared between the two groups. RESULTS: At 4 weeks and 12 weeks after discharge, the observation group showed higher scores on the Fugl-Meyer scale (FMA), Berg Balance Scale (BBS), modified Barthel Index (MBI), stride length, gait speed, gait frequency, and higher levels of BDNF, NT-3, and NGF. Additionally, the observation group had lower scores on the Hamilton Anxiety and Depression Scale (HADS) (P < 0.05). CONCLUSIONS: The application of Internet remote home rehabilitation guidance combined with wearable device training in stroke patients with hemiplegia can improve limb function recovery. It effectively increases the levels of BDNF, NT-3, and NGF, promoting the nutritional repair of damaged nerves. These findings hold clinical significance. [ABSTRACT FROM AUTHOR]

This study aimed to explore the motivations, attitudes, care management strategies and training needs of paid caregivers. Data were collected through 51 semi-structured interviews with paid caregivers and analyzed using thematic analysis. Their motivations included economic stability, the inability to secure other employment, a desire to secure independence through regularly paid employment and a passion and a love of caring. Their role involved being a key communicator of care between medical personnel and relatives, and participants emphasized the importance of paid caregivers being loving, caring, calm, patient, having the ability and willingness to cope with challenging situations. They outlined some specific challenges of the role of caregiving and expressed the importance of gaining recognition for the role as well as the need for bespoke and tailored training to underpin it. This study adds to the growing international literature around the needs of the paid carer workforce and has the potential to inform policy and training around the provision of a better-equipped workforce to meet the growing needs of the aging population. [ABSTRACT FROM AUTHOR]

Objective: Task-oriented therapy (TOT) is used to increase the effectiveness of upper extremity (UE) in activity daily living (ADL). This study aimed to investigate the effect of TOT on the participation and ADLs of stroke patients. Methods: Between October 2018 and February 2019, 28 chronic stroke patients were included in the study treated in Kocaeli University Hospital, Department of Physical Medicine and Rehabilitation, Turkey. The performance areas and participation status of the patients in which they experienced limitations were evaluated with the Canadian Occupational Performance Scale (COPM), and their level of independence in ADLs was evaluated with the Modified Frenchay Activity Index (mFAI) and Barthel Index (BI). All patients were included in the occupational therapy (OT) program five days a week for three weeks at Kocaeli University Hospital. Three ADLs in which they had difficulties were studied with 28 patients. Each of the activities was designed specifically for the patient. All assessments were repeated after three weeks of treatment. Results: A total of 28 patients, 12 females and 16 males, diagnosed with stroke, were included in the study. A statistically significant increase was found in the COPM performance and satisfaction value compared to the pretreatment value (p<0.001). A statistically significant difference was found between pre- and post-treatment mFAI and BI values (p<0.001). Conclusions: Adding task-oriented therapy to the rehabilitation programs of stroke patients will contribute to the improvement of ADL. [ABSTRACT FROM AUTHOR]

Background: Short‐term cognitive impairment is associated with SARS‐CoV‐2 infection but the long‐term impact is yet to be examined in detail. We aim to study the evolution of these symptoms in severe COVID‐19 patients admitted to the intensive care unit (ICU) between April and December 2020 1 year after hospital discharge and to analyze its clinical correlates. Method: A total of 58 patients agreed to participate in the 6 months follow‐up and 30 at 1 year after hospital discharge. Demographic, clinical and laboratory data were collected and a comprehensive neuropsychological battery including validated tests for the main cognitive domains was administered. To test the magnitude of neurocognitive sequelae, two standard deviations below normative group were considered. To compare the neuropsychological performance at 6 and 12 months follow‐up we used repeated measures tests. Finally, regression analyses were performed to test the main effects of medical and psychological factors on multiple cognition. Results: Almost half of the sample continued to have impaired performance on neuropsychological tests at 12 months follow‐up. In comparison with the results obtained at 6 months, significant improvements were found in immediate recall (d = 0.49), delayed recall (d = 0.45), and inhibitory control (d = 0.53). Medical variables predicted cognitive performance at 6 months but not at 12 months follow‐up, while anxiety and depression predicted cognitive deficits in the long‐term. Conclusions: A generalised improvement was observed in severe COVID‐19 patients at follow‐up. This improvement was particularly notable in verbal memory and executive functioning. However, a considerable proportion of the sample continued to present deficits at 1 year follow‐up. [ABSTRACT FROM AUTHOR]

