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Background: Vertebral and pelvic fractures are associated with a significant burden of negative health and psychosocial outcomes. The number of vertebral and pelvic fractures is increasing in an aging society. Vertebral and pelvic fractures are increasingly significant injuries for individuals and society. However, few epidemiological studies have examined the clinical course of vertebral and pelvic fractures. This is the protocol for a study that observes patients who have been admitted to the hospital with an incident vertebral or pelvic fracture for a period of 12 months. Methods: The observational cohort study is conducted at three study sites in Germany. Patients affected by vertebral or pelvic fractures are recruited within the first few days of hospital admission. Data collection takes place at four-time points: baseline, before discharge, after 4 months, and after 12 months after admission to the hospital. Particular emphasis is laid on the assessment of the fall mechanisms, physical function, physical activity, life space, mobility, treatment approach, and quality of life. The hospital stay involves the collection of biomaterials (blood and urine). Discussion: The study aims to enhance understanding of the clinical progression and outcomes in patients with fractures in the vertebrae or pelvis. [ABSTRACT FROM AUTHOR]

This study investigated the effectivity and sustainability of a physical activity (PA) promotion and motor training programs and analyzed predictors for PA changes in persons with dementia. A total of 122 participants with mild-to-moderate dementia were randomized to the intervention program designed for persons with dementia (intervention group) or a motor placebo activity (control group). The primary outcome was the Physical Activity Questionnaire for the Elderly assessed at the baseline, after the 3-month intervention, and at a 3-month follow-up. The PA promotion program significantly increased PA in the intervention group compared with the control group during the training intervention phase. Both groups showed an increase in habitual PA when intervention-induced activities were excluded. PA was sustainably increased in both groups at follow-up. Low baseline PA was predictive for increased PA after the intervention and low baseline PA, high motor performance, and low comorbidity for increased PA at follow-up. [ABSTRACT FROM AUTHOR]

Background: Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM.Methods: Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17-26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used.Results: One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89-13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00-0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different.Conclusions: The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction. [ABSTRACT FROM AUTHOR]

Objective: To investigate short-term changes in clinical characteristics in the transition period between geriatric inpatient rehabilitation and independent living at home in older patients with hip/pelvic fracture and cognitive impairment., Design: Longitudinal observational study., Subjects: A total of 127 multi-morbid, older patients with hip/pelvic fracture and cognitive impairment., Methods: Physical performance, fall-related self-efficacy, fear of falling, depressive symptoms, quality of life, and pain were assessed before discharge from geriatric inpatient rehabilitation and at home., Results: During the transition period (median 18.5 days; interquartile range 14-25 days), 25 participants dropped out due to admission to a nursing home (n = 11), withdrawal of consent (n = 8), death (n = 2), severe disease (n = 2), or other reasons (n = 2). Physical performance improved (p ≤ 0.001), while fall-related self-efficacy (p = 0.040) and fear of falling (p = 0.004) deteriorated. Depressive symptoms, quality of life, and pain did not change. Improvement in physical performance was associated with lower age, lower baseline physical performance, less baseline fear of falling, and living alone., Conclusion: While significant improvements in physical performance indicate a high potential for further enhancements in the majority of participants following inpatient rehabilitation, a considerable subgroup dropped out, partly indicating a negative trajectory in this vulnerable patient group. Sustained physical training or promotion of activity at home may further support rehabilitation in patients with hip/pelvic fracture and cognitive impairment.