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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Aging".

Deadline for manuscript submissions: closed (15 September 2022) | Viewed by 31056

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Special Issue Editor

Dr. Edgar Ramos Vieira

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Guest Editor

Department of Physical Therapy, Florida International University, Miami, FL 33199, USA
Interests: geriatrics; falls; frailty; physical decline; prevention; exercise

Special Issue Information

Dear Colleagues,

We are pleased to announce this Special Issue of the International Journal of Environmental Research and Public Health (IF: 3.390) focusing on “Physical Therapy in Geriatrics”. This is a timely issue considering the current environmental and contextual effects on the health of older adults. The ongoing pandemic, climate change, and chronic disease burden on older adults are pressing public health issues. Physical therapy has an important role in preventing physical decline and treating the effects of reduced physical activity associated with social distancing requirements due to COVID-19 and pre-existing low levels of physical activity among older adults. Physical therapists have had to innovate to support therapy and exercises online and address the issues associated with COVID-19 during and post-infection.

We aim to disseminate the ideas, challenges, efforts and effects of physical therapy interventions and treatments delivered to older adults and the innovations implemented during these challenging times.

Dr. Edgar Ramos Vieira
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

physical therapy
COVID-19
mobility
inactivity
disability
frailty
falls
prevention
treatment
telehealth

Published Papers (17 papers)

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Research

Open AccessArticle

Changes in Physical Performance among Community-Dwelling Older Adults in Six Years

Darlise Rodrigues dos Passos Gomes

Leonardo Pozza Santos

Maria Cristina Gonzalez

Edgar Ramos Vieira

and

Renata Moraes Bielemann

Int. J. Environ. Res. Public Health 2023, 20(8), 5579; https://doi.org/10.3390/ijerph20085579 - 19 Apr 2023

Viewed by 787

Abstract

Changes in physical performance (PP) occur with aging, and understanding the magnitude of these changes over time is important. This study evaluated changes in Gait Speed (GS) and Timed Up and Go (TUG) performance and their association with related factors among community-dwelling older adults over a period of five to six years. A cohort study of 476 older adults with baseline assessment conducted in 2014 and reassessment in 2019–2020 was carried out. Associations between PP changes over time and sociodemographic, behavioral, and health variables were evaluated using mixed linear models. Approximately 68% of the participants declined PP; 20% had no relevant change in GS and 9% in TUG time (sustained PP); 12% increased GS, and 23% decreased TUG time (improved PP). Being male (p = 0.023), living without a partner/separated (p = 0.035), higher education (p = 0.019), and alcohol consumption in the prior month (p = 0.045) were associated with decreased GS, while older age (p < 0.001), having lower socioeconomic status (p < 0.004), physical inactivity (p = 0.017), and being overweight (p = 0.007) were associated with increased TUG time. PP declined for most participants. Factors most strongly associated with PP decline are non-modifiable. The high prevalence of PP decline over time signals the importance of including physical tests in yearly health assessments. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study

Mariana Cevei

Roxana Ramona Onofrei

Anamaria Gherle

Cristina Gug

and

Dorina Stoicanescu

Int. J. Environ. Res. Public Health 2022, 19(22), 15350; https://doi.org/10.3390/ijerph192215350 - 21 Nov 2022

Cited by 2 | Viewed by 1497

Abstract

The musculoskeletal system is affected in over 40% of patients with Coronavirus disease 2019 (COVID-19). There is an increased need for post-acute rehabilitation after COVID-19, especially in elderly people with underlying health problems. The aim of this study was to evaluate the benefits of an early and goal-orientated rehabilitation program using combined approaches, robotic medical devices together with other rehabilitation techniques and therapies, in elderly people after acute COVID-19. Ninety-one patients (62.64 ± 14.21 years) previously diagnosed with severe SARS-CoV-2 infection were admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, for medical rehabilitation, but only six patients (85.33 ± 3.07 years) met the inclusion criteria and participated in the study. The rehabilitation treatment was complex, performed over 4 weeks, and included combined approaches: exercise therapy, robotic gait training, occupational therapy, and massages. Activity and participation evaluation were performed using the Barthel Index and Functional Independence Measure for activities of daily living (ADLs). Assessments were performed at admission and discharge from the rehabilitation clinic. Lokomat patients’ reports revealed that the patients had improved motor control (with one exception). The measurement of functional ability revealed an improvement in most cases. This study presents some of the first data on outcomes of COVID-19 patients’ musculoskeletal rehabilitation in our country. Early complex medical rehabilitation improved functional independence and autonomy in ADLs in very old patients, post-COVID-19. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Older Adults’ Vigorous Occupational Physical Activity Levels in Six Countries Are Explained by Country and ‘Having Multiple Jobs’