The purpose of the pilot survey was to understand current practice patterns and responses to the Patient-Driven Groupings Model and the coronavirus disease 2019 (COVID-19) pandemic in home health occupational therapy care. Fifty home health occupational therapy practitioners from 27 states in the United States completed the survey. Descriptive analysis was used to organize and summarize survey responses. The survey items on practice patterns included assessment tools, treatment approaches, and care coordination with physical therapy colleagues. The most reported assessment of occupational performance was the Barthel Index. The common treatment approaches included activities of daily living retraining, energy conservation, and functional mobility and transfer. The majority of respondents (n = 44) communicated with their physical therapy colleagues at least once a week. The communications were often related to scheduling and changes in a patient's condition. Seventy percent of practitioners experienced a reduction in home visits during the recent Medicare payment reform and the pandemic. These practitioners perceived that some patients might have been discharged from home health care prematurely. Additional studies to investigate the impact of policy changes and the pandemic on therapy intensity and patients' functional outcomes are warranted. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the characteristics of assistive device users and influencing factors among disabled elderly in China. Methods: A total of 13,510 disabled elderly in Sichuan Province were surveyed. Disability was assessed using the Barthel Activities of Daily Living Scale, mental status, sensory perception, and social engagement evaluation. Univariate analysis and logistic regression analysis were employed to identify the impact factors. Results: The prevalence of assistive device utilization among participants was 79.2% (10,700/13,510, 95% CI 78.5%–79.9%), with the wheelchair being the most commonly used device. Various factors were found to influence the usage of the device, including disability level, somatic disability, age, caregivers, income, caregiver fees, and living situation (p <.05). Additionally, several factors were identified associated with the frequency of device usage, such as somatic disability, education background, income, caregiver fees, living situation, access to acquire assistive devices, duration of assistive device usage, education on assistive devices, and satisfaction level (p <.05). Conclusions: The use of assistive devices among elderly individuals in China is prevalent. There are many factors that affect the use of assistive devices, which can provide a reference for the formulation of policies in the field of assistive devices. [ABSTRACT FROM AUTHOR]

Background: The Healthy Aging Brain Care Monitor Self-Report (HABC-M SR) is a tool to evaluate physical, mental and cognitive impairments. It has been validated in several countries for post-intensive care syndrome (PICS) assessment, but there is no Chinese version yet. Aim: The aim of this study is to translate and cross-cultural adapt HABC-M SR, and validate its psychological properties among Chinese ICU survivors. Study Design: This is a cross-sectional study. the HABC-M SR was translated into Chinese and validated in intensive care unit survivors (n = 145). Measures of internal consistency, construct validity, concurrent validity, and content validity were evaluated. Results: A 19-item Chinese version of HABC-M SR was yielded, with good reliability (Cronbach's α = 0.92) and validity (the variance was 64.4%, overall content validity was 0.91, and correlation coefficients were 0.62-0.90). Conclusions: The 19-item Chinese version HABC-M SR is a reliable and valid tool for PICS assessing and may be regarded as a standard measurement. Relevance to Clinical Practice: The Chinese version HABC-M SR may help in selecting PICS high-risk survivors for ICU follow-up interventions. The HABC-M SR can also be regarded as a standard specific PICS measurement, thus promote the comparability between studies and transformation of the clinical evidence. [ABSTRACT FROM AUTHOR]

