Special Issue "Healthcare and Rehabilitation of Older Adults"

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Community Care".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 12119

Special Issue Editors

Dr. Daniela Figueiredo
E-Mail Website
Guest Editor
Center for Health Technology and Services Research (CINTESIS), School of Health Sciences of the University of Aveiro, 3810-193 Aveiro, Portugal
Interests: health psychology; psychosocial adjustment to chronic disease; adherence and behavior change; psychosocial interventions; ageing; family caregiving; COPD (Chronic Obstructive Pulmonary Disease); CKD (Chronic Kidney Disease); dementia; subjective health-related measures
Special Issues, Collections and Topics in MDPI journals
Dr. Oscar Ribeiro
E-Mail Website
Co-Guest Editor
Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology of the University of Aveiro, 3810-193 Aveiro, Portugal
Interests: active aging; healthy aging; oldest-old; longevity; mental health; informal care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Demographic ageing is a worldwide phenomenon that places significant challenges to all societies. Although ageing is a highly individual and variable process, with many older adults ageing well and healthy in several life domains, many others are frail and vulnerable to complex chronic conditions that challenge the current approaches to care. There is a need to re-think healthcare, rehabilitation, and health promotion, with a focus on the development of integrated, comprehensive, and empowering interventions that are more closely oriented to the real needs and preferences of older persons and their caregivers.

The scope of this issue is to disseminate research evidence on innovative approaches to health promotion and rehabilitation for older adults. Prevention and rehabilitation programmes might be at any level: person-centered, family-based, home-based, community-based, and multicenter levels. Interventions can target health literacy, psychosocial support, behavioral change, adherence, exercise training, nutrition, cognitive training, and self-management, among others. Population might be healthy older adults or older adults with chronic conditions. Research might be quantitative, qualitative, mixed methods or reviews that meet established review standards.

Dr. Daniela Figueiredo
Dr. Oscar Ribeiro
Guest Editors

Manuscript Submission Information

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Keywords

  • Ageing well
  • Healthcare
  • Geriatric Rehabilitation
  • Adherence
  • Self-management
  • Empowering
  • Integrated care
  • Older adults
  • Health literacy
  • Quality of life
  • Mental health

Published Papers (13 papers)

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Article
Long-Term Maintenance Strategies after Pulmonary Rehabilitation: Perspectives of People with Chronic Respiratory Diseases, Informal Carers, and Healthcare Professionals
Healthcare 2022, 10(1), 119; https://doi.org/10.3390/healthcare10010119 - 07 Jan 2022
Viewed by 606
Abstract
Pulmonary rehabilitation (PR) is an effective intervention for people with chronic respiratory diseases (CRD); however, its effects fade after 6–12 months. Community-based strategies might be valuable to sustain PR benefits, but this has been little explored. People with CRD, informal carers, and healthcare [...] Read more.
Pulmonary rehabilitation (PR) is an effective intervention for people with chronic respiratory diseases (CRD); however, its effects fade after 6–12 months. Community-based strategies might be valuable to sustain PR benefits, but this has been little explored. People with CRD, informal carers, and healthcare professionals (HCPs) were recruited from pulmonology appointments of two local hospitals, two primary care centres, and one community institutional practice and through snowballing technique. Focus groups were conducted using a semi-structured guide. Data were thematically analysed. Twenty-nine people with CRD (24% female, median 69 years), 5 informal carers (100% female, median 69 years), and 16 HCPs (75% female, median 36 years) were included. Three themes were identified: “Maintaining an independent and active lifestyle” which revealed common strategies adopted by people with “intrinsic motivation and professional and peer support” as key elements to maintain benefits, and that “access to information and partnerships with city councils’ physical activities” were necessary future steps to sustain active lifestyles. This study suggests that motivation, and professional and peer support are key elements to maintaining the benefits of PR in people with CRD, and that different physical activity options (independent or group activities) considering peoples’ preferences, should be available through partnerships with the community, namely city councils. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Article
The Caregiver Support Ratio in Europe: Estimating the Future of Potentially (Un)Available Caregivers
Healthcare 2022, 10(1), 11; https://doi.org/10.3390/healthcare10010011 - 22 Dec 2021
Cited by 1 | Viewed by 863
Abstract
The caregiver support ratio (CSR) is defined as the number of potential caregivers aged 45–64 years, the most common caregiving age range, for each person aged 80+, the subgroup of older adults most at risk of needing long-term services and support. This study [...] Read more.