Pablo Villalobos Dintrans

and

Emelia Danquah

Int. J. Environ. Res. Public Health 2022, 19(21), 14065; https://doi.org/10.3390/ijerph192114065 - 28 Oct 2022

Cited by 1 | Viewed by 978

Abstract

Several studies have compared physical activity (PA) levels between countries, but none of these studies focused on older adults and occupational PA. This study aimed to assess potential inequalities in older adults’ occupational PA across six countries and to ascertain whether having multiple jobs is a factor that interacts with country of residence to modify inequalities. This study adopted a cross-sectional design with a statistical technique screening for potential covariates. Older adults (mean age = 64 years; range = 50–114 years) from six countries (Russia, Mexico, China, India, Ghana, and South Africa) participated in the study. We utilised data from the first wave of the Study on Global AGEing and Adult Health (SAGE). These data were collected from 2007 to 2010. A random sample of 34,114 older adults completed the survey. We analysed the data with a two-way multivariate analysis of variance after screening for the ultimate covariates. There were differences in occupational PA levels (i.e., vigorous and moderate PA) among the six countries. Occupational PA levels were not significantly associated with having multiple jobs. However, having multiple jobs interacted with country of residence to influence vigorous occupational PA. Older adults from most countries who had more than one job reported more vigorous occupational PA. Older adults’ occupational PA differed among the six countries, and having multiple jobs was associated with more vigorous occupational PA. Older adults who keep multiple jobs at a time may be more active than their counterparts who had one job or were unemployed. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

Open AccessArticle

Pre-Frailty Phenotype and Arterial Stiffness in Older Adults Free of Cardiovascular Diseases

Geovani Araújo Dantas Macêdo

Yuri Alberto Freire

Rodrigo Alberto Vieira Browne

Marcyo Câmara

Ludmila Lucena Pereira Cabral

Daniel Schwade

Ronildo Paulo-Pereira

Raíssa de Melo Silva

Alana Monteiro Bispo Silva

Luiz Fernando Farias-Junior

Todd A. Duhamel

and

Eduardo Caldas Costa

Int. J. Environ. Res. Public Health 2022, 19(20), 13469; https://doi.org/10.3390/ijerph192013469 - 18 Oct 2022

Cited by 1 | Viewed by 1140

Abstract

Purpose: Arterial stiffness is a subclinical marker of cardiovascular disease (CVD). The pre-frailty phenotype is associated with a higher risk for CVD. This study investigated the association between the pre-frailty phenotype and arterial stiffness in community-dwelling older adults without diagnosed CVD. Methods: In total, 249 community-dwelling older adults aged 60–80 years were included in this cross-sectional study. The pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Participants with one or two standardized Fried criteria were classified as pre-frail and those with zero criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The data were analyzed using the generalized linear model. Results: From 249 participants (66.1 ± 5.3 years; 79.5% females), 61.8% (n = 154) were pre-frail and 38.2% (n = 95) robust. Pre-frail older adults had a higher aPWV (β = 0.19 m/s; p = 0.007) compared to their robust peers. Conclusions: The pre-frailty phenotype was associated with higher arterial stiffness in community-dwelling older adults aged 60–80 years. Pre-frail older adults may have a higher risk for CVD. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Physiological and Ankle Functions Are Discriminating Factors for the Risk of Falls in Women in Treatment of Osteoporosis

Renata Gonçalves Pinheiro Correa

Anna Raquel Silveira Gomes

and

Victoria Zeghbi Cochenski Borba

Int. J. Environ. Res. Public Health 2022, 19(19), 12643; https://doi.org/10.3390/ijerph191912643 - 03 Oct 2022