Aim and objectives: To investigate the nutritional status of older adults in nursing homes in Chongqing, China, compare and analyse the differences in the physical condition, cognitive function and social‐related factors of older adults with different nutritional statuses. Background: Malnurtition in the older people has become a priority concer, and the incidence and factors associated with malnutrition vary somewhat by healthcare setting. In Chongqing ,China, there is lack of research on malnutrition of the older people in nursing homes. Here, we investigated the incidence of malnutrition and analysed the associated factors. Design: A cross‐sectional study. Methods: From January to April 2023, a cross‐sectional survey was conducted in three nursing homes in Chongqing, China. Participants completed a series of questionnaires, including the Demographic Information Questionnaire which included age, gender, education level, previous occupation, marital status and other information. The survey also included validated non‐demographic instruments [Short‐Form Mini‐Nutritional Assessment (MNA‐SF), Barthel Index (BI) and Mini‐mental State Examination (MMSE)] to identify related impact factors. The Guidelines for cross‐sectional studies were used in this study (Data S1). Results: 209 older adults aged 60 and over participated in this study, of whom 121 were women and 88 were men. The average (SD) age of the participants was 84.7 (6.3) years. Of the participants, 46.4% were classified as well nourished. About 39.2% were at risk of malnutrition and 14.4% were malnourished. Compared to those who were well nourished, those who were malnourished or at risk of becoming malnourished were more likely to suffer from comorbidities, polypharmacy, a higher risk of falling, ADL dependence and to receive more nutritional interventions. However, there are no significant differences after adjustment for age, education level, previous occupation, marital status, length of stay, and type of health care payment. Conclusion: Malnutrition is a common problem among older adults innursing homes in Chongqing, China. There are certain differences in physical conditions and nutritional interventions among older adults withdifferent nutritional status. Public Contribution: This study suggests that the problem of malnutrition is very prominent in nursing homes in Chongqing, China. Cognitive impairment, impaired activities of daily living, fall risk and nutritional intervention need to be prevalent in older adults with (risk of) malnutrition. [ABSTRACT FROM AUTHOR]

To examine the psychometric properties of a Chinese version of the Moorong Self-Efficacy Scale (MSES-C) among stroke survivors. A cross-sectional descriptive study was conducted with 160 stroke survivors recruited from the three neurology departments in China. Reliability, concurrent validity, and construct validity of the scale were determined. The MSES-C whole scale showed good internal consistency with a Cronbach's α of 0.953. There was a moderate to a strong positive correlation between the MSES-C and Chinese version of the General Self-Efficacy Scale (r = 0.695, p < 0.000), a strong positive correlation between the MSES-C and Chinese version of the stroke specific self-efficacy scale (r = 0.801, p < 0.000), positive correlations between the MSES-C and Chinese versions of the Modified Barthel Index (r = 0.695, p < 0.000), and a negative correlation between the MSES-C and National Institutes of Health Stroke Scale (r = –0.511, p < 0.000). Known-group validity was also supported. The MSES-C is a reliable and valid instrument for assessing self-efficacy in Chinese stroke survivors. The Chinese version of the Moorong Self-Efficacy Scale demonstrated good internal consistency and showed satisfactory concurrent and construct validity among stroke survivors. The Moorong Self-Efficacy Scale can be used to assess stroke recovery among the Chinese population in clinical and research settings. [ABSTRACT FROM AUTHOR]