The caregiver support ratio (CSR) is defined as the number of potential caregivers aged 45–64 years, the most common caregiving age range, for each person aged 80+, the subgroup of older adults most at risk of needing long-term services and support. This study uses data from the CENSUS HUB database and from the UN database to calculate the current (last year available: 2011) and projected (2020, 2030, 2040 and 2050) CSR for a group of European countries. Mediterranean countries, France, Belgium, and Sweden presented the lowest CSR (5:1) in 2011. The countries with the highest CSR were Slovakia (9:1) and Ireland, Poland, Cyprus, and Malta (8:1). The estimated CSR is expected to progressively decline from 6:1 (2011) to 2:1 (2050) for all countries. Although differences in the CSR exist between countries, the number of people aged 45–64 who are available to care for each person aged 80+ will decrease uniformly in the coming decades. Cross-national challenges for gerontological social policies and healthcare provision are expected due to the increasing demand for long-term care among the oldest population. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Article
“Together We Stand”: A Pilot Study Exploring the Feasibility, Acceptability, and Preliminary Effects of a Family-Based Psychoeducational Intervention for Patients on Hemodialysis and Their Family Caregivers
Healthcare 2021, 9(11), 1585; https://doi.org/10.3390/healthcare9111585 - 19 Nov 2021
Viewed by 673
Abstract
This pilot study aimed to assess the feasibility, acceptability, and preliminary effects of a family-based psychoeducational intervention for patients undergoing hemodialysis (HD) and their family members. This was a single-group (six dyads), six-week, pre–post pilot study, delivered in a multifamily group format. Feasibility [...] Read more.
This pilot study aimed to assess the feasibility, acceptability, and preliminary effects of a family-based psychoeducational intervention for patients undergoing hemodialysis (HD) and their family members. This was a single-group (six dyads), six-week, pre–post pilot study, delivered in a multifamily group format. Feasibility was based on screening, eligibility, content, retention, completion, and intervention adherence rates. Acceptability was assessed at post-intervention through a focus group interview. Self-reported anxiety and depression and patients’ inter-dialytic weight gain (IDWG) were also measured. The screening (93.5%), retention (85.7%), and completion (100%) rates were satisfactory, whereas eligibility (22.8%), consent (18.4%), and intervention adherence (range: 16.7–50%) rates were the most critical. Findings showed that participants appreciated the intervention and perceived several educational and emotional benefits. The results from the Wilcoxon Signed-Rank Test showed that a significant decrease in anxiety symptoms (p = 0.025, r = 0.646) was found, which was followed by medium to large within-group effect sizes for changes in depression symptoms (p = 0.261, r = 0.325) and patients’ IDWG (p = 0.248, r = 0.472), respectively. Overall, the results indicated that this family-based psychoeducational intervention is likely to be feasible, acceptable, and effective for patients undergoing HD and their family caregivers; nonetheless, further considerations are needed on how to make the intervention more practical and easily implemented in routine dialysis care before proceeding to large-scale trials. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
Article
Relationships between Gait Regularity and Cognitive Function, including Cognitive Domains and Mild Cognitive Impairment, in Community-Dwelling Older People
Healthcare 2021, 9(11), 1571; https://doi.org/10.3390/healthcare9111571 - 18 Nov 2021
Viewed by 551
Abstract
The aim of this cross-sectional study was to examine the correlations between gait regularity, cognitive functions including cognitive domains, and the mild cognitive impairment (MCI) in community-dwelling older people. This study included 463 older adults (63.4% women, mean age: 74.1), and their step [...] Read more.