Viewed by 1001

Abstract

Introduction: Elderly women with osteoporosis are at risk of falls and fractures. Objective: To compare the intrinsic factors of falls, including ankle evaluation, in a group of elderly women in treatment for osteoporosis compared with a control group. Methods: A cross-sectional study of elderly women in treatment for osteoporosis (TG) was paired with a control group (CG) not in treatment. All groups completed a questionnaire and underwent a bone mineral density test; the mini-mental state examination (MMSE); physical performance tests; lower-limb strength and power, ankle, and muscle architecture evaluations; and a physiological profile assessment (PPA). Results: A total of 128 women were included (68 TG, 60 CG); the mean age was 71.55 ± 3.07 years; TG had a worse performance in the intrinsic factors in the MMSE, plantarflexions range of motion, gait speed, plantarflexions peak isometric strength, and short physical performance battery (p < 0.05 for all). PPA stratification (proprioception and lower-limb strength) presented a greater risk of falls in the TG, with proprioception increasing the risk by 2.4 times. Conclusion: Patients undergoing treatment for osteoporosis are influenced by intrinsic factors of falls, many being present in the CG. PPA and ankle strength and flexibility tests are more discriminative for evaluating fall risks in patients in treatment for osteoporosis. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

A Proposed Method of Converting Gait Speed and TUG Test in Older Subjects

and

Int. J. Environ. Res. Public Health 2022, 19(19), 12145; https://doi.org/10.3390/ijerph191912145 - 25 Sep 2022

Cited by 1 | Viewed by 1353

Abstract

Sarcopenia is one of the most important health problems in advanced age. In 2019, the European Working Group of Sarcopenia in Older People (EWGSOP) updated the operational diagnostic criteria for identification of people with sarcopenia (EWGSOP2). Among the two proposed low performance measures of sarcopenia are gait speed and the Timed Up and Go (TUG) test. Usage of any of those tools requires recalculation for the second one for eventual comparisons. The simple linear regression has been used for such comparisons in several previous studies, but the appropriateness of such an approach has not been verified. The aim of this study is to find the most appropriate model describing the relationship between these two popular measures of physical function. The study was performed in 450 consecutive outpatients of the Geriatric Clinic of the Medical University of Lodz, Poland, aged 70 to 92 years who volunteered to participate in the study. The TUG test and gait speed at 4 m to assess physical function were used. Different alternative models were compared to obtain the highest R-squared values. A Reciprocal-Y model (R-squared = 71.9%) showed the highest performance, followed by a Logarithmic-Y square root-X model (R-squared = 69.3%) and a Reciprocal-Y square root-X model (R-squared = 69.1%). The R-squared for the linear model was 49.5%. For the selected reciprocal model, the correlation coefficient was 0.85 and the equation of the fitted model was: Gait speed (m/s) = 1/(−0.0160767 + 0.101386 × TUG). In conclusion, in independent community-dwelling older adults, the relationship between gait speed and the TUG test in older subjects is nonlinear. The proposed reciprocal model may be useful for recalculations of gait speed or TUG in future studies. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Relationship between Pain, Fear of Falling and Physical Performance in Older People Residents in Long-Stay Institutions: A Cross-Sectional Study

Sabrina Gomes Fernandes

Weslley Barbosa Sales

Diego Villar Tavares

Dayanna da Silva Pereira

Patrícia Vidal de Negreiros Nóbrega

Cristina Marques de Almeida Holanda

and

Alvaro Campos Cavalcanti Maciel

Int. J. Environ. Res. Public Health 2022, 19(19), 12014; https://doi.org/10.3390/ijerph191912014 - 22 Sep 2022

Cited by 1 | Viewed by 931

Abstract

Introduction: To analyze the relationship between pain, the fear of falling and functional performance in older people living in a long-stay institution (LSI) in the interior of northeastern Brazil. Methods: A cross-sectional study was conducted with 133 older residents in an LSI in the State of Paraíba. The instruments used for data collection were the Geriatric Pain Measure (GPM), the Falls Efficacy Scale-International (FES-I) and the Short Physical Performance Battery (SPPB). Results: Pain was reported by 57.5% of those evaluated, 48% being classified as chronic pain and presenting an average of 25.2 in the GPM. As for physical performance, assessed using the SPPB, the 133 older residents showed moderate to poor performance, with an average of 6.43 (±2.96) on the scale. By correlating the adjusted GPM values with the FES-I, a weak and statistically significant positive correlation was obtained (ρ = 0.31: p < 0.001). Conclusions: It can be concluded that those who reported pain had a worse performance in the applied tests, in addition to having higher scores on the scale referring to a fear of falling. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Clinical-Functional Vulnerability, Functional Capacity, and Falls in Octogenarians with Different Physical Activity Levels—A Cross-Sectional Study

