Journal of Geriatric Physical Therapy最新文献

{"title":"Four Square Step Test Performance in Hip Fracture Patients.","authors":"Heather L Mutchie,&nbsp;Denise L Orwig,&nbsp;Brock Beamer,&nbsp;Vincent Conroy,&nbsp;Jack Guralnik,&nbsp;Jay Magaziner,&nbsp;Ann L Gruber-Baldini","doi":"10.1519/JPT.0000000000000310","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000310","url":null,"abstract":"<p><strong>Background and purpose: </strong>Preventing subsequent falls in persons recovering from hip fracture is paramount. The Four Square Step Test (FSST) is a fast, easy measure of dynamic balance, with times more than 15 seconds previously associated with multiple fall risk in older adults. This study investigates among hip fracture patients (1) FSST performance, and how (2) unique population characteristics (such as fracture side) and (3) cognition impact FSST performance.</p><p><strong>Methods: </strong>Patients with hip fracture (n = 40) 60 years and older came from an ancillary study to a larger randomized controlled trial testing two 16-week in-home physical therapy interventions after completion of usual care rehabilitation. Baseline measurers included: FSST, demographics, fracture characteristics, Modified Mini-Mental State Examination (3MS), Hooper Visual Organization Test (HVOT), and Trails Making Tests (TMT) A and B.</p><p><strong>Results: </strong>Of 40 patients with hip fracture, 13 did not complete the FSST at baseline and were significantly older (P = .040) and performed worse on cognitive tests (3MS, HVOT, TMT-B; P < .05). Mean FSST time was 24.3 ± 13.1 seconds for the other 27, of whom 7 finished in less than 15 seconds. A significant 3-way interaction was observed, such that those with left-side pertrochanteric fractures who performed poorly on the HVOT did significantly worse on the FSST (P < .01, R2 = 0.93).</p><p><strong>Discussion: </strong>Almost one-third of patients with hip fracture could not perform the FSST after completing usual care rehabilitation. Inability to perform the FSST was not random, as those without the FSST were physically and cognitively worse than those who did perform the FSST. Among those who could attempt the FSST, few performed well. Cognitive ability related to spatial orientation and fracture characteristics such as fracture side and fracture type has a synergistic effect on FSST performance.</p><p><strong>Conclusions: </strong>This is one of the first studies to assess the FSST in a population with hip fracture. At 4 months after hip fracture, most patients cannot perform the FSST in less than 15 seconds. Fracture side and fracture type appear important to FSST performance, as does cognition. More work needs to be done longitudinally to study the FSST in patients with hip fracture.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 2","pages":"81-89"},"PeriodicalIF":2.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551310/pdf/nihms-1682339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10025181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Domains of Balance Training Delivered in Rehabilitation Programs Following Hip Fracture Surgery in Older Adults: A Systematic Review.","authors":"Camila Astolphi Lima,&nbsp;Monica Rodrigues Perracini,&nbsp;Martha Funabashi,&nbsp;Sydnie Weber,&nbsp;Lauren Beaupre","doi":"10.1519/JPT.0000000000000286","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000286","url":null,"abstract":"<p><strong>Background and purpose: </strong>The aim of this systematic review was to assess the domains and characteristics of balance training (BT) interventions delivered in rehabilitation programs following hip fracture to identify potential treatment gaps.</p><p><strong>Methods: </strong>Manual and electronic searches (Web of Science, Medline, EMBASE, CINAHL, and ProQuest) were conducted. We selected randomized controlled trials with older adults following hip fracture surgery that included either specific BT or gait, mobility, or transfer training. Two independent reviewers extracted data and rated the methodological quality using the Physiotherapy Evidence Database scale. A third reviewer provided consensus. Extracted BT data included balance domain, progression, frequency, duration, intensity, level of supervision, setting, and rehabilitation phase.</p><p><strong>Results and discussion: </strong>We included 17 trials from 19 studies; 11 studies were rated as moderate to high methodological quality, but only 8 were considered to have high-quality BT components. Half of the interventions included only one balance domain, with stability during movement being the most commonly included domain. The primary balance progression utilized was reducing hand support. Dual task, anticipatory postural adjustment, reactive strategies, and perceptual training domains were rarely included. Balance training duration and intensity were poorly described. Although most programs were home-based with minimal levels of supervision, a few extended beyond postacute phase of rehabilitation.