The aim of this cross-sectional study was to examine the correlations between gait regularity, cognitive functions including cognitive domains, and the mild cognitive impairment (MCI) in community-dwelling older people. This study included 463 older adults (63.4% women, mean age: 74.1), and their step and stride regularity along the three-axis components was estimated from trunk acceleration, which was measured by inertial measurement units during a comfortable gait. Four aspects of cognitive function were assessed using a tablet computer: attention, executive function, processing speed, and memory, and participants were classified into those with or without MCI. The vertical component of stride and step regularity was associated with attention and executive function (r = −0.176–−0.109, p ≤ 0.019), and processing speed (r = 0.152, p < 0.001), after it was adjusted for age and gait speed. The low vertical component of step regularity was related to the MCI after it was adjusted for covariates (OR 0.019; p = 0.016). The results revealed that cognitive function could affect gait regularity, and the vertical component of gait regularity, as measured by a wearable sensor, could play an important role in investigating cognitive decline in older people. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Article
Investigating the Relationship between Media Usage, Depression, and Quality of Life among Older Adults
Healthcare 2021, 9(9), 1154; https://doi.org/10.3390/healthcare9091154 - 03 Sep 2021
Cited by 3 | Viewed by 928
Abstract
Background: The uses and gratifications theory suggests that various types of media can greatly affect people’s lives. This is especially true among older adults who tend to use media for leisure. However, there is insufficient research regarding the relationship between media usage, depression, [...] Read more.
Background: The uses and gratifications theory suggests that various types of media can greatly affect people’s lives. This is especially true among older adults who tend to use media for leisure. However, there is insufficient research regarding the relationship between media usage, depression, and quality of life among older adults. Purpose: The purpose of this study was to explore the association between media usage (traditional and internet media), depression, and quality of life among older adults. Methods: Using a cross-sectional design, this study recruited individuals aged 65 years and older in central Taiwan and collected data via a structured questionnaire. Contents of the questionnaire included demographic details, a media usage behavior questionnaire, the Brief Symptoms Rating Scale (BSRS-5), and the Quality of Life Scale developed by the World Health Organization (WHOQOL-BREF). Subsequently, multiple regression analyses were conducted to investigate the association between media usage, depression, and quality of life of older adults. Results: The average age of the 252 participants (107 males) was 70.0 ± 5.4 years. Regression analysis revealed a significant, negative relationship between the number of hours spent watching television and the degree of depression. Additionally, the number of hours spent watching television was significantly negatively related to the quality of life in terms of both the psychological health and social relationships categories. In contrast, the number of hours spent reading newspapers and magazines was significantly positively related to quality of life in the categories of psychological health, social relationships, and environment. Finally, the number of hours spent browsing internet media was significantly positively related to the quality of life in the psychological health category. Conclusion: Media usage may affect the degree of depression and quality of life of older adults depending on the type of media and amount of usage. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
Article
Bright Light Therapy in Older Adults with Moderate to Very Severe Dementia: Immediate Effects on Behavior, Mood, and Physiological Parameters
Healthcare 2021, 9(8), 1065; https://doi.org/10.3390/healthcare9081065 - 19 Aug 2021
Cited by 2 | Viewed by 893
Abstract
Bright light therapy (BLT) has demonstrated positive short- and long-term effects in people with cognitive impairment or dementia; however, the immediate impact of BLT sessions has been scarcely investigated. In this study, we aimed to explore the immediate effects of BLT on behavior, [...] Read more.
Bright light therapy (BLT) has demonstrated positive short- and long-term effects in people with cognitive impairment or dementia; however, the immediate impact of BLT sessions has been scarcely investigated. In this study, we aimed to explore the immediate effects of BLT on behavior, mood, and physiological parameters (oxygen saturation/heart rate) in a sample of institutionalized older adults with moderate to very severe dementia, with a median age of 85.0 (interquartile range, IQR, 82.0–90.0), being higher in men (87.0 years, IQR 80.0–94.0) than in women (84.5 years, IQR 82.0–89.5). The BLT protocol consisted of 30-min morning sessions of 10,000 lux, Monday through Friday, for 4 weeks. The physiological parameters were recorded immediately before and after each session by pulse oximetry. Mood and behavior were assessed before, after, and during the sessions using the Interact scale. Post-session Interact scores showed a significant decrease in the items Tearful/sad and Talked spontaneously, and a significant increase in the items Enjoying self, active or alert, and Relaxed, content or sleeping appropriately. Interact scores during the sessions reflected a significant decrease in the speech-related items. Both physiological parameters changed positively from before to after sessions. Our results suggest that BLT provides immediate positive effects on mood, stimulation level, and physiological parameters, as well as a trend toward decreased speech. More robust research is needed to further explore the immediate impact of BLT. This study is registered with Clinicaltrials.gov (NCT04949984). Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Article
Effect of Regular Taekwondo Self-Defense Training on Oxidative Stress and Inflammation Markers in Postmenopausal Women
Healthcare 2021, 9(8), 985; https://doi.org/10.3390/healthcare9080985 - 03 Aug 2021
Viewed by 645
Abstract
We aimed to investigate the effect of a 12-week Taekwondo self-defense training course on oxidative stress and inflammation in postmenopausal women. Sixteen middle-aged women participated and were randomized into two groups: a control group (CG, n = 8) and a Taekwondo self-defense training [...] Read more.