Letícia Pophal da Silva

Natália Boneti Moreira

Renata Zacharias Grando

Paulo César Baraúce Bento

and

André Luiz Felix Rodacki

Int. J. Environ. Res. Public Health 2022, 19(19), 11909; https://doi.org/10.3390/ijerph191911909 - 21 Sep 2022

Cited by 1 | Viewed by 867

Abstract

Aim: To compare differences between frailty, functional capacity, and fall prevalence among community-dwelling oldest-old adults regarding their physical activity levels. Methods: Two hundred and thirty-nine octogenarians (80+ years) were allocated according to their physical activity as insufficiently active (<150 min week⁻¹; n = 98; 84.4 ± 3.7 years), active (150 to 300 min week⁻¹, n = 81, 83.9 ± 3.1 years), and very active (>300 min week⁻¹, n = 60; 83.8 ± 3.4 years). Frailty (CFVI-20 questionnaire), functional capacity (Five Times Sit-to-Stand Test, Timed Up and Go, Balance, and handgrip strength), fall history, and physical activity were assessed. Results: The insufficiently active group was the frailest and presented the worst functional performance compared to the other groups. The fall prevalence was higher in the insufficiently active (60.9%) compared to the active (26.4%) and very active (12.7%) groups. Conclusions: The group of insufficiently active octogenarians showed the greatest frailty, worst functional capacity, and higher fall prevalence than the active and very active groups. The engagement in physical activity of at least 300 min week⁻¹ is essential to reverse or minimize the deleterious effects of aging on frailty, functional capacity, and falls in octogenarians. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Does 8-Week Resistance Training with Slow Movement Cadenced by Pilates Breathing Affect Muscle Strength and Balance of Older Adults? An Age-Matched Controlled Trial

Ilha G. Fernandes

Maria C. G. S. Macedo

Matheus A. Souza

Gabriela Silveira-Nunes

Michelle C. S. A. Barbosa

Andreia C. C. Queiroz

Edgar R. Vieira

and

Alexandre C. Barbosa

Int. J. Environ. Res. Public Health 2022, 19(17), 10849; https://doi.org/10.3390/ijerph191710849 - 31 Aug 2022

Cited by 1 | Viewed by 2023

Abstract

This study investigated the balance and dorsiflexion strength of older adults after eight weeks of resistance training, with the exercise velocity cadenced by the Pilates breathing technique and the volume modulated by the session duration. Forty-four older adults were divided into two groups: resistance training (TR; n = 22) and resistance training with the Pilates breathing technique cadencing all exercises (TR + P; n = 22), both during eight weeks. The total exercising volume was controlled by time of execution (50 min/session). The dorsiflexion strength and balance were assessed. The RT group showed higher dorsiflexion strength after the protocol: Right (RT = 29.1 ± 7.7 vs. RT + P = 22.9 ± 5.2, p = 0.001) and Left (RT = 29.5 ± 6.9 vs. RT + P = 24.0 ± 5.2, p = 0.001). All balance parameters were improved in RT + P group compared to its own baseline: Path Length (cm) (pre = 71.0 ± 14.3 vs. post = 59.7 ± 14.3, p = 0.003); Sway Velocity (cm/s) (pre = 3.6 ± 0.7; post = 2.9 ± 0.7; p = 0.001); Sway Area (cm²) (pre = 8.9 ± 5.3 vs. post = 5.7 ± 2.1, p = 0.003); Excursion Medio Lateral (cm) (pre = 3.0 ± 0.7 vs. post = 2.6 ± 0.5 cm, p = 0.002); and Excursion AP (cm) (pre = 3.6 ± 1.4 vs. post = 2.8 ± 0.7 cm, p = 0.010). Resistance training using slower velocity movement cadenced by Pilates breathing technique produced balance improvements compared to baseline (moderate to large effect sizes), but no between-group effect was observed at the end of the protocol. The dorsiflexion strength was higher in the RT group compared to RT + P group. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Physical and Functional Clinical Profile of Older Adults in Specialized Geriatric Rehabilitation Care Services in Saguenay-Québec: A Retrospective Study at La Baie Hospital

Maria do Carmo Correia de Lima

Isabela Calixto Maluf

and

Int. J. Environ. Res. Public Health 2022, 19(16), 9994; https://doi.org/10.3390/ijerph19169994 - 13 Aug 2022