</p><p><strong>Conclusion: </strong>Further consideration should be given to include more challenging BT domains with planned progressions to maximize patient recovery through hip fracture rehabilitation programs.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 2","pages":"90-106"},"PeriodicalIF":2.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10022383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Pilates Exercise on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-analysis.","authors":"Raphael Gonçalves de Oliveira,&nbsp;Gustavo Eiji Ueno Anami,&nbsp;Edilaine Aparecida Coelho,&nbsp;Laís Campos de Oliveira","doi":"10.1519/JPT.0000000000000309","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000309","url":null,"abstract":"<p><strong>Background and purpose: </strong>Despite the popularity of Pilates exercises among postmenopausal women, few studies have devoted attention to verifying the effects of the technique on bone mineral density (BMD), and, to date, no systematic review and meta-analysis have been conducted on this topic. Our objective was to conduct a systematic review and meta-analysis of randomized controlled trials examining the effect of Pilates on BMD.</p><p><strong>Methods: </strong>Randomized controlled trials were considered eligible, with follow-up of 6 months and more, which verified the effects of Pilates exercise on the BMD of postmenopausal women. The calculations of the meta-analysis were performed through the weighted mean difference between the Pilates exercise and control groups, through the absolute change between pre- and postintervention in the areal bone mineral density.</p><p><strong>Results: </strong>Three randomized controlled trials met the inclusion criteria and were included in the meta-analysis. Only 1 study presented satisfactory methodological quality. Pilates exercises did not offer significant effects to improve areal bone mineral density of the lumbar spine (0.019 g/cm2 [95% confidence interval (CI), -0.018 to 0.057], P = .32), total hip (0.012 g/cm2 [95% CI, -0.002 to 0.027], P = .10), or femoral neck (0.000 g/cm2 [95% CI, -0.021 to 0.022], P = .97).</p><p><strong>Conclusions: </strong>Pilates exercises had no significant effects on BMD in postmenopausal women. However, the few studies included in the meta-analysis and the low methodological quality of the majority of the studies do not allow safe extrapolation of the results at this time. More robust randomized controlled trials with high methodological quality are needed so that the results of this meta-analysis can be confirmed.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 2","pages":"107-114"},"PeriodicalIF":2.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10013823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Therapist Management of Patients With Suspected or Confirmed Osteoporosis: A Clinical Practice Guideline From the Academy of Geriatric Physical Therapy.","authors":"Gregory W Hartley,&nbsp;Kathryn E Roach,&nbsp;Robert W Nithman,&nbsp;Sherri R Betz,&nbsp;Carleen Lindsey,&nbsp;Robyn K Fuchs,&nbsp;Keith G Avin","doi":"10.1519/JPT.0000000000000357","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000357","url":null,"abstract":"<p><p>A clinical practice guideline on physical therapist management of patients with suspected or confirmed osteoporosis was developed by a volunteer guideline development group (GDG) that was appointed by the Academy of Geriatric Physical Therapy (APTA Geriatrics). The GDG consisted of an exercise physiologist and 6 physical therapists with clinical and methodological expertise. The guideline was based on a systematic review of existing clinical practice guidelines, followed by application of the ADAPTE methodological process described by Guidelines International Network for adapting guidelines for cultural and professional utility. The recommendations contained in this guideline are derived from the 2021 Scottish Intercollegiate Guideline Network (SIGN) document: Management of Osteoporosis and the Prevention of Fragility Fractures. These guidelines are intended to assist physical therapists practicing in the United States, and implementation in the context of the US health care system is discussed.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"44 2","pages":"80"},"PeriodicalIF":2.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10124002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academy of Geriatric Physical Therapy Research Agenda: Rationale for the Development and the Intent for Use.","authors":"Jessie VanSwearingen,&nbsp;Sara Knox,&nbsp;Kristin A Lowry,&nbsp;Leslie K Allison,&nbsp;Cathy Ciolek,&nbsp;Kenneth L Miller,&nbsp;Keith G Avin,&nbsp;Greg W Hartley","doi":"10.1519/JPT.0000000000000341","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000341","url":null,"abstract":"<p><p>The rationale for the development and the intent for use of a research agenda for the Academy of Geriatric Physical Therapy is described. The reasons for the research agenda for geriatric physical therapy are (1) to have a broad representation