We aimed to investigate the effect of a 12-week Taekwondo self-defense training course on oxidative stress and inflammation in postmenopausal women. Sixteen middle-aged women participated and were randomized into two groups: a control group (CG, n = 8) and a Taekwondo self-defense training group (TSDG, n = 8). The TSDG was trained for 60 min, four times per week, for 12 weeks. Following the Taekwondo training intervention, side-step was significantly higher in the TSDG than in the CG (p < 0.001). Malondialdehyde levels were significantly lower after the intervention than before in the TSDG (p < 0.01). Superoxide dismutase (SOD) levels were also significantly higher after the intervention than before in the TSDG (p < 0.001). After the Taekwondo training intervention, SOD levels were significantly higher in the TSDG than in the CG (p < 0.01). Tumor necrosis factor α (TNF-α) levels were significantly lower after the intervention than before in the TSDG (p < 0.05). After the Taekwondo training intervention, TNF-α levels were significantly lower in the TSDG than in the CG (p < 0.05). The results of this study suggest that Taekwondo self-defense training is an effective exercise that improves agility, oxidative stress, and inflammatory responses in postmenopausal women. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Article
Complex Exercise Improves Anti-Inflammatory and Anabolic Effects in Osteoarthritis-Induced Sarcopenia in Elderly Women
Healthcare 2021, 9(6), 711; https://doi.org/10.3390/healthcare9060711 - 10 Jun 2021
Viewed by 960
Abstract
We investigated the effects of a 15-week complex exercise program on osteoarthritis and sarcopenia by analyzing anabolic effects and the impact on the activities of daily living (ADLs). Nineteen women aged ≥60 years with sarcopenia (SEG, n = 9) or diagnosed with osteoarthritis [...] Read more.
We investigated the effects of a 15-week complex exercise program on osteoarthritis and sarcopenia by analyzing anabolic effects and the impact on the activities of daily living (ADLs). Nineteen women aged ≥60 years with sarcopenia (SEG, n = 9) or diagnosed with osteoarthritis with sarcopenia (OSEG, n = 10) were enrolled and underwent an exercise program. Insulin-like growth factor 1 (IGF-1), irisin, myostatin, interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-a) levels were analyzed pre- and post-intervention. Thigh cross-sectional area (TCSA) was measured pre- and post-intervention via computed tomography. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Physical Performance Battery (SPBB) were assessed pre- and post-interventions to assess ADL. There was a significant interaction effect between SEG and OSEG at the IGF-1 level post-intervention. Irisin increased and myostatin decreased post-intervention in both groups. IL-10 increased and TNF-α decreased post-intervention with a significant interaction effect in the OSEG group. TCSAs increased post-intervention in both groups. There was a significant interaction between the two groups. OSEG showed a greater WOMAC decrease and SPPB increase post-intervention, and there was a significant interaction effect. Combined exercise may be effective in improving biochemical factors, anabolic effects, and ADL in elderly women with osteoarthritis and sarcopenia. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Article
Improved Balance and Gait Ability and Basic Activities of Daily Living after Comprehensive Geriatric Care in Frail Older Patients with Fractures
Healthcare 2021, 9(5), 560; https://doi.org/10.3390/healthcare9050560 - 11 May 2021
Viewed by 744
Abstract
(1) Purpose: Comprehensive geriatric care (CGC) is a multidisciplinary treatment approach for elderly patients. We aimed to investigate outcomes in fracture patients who had been treated using this approach in a large geriatric unit. (2) Methods: This observational cohort study assessed the gait [...] Read more.