Viewed by 1281

Abstract

Musculoskeletal disorders, cardiovascular and neurological diseases were the most commonly debilitating conditions and risk factors associated with pain, mobility limitations, increased risk of falls and disability. Studies barely address the profile of older adults in care within a specialized geriatric rehabilitation service (SGRS) to provide subsidies for new actions within the public healthcare to reduce falls and improve management in health investments. This study aimed to establish a clinical physical and functional profile of the patients with neuromusculoskeletal and cognitive disorders and fallers in interventions within SGRS. From a retrospective study design, 127 medical records were compiled and analyzed to determine the physical and functional profile of older adults and differences according to sex, age groups and the benefits for local physical therapy intervention. The users were between 76 and 85 years of age, with diverse clinical diagnoses and debilitating conditions and impairments. A higher proportion presented gait and balance impairments and had two or more falls in 12 months. A significant effect for advanced age was observed. Overall, real benefits were reported with intervention for functional improvement, although the absence of a control group. These results have direct implications for a better understanding of a local SGRS and provide subsidies for developing new approaches for the assessment and treatment of older adults with high a risk of falls in order to reduce costs for the public health system. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

Open AccessArticle

Combined Use of Transcutaneous Electrical Nerve Stimulation and Short Foot Exercise Improves Navicular Height, Muscle Size, Function Mobility, and Risk of Falls in Healthy Older Adults

Juntip Namsawang

and

Pornpimol Muanjai

Int. J. Environ. Res. Public Health 2022, 19(12), 7196; https://doi.org/10.3390/ijerph19127196 - 11 Jun 2022

Cited by 2 | Viewed by 2153

Abstract

Electrical stimulation is an established method that is used to improve muscle strength. The present study compared changes in the navicular drop test (NDT), muscle size, the five times sit to stand (5TSTS) test, the timed up and go (TUG) test, and the risk of falls in response to transcutaneous electrical nerve stimulation (TENS) plus short foot exercise (SFE) and SFE alone in 68 healthy elderly participants aged 65–75 years. Participants were randomly assigned to two groups: TENS plus SFE and SFE alone (with sham TENS). Measurements of NDT, muscle size, 5TSTS, TUG, and risk of falls were made before and after 4 weeks of training. The NDT was significantly improved by a median of 0.31 mm in the TENS plus SFE group and 0.64 mm in the SFE alone group (p < 0.001). Similarly, there was a significant improvement in Falls Efficacy Scale International (FES-I), 5TSTS, and TUG for both groups (p < 0.001). The abductor hallucis muscle size increased by 0.23 cm² in the TENS plus SFE group and 0.26 cm² in the SFE alone group (p < 0.001). There were no significant differences between the two groups for any variables (p > 0.05) except TUG, which showed a greater improvement in the TENS plus SFE group (p = 0.008). Our findings demonstrated that TENS plus SFE and SFE alone improved intrinsic foot muscle size. However, TENS plus SFE tended to improve NDT more than SFE alone, particularly in cases of severe muscle weakness. Thus, the combined use of TENS plus SFE could be recommended for muscle strengthening and balance programs for fall prevention in older adults. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessCommunication

Association between Abnormal Gait Patterns and an Elevated Degree of Pain after Daily Walking: A Preliminary Study

and

Int. J. Environ. Res. Public Health 2022, 19(5), 2842; https://doi.org/10.3390/ijerph19052842 - 01 Mar 2022

Viewed by 1877

Abstract

This study aimed to investigate whether abnormal gait patterns are associated with experiencing an elevated degree of pain after daily walking. In this preliminary, cross-sectional study, 223 community-dwelling older adults were assessed for pain experienced after daily walking using a simple question that involved asking the subject about their past experiences of an elevated degree of pain after walking for 400 m or more. Gait patterns were assessed using the Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score), derived from the data measured by Inertial sensors attached to the lower trunk and heel when subjects walked along a 15 m walkway at a self-selected preferred speed. The score was the sum of 10 gait parameter scores. The lower scores indicated more and worse abnormal gait patterns. In total, 24 older adults (10.8%) reported that they experienced pain after daily walking. According to the multiple logistic regression analyses, older adults with a lower total C-GAITS score had a significantly greater probability of having past experiences of pain after walking (odds ratio = 1.11, 95% confidence interval = 1.03–1.20). The findings of this study suggest that more and worse abnormal gait patterns among older adults in a clinical walking test are associated with an elevated degree of pain after daily walking. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Physical Therapists and Physical Therapist Assistants’ Knowledge and Use of the STEADI for Falls Risk Screening of Older Adults in Physical Therapy Practice in the United States

and

Int. J. Environ. Res. Public Health 2022, 19(3), 1354; https://doi.org/10.3390/ijerph19031354 - 26 Jan 2022