of the research conducted by physical therapist(s) working with older adults, (2) to provide guidance and assistance to emerging investigators to aid the trajectory of a research career, and (3) as a document to engage potential funding agencies, foundations, and individuals in support of physical therapist-conducted research. The design was based on the Research Agenda for Physical Therapy (APTA document), formatted to be consistent with the World Health Organization International Classification of Functioning, Disability and Health, priority ratings for the research statements, and specific examples of research questions for each category of the Research Agenda. The Academy of Geriatric Physical Therapy Research Agenda generated to be a living document, with revisions to research questions and priority ratings expected in the future to enable the agenda to adapt to changes in science, practice, workforce, education, and health policy.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 2","pages":"76-79"},"PeriodicalIF":2.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463266/pdf/nihms-1924909.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10093640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential Components of Physical Therapist Management of Patients With Osteoporosis: A Delphi Study.","authors":"Keith G Avin,&nbsp;Robert W Nithman,&nbsp;Raine Osborne,&nbsp;Sherri R Betz,&nbsp;Carleen Lindsey,&nbsp;Gregory W Hartley","doi":"10.1519/JPT.0000000000000347","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000347","url":null,"abstract":"<p><strong>Background and purpose: </strong>Osteoporosis is a systemic, metabolic bone disease that affects bone quality, increases susceptibility to low-trauma bone fracture, and has downstream effects on falls and fragility fractures. Osteoporosis is a multifactorial disease process that requires management from multiple health care providers including physicians, nurses, and physical therapists. However, the paucity of information regarding comprehensive physical therapist management for patients with osteoporosis indicated the need for an evidence-based document. The purpose of this document was to provide the best available expert guidance for clinicians in the selection of screening tools, essential tests and measures, treatment goals, and interventions for patients with osteoporosis.</p><p><strong>Methods: </strong>A Delphi process was used. Thirty-one physical therapists with expertise in the care of patients with osteoporosis participated in a series of 3 sequential surveys designed to build and reach agreement on the management of patients with osteoporosis. The desired survey outcomes were to: (1) identify the range of examination and plan of care components considered important to physical therapists' care for patients with osteoporosis, (2) determine which components should be considered essential, and (3) achieve consensus on the final list of essential components and related operational definitions.</p><p><strong>Results: </strong>A clear consensus on the essential components of examination and interventions was achieved. In general, there were 4 to 6 items across each category of history, tests and measures, education/goals, and treatment.</p><p><strong>Conclusions: </strong>The prioritization of these management items will better support clinicians working with adults who have osteoporosis.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 2","pages":"E120-E126"},"PeriodicalIF":2.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501331/pdf/nihms-1927361.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10247947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Therapist Management of Patients With Suspected or Confirmed Osteoporosis: A Clinical Practice Guideline From the Academy of Geriatric Physical Therapy.","authors":"Gregory W Hartley, Kathryn E Roach, Robert W Nithman, Sherri R Betz, Carleen Lindsey, Robyn K Fuchs, Keith G Avin","doi":"10.1519/JPT.0000000000000346","DOIUrl":"10.1519/JPT.0000000000000346","url":null,"abstract":"<p><p>A clinical practice guideline on physical therapist management of patients with suspected or confirmed osteoporosis was developed by a volunteer guideline development group (GDG) that was appointed by the Academy of Geriatric Physical Therapy (APTA Geriatrics). The GDG consisted of an exercise physiologist and 6 physical therapists with clinical and methodological expertise. The guideline was based on a systematic review of existing clinical practice guidelines, followed by application of the ADAPTE methodological process described by Guidelines International Network for adapting guidelines for cultural and professional utility. The recommendations contained in this guideline are derived from the 2021 Scottish Intercollegiate Guideline Network (SIGN) document: Management of Osteoporosis and the Prevention of Fragility Fractures. These guidelines are intended to assist physical therapists practicing in the United States, and implementation in the context of the US health care system is discussed.