Objective: To investigate the therapeutic effect of Xingnao Kaiqiao acupuncture combined with modern rehabilitation therapy on cognitive dysfunction after acute ischemic stroke (AIS). Methods: Totally 140 patients with cognitive impairment after AIS admitted to Sichuan Provincial Rehabilitation Hospital from September 2016 to May 2021 were included in this prospective randomized controlled trial. After admission, patients were randomly divided into the trial group and the control group based on a computer-generated random number table. Patients in the trial group were treated with Xingnao Kaiqiao acupuncture combined with modern rehabilitation therapy, and those in the control group were treated with modern rehabilitation therapy alone. Before and after treatment, Mini-Mental State Examination (MMSE) and Barthel index (BI) were used to evaluate the cognitive function and daily living activities, and event-related potentials (ERP) were also measured in both groups. Statistical analyses were performed to compare the results between the two groups. Results: Finally 135 patients were included, 67 in the trial group and 68 in the control group. After treatment, the MMSE score and BI were significantly improved in both groups as compared with those before treatment (both P < .001). In the trial group, the BI and the MMSE subscores in the domains of orientation, registration, recall, and language were significantly higher than those in the control group (all P < 0.05). The global MMSE score of the trial group was higher than that of the control group both after 2 and 4 weeks of treatment, and the differences were statistically significant (P = 0.000/0.001). In the analysis of time effect alone, time had significant effects on the MMSE score in both groups (P < 0.001). After treatment, the latencies of P3 waves were significantly shorter and the amplitudes of P3 waves were significantly higher in the trial group as compared with the control group (both P < 0.05). Conclusion: Xingnao Kaiqiao acupuncture combined with modern rehabilitation therapy may be associated with a better efficacy in treating cognitive dysfunction after AIS. The effect of Xingnao Kaiqiao acupuncture on ERP may play a role in the mechanism underlying such a therapeutic effect. [ABSTRACT FROM AUTHOR]

Background: The aging society in Japan is progressing rapidly compared with that in the United States and European countries. Aging limits activities of daily living (ADL) in older adults, declining their lives and functions at home. Therefore, improving their ADL to effectively support their functioning at home for as long as possible is vital. Consequently, supporters need to have a common understanding, be promptly aware of the decline in ADL, and quickly introduce rehabilitation. The Functional Independence Measure (FIM) and Barthel Index (BI) are the main scales used to quantitatively assess ADL. However, previous studies have reported that FIM requires specialized knowledge for evaluation, and BI does not appropriately capture changes in ADL. The Self-Assessment Burden Scale-Motor (SAB-M) was developed as a scale for family caregivers to appropriately assess changes in ADL in older adults. Previous studies using the SAB-M have confirmed its reliability and validity in hospitalized patients as assessed by their family caregivers. Therefore, this study aimed to investigate the reliability and validity of the SAB-M among community-dwelling older adults as assessed by their family caregivers. Methods: This study included community-dwelling older adults who received home-visit rehabilitation at the first author's facility between October 2020 and December 2020 in Japan. Following previous studies, the SAB-M was used by family caregivers to assess 20 older adults twice for intra-rater reliability. Furthermore, 168 older adults were evaluated by family caregivers for internal consistency using the SAB-M. For criterion validity, the SAB-M was used for the assessment by family caregivers, and therapists used the FIM-Motor (FIM-M). This study used the weighted kappa, Cronbach's alpha, and Spearman's rank correlation coefficients for the statistical analysis of intra-rater reliability, internal consistency, and criterion validity, respectively. Results: The weighted kappa coefficient for the total score was 0.98 (p < 0.01) and individual item, it was 0.93 for feeding (p < 0.01), 0.91 for bathing (p < 0.01), 0.98 for dressing (p < 0.01), 0.94 for transfer (p < 0.01), 0.94 for walking/wheelchair (p < 0.01), 0.95 for stairs (p < 0.01), and 0.96 for bladder management (p < 0.01). The Cronbach's alpha was 0.93 for the seven items. The Spearman's rank correlation coefficient between the SAB-M and FIM-M scores was 0.91 (p < 0.01). Conclusion: The SAB-M has sufficient reliability and validity among community-dwelling older adults. Family caregivers can routinely assess changes in the ADL of community-dwelling older adults using the SAB-M, enabling them to promptly consider introducing rehabilitation when older adults' ADL declines. Therefore, implementing SAB-M helps older adults live and function at home for as long as possible. [ABSTRACT FROM AUTHOR]