Cited by 1 | Viewed by 3690

Abstract

Fall-risk screening and prevention is within the scope of physical-therapy practice. Prior research indicates United States-based physical therapists (PTs) and physical-therapist assistants (PTAs) use the Centers for Disease Control and Prevention’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) toolkit for community-based fall-risk screenings of older adults. However, clinically based fall-risk screenings and knowledge and use of the STEADI by PTs and PTAs is unknown. We conducted a cross-sectional survey distributed to a convenience sample of PTs and PTAs in the United States through email blasts and social media. PTs and PTAs (N = 425) who responded to the survey and worked in clinical settings with older adults were included. Eighty-nine percent of respondents reported conducting clinical fall-risk screening. Approximately 51% were ‘familiar’ to ‘very familiar’ with the STEADI, and 21.7% of the overall sample were not familiar at all. Only 26.1% utilize the STEADI for clinical fall-risk screening. Of the respondents who were ‘very familiar’ with the STEADI (n = 132, 31.1%), 84.1% (n = 111) reported using the STEADI in clinical practice. Seventy-six percent of respondents who use the STEADI implemented it by choice even though the majority (52.1%, n = 63) did not have it embedded in their documentation/workflow. Some PTs/PTAs can and do manage falls using the STEADI, but there is a gap in knowledge and use of the STEADI for falls management among PTs and PTAs in the United States. Further research is needed to identify the tools PTs use for multifactorial-fall screening and management and the impact of PTs’ use of the STEADI on patient outcomes. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Timothy Gustavo Cavazzotto

Natã Gomes de Lima Stavinski

Marcos Roberto Queiroga

Michael Pereira da Silva

Edilson Serpeloni Cyrino

Helio Serassuelo Junior

and

Edgar Ramos Vieira

Int. J. Environ. Res. Public Health 2022, 19(1), 502; https://doi.org/10.3390/ijerph19010502 - 03 Jan 2022

Cited by 5 | Viewed by 2277

Abstract

Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health effect of marriage or divorce is age-dependent and differs between women and men. The study aimed to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals from 18 to 99 years, with a TV time > 3 h/day (prevalence = 25.2%) and PA > 150 min/week (prevalence = 35%). Later, we divided our sample in seven age groups by marital status and sex. Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants >30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, our study suggests that the investments in public policies to encourage the practice of PA and reduction of TV time could be based on the marital status, sex, and age, prioritizing less active groups. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

Open AccessArticle

Effects of Exergames and Protein Supplementation on Body Composition and Musculoskeletal Function of Prefrail Community-Dwelling Older Women: A Randomized, Controlled Clinical Trial

Simone Biesek

Audrin Said Vojciechowski

Jarbas Melo Filho

Ana Carolina Roos de Menezes Ferreira

Victória Zeghbi Cochenski Borba

Estela Iraci Rabito

and

Anna Raquel Silveira Gomes

Int. J. Environ. Res. Public Health 2021, 18(17), 9324; https://doi.org/10.3390/ijerph18179324 - 03 Sep 2021

Cited by 8 | Viewed by 2341

Abstract

This study aimed to investigate the effects of exergames and protein supplementation on the body composition and musculoskeletal function of pre-frail older women. Methods: A randomized controlled clinical trial was conducted with 90 pre-frail older women (71.2 ± 4.5 years old) divided into five groups: control (CG); exergames training (ETG); protein supplementation (PSG); exergames combined with protein supplementation (ETPSG); exergames combined with isoenergetic supplementation (ETISG). The primary outcomes were pre-frailty status, body composition (appendicular muscle mass (ASM); appendicular muscle mass index (ASMI)) assessed by dual energy X-ray absorptiometry and gastrocnemius muscle architecture via ultrasound. Secondary outcomes were protein intake, plasma levels of interleukin (IL)-6, plantar and dorsiflexion isokinetic peak torque, and handgrip strength (HS). Data were analyzed using an ANOVA mixed model test and Bonferroni post hoc test (p < 0.05). The ETG showed a reduction of ASM (16.7 ± 3.4 vs. 16.1 ± 3.3 kg; Δ = −0.5; p = 0.02; d = 0.26) and ASMI (6.8 ± 0.9 vs. 6.5 ± 0.9 kg; Δ = −0.2; p = 0.03; d = 0.35), without changing ASM in other groups. The average protein intake in the supplemented groups (PSG and ETPSG) was 1.1 ± 0.2 g/kg/day. The dorsiflexion peak torque increased 11.4% in ETPSG (16.3 ± 2.5 vs. 18.4 ± 4.2 Nm; p = 0.021; d = −0.58). The HS increased by 13.7% in ETG (20.1 ± 7.2 vs. 23.3 ± 6.2 kg, Δ = 3.2 ± 4.9, p = 0.004, d = −0.48). The fatigue/exhaustion reduced by 100% in ETG, 75% in PSG, and 100% in ETPSG. Physical training with exergames associated with protein supplementation reversed pre-frailty status, improved the ankle dorsiflexors torque, and ameliorated fatigue/exhaustion in pre-frail older women. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Open AccessArticle