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"44 2","pages":"E106-E119"},"PeriodicalIF":2.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/57/jgpt-44-e106.PMC8983944.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10124003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"APTA Geriatrics' Guiding Principles for Best Practices in Geriatric Physical Therapy: An Executive Summary.","authors":"Michelle G Criss, M. Wingood, W. H. Staples, Veronica Southard, Kenneth L Miller, Traci L. Norris, D. Avers, C. Ciolek, C. Lewis, Ellen R. Strunk","doi":"10.1519/jpt.0000000000000342","DOIUrl":"https://doi.org/10.1519/jpt.0000000000000342","url":null,"abstract":"Geriatric physical therapy requires a unique skill set and knowledge to provide best practice care. The skill set requires clinicians to recognize the significance of the continuum of aging from optimal to pathology-influenced aging and how psychosocial, environmental, behavioral, accessibility, and economic factors affect this aging continuum, optimal health, and wellness. Employing this distinctive skill set while also utilizing evidence-based practice, acknowledging the variability observed in older adults, and utilizing interwoven care systems that impact outcomes are key characteristics of best practice. The Academy of Geriatric Physical Therapy developed best practice guidelines consisting of 6 principles needed to ensure patients receive the care that they deserve. Best practice principles include person-centered care, anti-ageist beliefs, holistic assessment using sound outcome measures, evidence-based interventions, physical activity promotion, and interprofessional collaborative practice. This executive summary presents these principles along with suggested action steps for each element of best practice. The aims are to encourage individual self-assessment, promote improvement in practice on an individual and facility/system level, increase communication and collaboration with other health care providers about global best practices for older adults, and to further target education, resources, and advocacy toward achieving best practice on a larger scale.","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 2 1","pages":"70-75"},"PeriodicalIF":2.4,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46347579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Message: 2022 JGPT Best Article Award, Journal Status, and Reviewer Appreciation 2021.","authors":"","doi":"10.1519/jpt.0000000000000348","DOIUrl":"https://doi.org/10.1519/jpt.0000000000000348","url":null,"abstract":"","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 2 1","pages":"63-64"},"PeriodicalIF":2.4,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47712580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Neighborhood Walkability is Associated with Recent Falls in Urban Dwelling Older Adults.","authors":"Jennifer Blackwood,&nbsp;Rie Suzuki,&nbsp;Hannah Karczewski","doi":"10.1519/JPT.0000000000000300","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000300","url":null,"abstract":"<p><strong>Background and purpose: </strong>In rural communities, perceptions of neighborhood walkability, the rating of how easy it is to walk in an area, influence engagement in physical activity outside the home. This has not been studied in older adults residing in urban settings. Additionally, it is not known how perceived walkability is associated with falls. Therefore, the purpose of this study was to first describe the perceptions of neighborhood walkability in urban-dwelling older adults based on recent fall history and then examine associations between recent falls and neighborhood walkability constructs after controlling for fall risk factors.</p><p><strong>Methods: </strong>Urban-dwelling older adults (N = 132) 65 years and older without cognitive dysfunction or uncontrolled comorbidity completed a survey assessing health status, physical activity, and walkability using the Neighborhood Environment Walkability Scale-Abbreviated. Group assignment was based on recent fall history. Between-group comparisons of demographic and walkability constructs were completed using analysis of variance. Logistic regression was used to examine associations between walkability constructs and recent falls after controlling for covariates.</p><p><strong>Results and discussion: </strong>Poorer perception of land use was significantly associated with recent falls. Questions assessing the ease of walking to a store or transit stop may be valuable in understanding fall risk in older adults living in urban settings.</p><p><strong>Conclusions: </strong>Perceptions of neighborhood walkability are lower in urban-dwelling older adults with a history of falling.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 1","pages":"E8-E15"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/60/jgpt-45-e8.PMC8687612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10023179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}