(1) Purpose: Comprehensive geriatric care (CGC) is a multidisciplinary treatment approach for elderly patients. We aimed to investigate outcomes in fracture patients who had been treated using this approach in a large geriatric unit. (2) Methods: This observational cohort study assessed the gait function (using the Tinetti Balance and Gait Test (TBGT)) and basic activities of daily living (ADL) (using the Barthel index (BI)) before and after CGC and compared the results. Baseline data, walking ability assessments (Timed Up and Go, TUG), and cognitive status (mini mental status examination, MMSE) were also analyzed in the subgroup of patients with versus without fractures. (3) Results: Out of 1263 hospitalized patients, 1099 received CGC (median age: 83.1 years (IQR: 79.0–87.8 years); 64.1% were female). TBGT improvement was observed in 90.7% and BI increased in 82.7% of fracture patients. A TBGT improvement of >5 was noted in 47.3% and was associated with female sex, a lower BI at admission (median: 40 versus 45; p = 0.010), and poorer mobility on admission (TUG: median 5 versus 4; p = 0.001). An improvement in BI of ≥15 was observed in 63.0% of the cases, and was associated with a better cognitive status (MMSE: median 25 versus 18; p = 0.001) and inversely associated with diabetes mellitus and a previous stroke. (4) Conclusion: CGC in specialized geriatric units improves the balance and gait and the basic ADL in geriatric patients. After fracture, female patients are more likely to experience improvements in gait and balance, while patients with better cognitive condition are more likely to experience improvements in ADL. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Article
Prevalence of Low Back Pain and Associated Factors in Older Adults: Amazonia Brazilian Community Study
Healthcare 2021, 9(5), 539; https://doi.org/10.3390/healthcare9050539 - 05 May 2021
Cited by 1 | Viewed by 680
Abstract
To investigate the prevalence of low back pain (LBP) and associated factors in the older adult Amazonia Brazilian community, a cross-sectional study was conducted to evaluate 700 participants that were ≥60 years old. Pain intensity and functional disability were assessed using the Numerical Pain [...] Read more.
To investigate the prevalence of low back pain (LBP) and associated factors in the older adult Amazonia Brazilian community, a cross-sectional study was conducted to evaluate 700 participants that were ≥60 years old. Pain intensity and functional disability were assessed using the Numerical Pain Scale and the Roland Morris Questionnaire, respectively, and their sociodemographic, clinical, and behavior variables were collected, i.e., age, sex, education level, socioeconomic level, anthropometric measurements, physical activity, health perception, and emotional state. The punctual prevalence rates of LBP were 42.4% (95% CI: 38.2–46.6%), and for the last 365 days, these prevalence rates were 93.7% (95% CI: 91.3–95.6%), the mean pain and functional disability scores were 6.17 ± 2.13 and 11.30 ± 6.07, and the moderate-to-severe disability was 39.7%. Pain and functional disability were associated with sex, chronic diseases, body mass index (BMI), physical activity level, health perception, and emotional level. In conclusion, the prevalence of LBP was high (for both punctual and the last 365 days), but the variables associated with being female, fewer years of schooling, sedentary behavior, diseases related to diet and the cardiovascular system, and impaired emotional levels had a higher level LBP, even though they considered themselves in good health. These findings can aid with coordinated efforts from government and health professionals to help manage and promote the prevention of LBP by considering the older adult population’s needs in the state of Amazonas. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Article
Effects of a Home-Based Pulmonary Rehabilitation Program in Patients with Chronic Obstructive Pulmonary Disease in GOLD B Group: A Pilot Study
Healthcare 2021, 9(5), 538; https://doi.org/10.3390/healthcare9050538 - 04 May 2021
Viewed by 1166
Abstract
Patients with chronic obstructive pulmonary disease (COPD) in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) B group can be included in pulmonary rehabilitation (PR) settings outside the hospitals. This study aimed to explore the feasibility of a home-based pulmonary rehabilitation (HBPR) [...] Read more.