Changes in Clinical Characteristics and Outcomes of Patients Admitted to Inpatient Cardiac Rehabilitation

and

Int. J. Environ. Res. Public Health 2021, 18(16), 8871; https://doi.org/10.3390/ijerph18168871 - 23 Aug 2021

Cited by 2 | Viewed by 1727

Abstract

Aims: Cardiac rehabilitation (CR) has proven to be effective and beneficial in middle-aged and older patients. However, solid data in large cohorts of elderly individuals are yet to be explored. This retrospective study investigated the general characteristics, outcomes, and the level of response of patients referred to CR over 13 consecutive years. Methods: We reviewed the medical records of patients admitted to Villa Pineta Rehabilitation Hospital for exercise-based CR from 2006 to 2018. The patients’ baseline characteristics and changes following CR in an upper-limb weightlifting test (ULW), 30-s sit-to-stand test (30STS), and the 6-min walking test (6MWT) with associated Borg-related dyspnea (D) and fatigue (F) were collected. We also calculated the number of individuals that reached the minimal clinically relevant change (MCRC) following CR for each outcome. Results: One thousand five hundred and fifty-one patients (70.2 ± 9.7 years, 66% men) with complete datasets were included in the analysis. Coronary artery bypass graft and cardiac valve replacement surgery were the most frequent surgical procedures leading to CR referral (41.1% and 35.8%, respectively). The patients’ age (p = 0.03), number of total comorbidities (p < 0.0001), and post-surgical complications (p = 0.02) significantly increased over time. In contrast, the average absolute changes in ULW, 30STS, and 6MWT with associated D and F, and the proportion of patients that reached their respective MCRC, remained constant over the same period. Conclusion: The patients admitted to exercise-based CR were older and had more comorbidities and complications over time. The outcomes, however, were not influenced in terms of the absolute change or clinically meaningful response. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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Effects of Exercise and Diet on Body Composition and Physical Function in Older Hispanics with Type 2 Diabetes

Edgar Ramos Vieira

Fabricia Azevedo da Costa Cavalcanti

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Marcos Roberto Queiroga

Int. J. Environ. Res. Public Health 2021, 18(15), 8019; https://doi.org/10.3390/ijerph18158019 - 29 Jul 2021

Cited by 8 | Viewed by 3169

Abstract

Type 2 Diabetes mellitus (DM2) affects 9.3% of the U.S. population. Health disparities are evident in DM2; twice as many Hispanics as non-Hispanic Whites have DM2. The objective of this study was to pilot test the feasibility of implementing and evaluating trends of nutrition and exercise interventions to improve diabetes management and physical function in 29 disadvantaged older Hispanics with DM2. We delivered combined diet and exercise (n = 8) and diet-only (n = 6) interventions and compared the results to a control/no intervention group (n = 15). We cluster-randomized the participants into the three arms based on the senior center they attended. The interventions were delivered twice a week for 3 months (24 sessions) and assessments were conducted pre and post intervention. The results indicate the feasibility of implementing the interventions and slight improvements in both intervention groups compared to the control group. The diet-only group tended to have larger improvements on body composition measures (especially in muscle mass), while the diet + exercise group tended to have larger improvements on physical function (especially in chair stands). There was a high rate of attrition, especially in the diet + exercise group, but those who completed the intervention tended to have improvements in body composition and physical function. Full article

(This article belongs to the Special Issue Physical Therapy in Geriatrics)

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