Patients with chronic obstructive pulmonary disease (COPD) in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) B group can be included in pulmonary rehabilitation (PR) settings outside the hospitals. This study aimed to explore the feasibility of a home-based pulmonary rehabilitation (HBPR) program and assess its impact on patients with COPD in the GOLD B group. A real-world, pre–post intervention study was conducted with 12 weeks of HBPR (presential home visits and phone calls) using the self-management program Living Well with COPD. The 1-min sit-to-stand test (1MSTS), modified Medical Research Council Questionnaire (mMRC), COPD Assessment Test (CAT), Hospital Anxiety and Depression Scale (HADS), and London Chest Activity of Daily Living (LCADL) were used to assess the impact. Pre–post differences and correlations between changes in outcomes were calculated. In 30 patients (71.6 years, FEV1 (%) 52.8), significant improvements (p < 0.05) were observed on 1MSTS (Pre 17.2, Post 21.2), mMRC (Pre 2.0, Post 1.0), CAT (Pre 16.3, Post 9.9), HADS (Pre 14.4, Post 9.6), and LCADL (Pre 21.0, Post 15.8), with no adverse events reported. When significant, correlations between changes in outcomes were moderate or strong (0.48 ≤ ρ ≤ 0.66). HBPR can be feasible and safe, and it shows the potential to significantly improve outcomes of patients with COPD in the GOLD B group. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Case Report
Distinct Ground Reaction Forces in Gait between the Paretic and Non-Paretic Leg of Stroke Patients: A Paradigm for Innovative Physiotherapy Intervention
Healthcare 2021, 9(11), 1542; https://doi.org/10.3390/healthcare9111542 - 12 Nov 2021
Cited by 1 | Viewed by 441
Abstract
This case report study aims to identify the differences in the ground reaction forces (GRF) placed on the forefoot, hindfoot, and entire foot between the paretic and non-paretic legs in two stroke patients to identify potential targets for improved physiotherapy treatment. A digital [...] Read more.
This case report study aims to identify the differences in the ground reaction forces (GRF) placed on the forefoot, hindfoot, and entire foot between the paretic and non-paretic legs in two stroke patients to identify potential targets for improved physiotherapy treatment. A digital gait analysis foot pressure insole was fitted inside the participants’ shoes to measure the percentage of body weight taken during the stance phase, and the vertical GRF of the two subjects are reported in this paper. Both patients presented noteworthy differences in gait parameters individually and between their paretic and non-paretic legs. The trend shows a decreased percentage of body weight on the paretic forefoot and hindfoot, although the percentage bodyweight placed on the entire foot remained similar in both feet. The gait patterns shown were highly individual and indicated that both legs were affected to some degree. These findings identify key motion targets for an improved physiotherapy treatment following a stroke, suggesting that physiotherapy treatment should be targeted and individually tailored and should include both extremities. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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Systematic Review
Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review
Healthcare 2021, 9(6), 624; https://doi.org/10.3390/healthcare9060624 - 24 May 2021
Cited by 4 | Viewed by 1675
Abstract
While the association between dysphagia and malnutrition is well established, there is a lack of clarity regarding the nutritional status and mealtime satisfaction of those consuming texture-modified diets (TMDs). This systematic review summarises and critically appraises the nutritional status and mealtime satisfaction of [...] Read more.
While the association between dysphagia and malnutrition is well established, there is a lack of clarity regarding the nutritional status and mealtime satisfaction of those consuming texture-modified diets (TMDs). This systematic review summarises and critically appraises the nutritional status and mealtime satisfaction of adults consuming TMDs. A systematic database search following PICO criteria was conducted using Cochrane Central (via Ovid), MEDLINE, CINAHL, EMBASE and Scopus. Nutritional status, mealtime satisfaction and costs were identified as primary outcomes. Eligible studies were grouped according to outcome measurement. In total, 26 studies met the inclusion criteria. Twenty studies evaluated the nutritional status by weight change or using malnutrition screening tools and found the consumption of TMDs correlated with weight loss or malnutrition. Nine studies evaluated mealtime satisfaction, with two reporting poor satisfaction for people on thickened fluids (TFs). Nutrition intervention through adjusting texture and consistency and nutrition enrichment showed positive effects on weight and mealtime satisfaction. The majority of the studies were rated as ‘neutral’ quality due to the limited number of experiments. TMD consumers had compromised nutritional status and poor mealtime satisfaction. More research input is required to identify promising strategies for improving the nutritional status and mealtime satisfaction of this population. Food services need to consider texture, consistency and fortification in designing menus for people on TMDs to avoid weight loss and malnutrition, and to enhance mealtime enjoyment. Full article
(This article belongs to the Special Issue Healthcare and Rehabilitation of Older Adults)
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