Patrick J Knox, Jenifer M Pugliese, Ryan T Pohlig, Peter C Coyle, Jaclyn M Sions, Gregory E Hicks
{"title":"A Clinical Measure of Trunk Neuromuscular Function Predicts Falling in Older Adults With Chronic Low Back Pain.","authors":"Patrick J Knox, Jenifer M Pugliese, Ryan T Pohlig, Peter C Coyle, Jaclyn M Sions, Gregory E Hicks","doi":"10.1519/JPT.0000000000000372","DOIUrl":"10.1519/JPT.0000000000000372","url":null,"abstract":"<p><strong>Background and purpose: </strong>Older adults with low back pain (LBP) are at risk for falling, but condition-specific mechanisms are unknown. Trunk neuromuscular function is critical for maintaining balance during mobility tasks and is often impaired in older adults with LBP. The purpose of this study was to assess whether aberrant lumbopelvic movements (or aberrant movements), a clinical index of trunk neuromuscular function, were associated with increased fall risk among older adults with chronic LBP over a 12-month follow-up period.</p><p><strong>Methods: </strong>This study analyzed data from a prospective cohort study of 250 community-dwelling older adults with chronic LBP. Participants were screened for 4 aberrant movements during 3 trials of forward flexion from a standing position: instability catch, painful arc, altered lumbopelvic rhythm, and Gower's sign. Aberrant movements were totaled to yield a summary score (ie, 0-4). Prospective falls were monitored via monthly fall calendars for 12 months. A generalized linear model with Poisson distribution and log link function was used to evaluate the association between aberrant movements and prospective fall risk. Age, sex, body mass index, LBP intensity, dynamic balance performance, prior falls, anxiolytic medication usage, and hip osteoarthritis characteristics were included as covariates in the model.</p><p><strong>Results: </strong>Baseline aberrant movements were independently associated with greater fall risk (risk ratio = 1.249, 95% CI = 1.047-1.491, P = .014); each 1-unit increase in aberrant movement score imparted a 24.9% increase in the risk of falling.</p><p><strong>Conclusions: </strong>Aberrant movements increased the risk of falling among older adults with chronic LBP over a 1-year span.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"13-20"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10447628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10438042","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}
Dalerie Lieberz, Toni Bishop, Mary Rohde, Aaron Schmidt, Olivia Schmitz, Marilyn Moffett, Alexandra Borstad
{"title":"Developing Patient-Centered Preventative Care to Reduce Mobility Disability With Aging: Preferences From a Discrete Choice Experiment.","authors":"Dalerie Lieberz, Toni Bishop, Mary Rohde, Aaron Schmidt, Olivia Schmitz, Marilyn Moffett, Alexandra Borstad","doi":"10.1519/JPT.0000000000000380","DOIUrl":"10.1519/JPT.0000000000000380","url":null,"abstract":"<p><strong>Background and purpose: </strong>Mobility disability is the most prevalent form of disability for older adults in the United States. A physical therapy mobility checkup (MC) under development is a patient-centered preventative physical therapy visit. It includes physical performance testing and education on physical performance as a valuable and modifiable health indicator. The purpose of this study was to identify the proportion of older adults willing to participate in an MC, the age at which they would initiate care, their desired frequency of participation, and the characteristics, or attributes, of the MC they preferred.</p><p><strong>Methods: </strong>In a cross-sectional study conducted at the Minnesota State Fair, adults older than 55 years answered survey questions about preventative health practices and completed a discrete choice experiment (DCE) to determine their preferences for the MC. Attributes studied in the DCE were visit duration, checkup content, education, and possible outcomes of participating in preventative care for mobility. Descriptive statistics characterized demographic information and survey responses. Conjoint choice modeling estimated the main effect for each DCE attribute.</p><p><strong>Results and discussion: </strong>One hundred sixty-six older adults participated in the study. Seventy-eight percent indicated that they would choose an MC if available. Most participants (66%) believed that MCs should occur before 60 years of age and at least annually (68%). A 30-minute visit duration, which accounted for 84% of attribute importance, was preferred. Balance, the preferred content of the MC, accounted for 12% of the attribute importance. Preferences for educational content and possible outcomes of participation with preventative care aimed at preventing mobility loss were not statistically significant.</p><p><strong>Conclusion: </strong>Older adults value preventative care for reducing mobility disability. They identified time efficiency and the inclusion of measures to assess balance as priorities for this preventative physical therapy visit.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"36-42"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10777346","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}
Bettina Barisch-Fritz, Jelena Bezold, Andrea Scharpf, Sandra Trautwein, Janina Krell-Roesch, Alexander Woll
{"title":"A New Approach to Individualize Physical Activity Interventions for Individuals With Dementia: Cluster Analysis Based on Physical and Cognitive Performance.","authors":"Bettina Barisch-Fritz, Jelena Bezold, Andrea Scharpf, Sandra Trautwein, Janina Krell-Roesch, Alexander Woll","doi":"10.1519/JPT.0000000000000396","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000396","url":null,"abstract":"BACKGROUND AND PURPOSE\u0000Physical activity (PA) can have a beneficial effect on cognitive and physical performance in individuals with dementia (IWD), including those residing in nursing homes. However, PA interventions in nursing homes are usually delivered using a group setting, which may limit the effectiveness of the intervention due to the heterogenous nature of IWD. Therefore, the purpose of this study was to identify clusters based on cognitive and physical performance values, which could be used to improve individualization of PA interventions.\u0000\u0000\u0000METHODS\u0000Based on the cognitive and physical performance variables of 230 IWD, a cluster analysis was conducted. Global cognition (Mini-Mental State Examination), mobility (6-Meter Walking Test), balance (Frailty and Injuries: Cooperative Studies of Intervention Techniques-subtest-4), and strength and function of lower extremities (30-Second Chair-Stand Test) were assessed, and values were used to perform a hierarchical cluster analysis with Ward's method. Differences in physical and cognitive performance as well as other secondary outcomes (age, sex, body mass index, use of walking aids, diagnosis and etiology of dementia, number of medications, and Cumulative Illness Rating Scale) were tested using 1-factorial analyses of variance.\u0000\u0000\u0000RESULTS AND DISCUSSION\u0000Out of 230 data sets, 3-cluster solutions were identified with similar cluster sizes of 73 to 79. The silhouette coefficients for all calculated clusters ranged between 0.15 and 0.34. The cluster solutions were discussed in the context of cognitive and physical functions as well as training modalities and opportunities. The 4-cluster solution appears to be best suited for providing or developing an individualized PA intervention.\u0000\u0000\u0000CONCLUSIONS\u0000The identified clusters of the 4-cluster solution may be used in future research to improve individualization of dementia-specific PA interventions. By assigning IWD to these clusters, more homogenous groups with regard to cognitive and physical performance can be formed. This allows for more individualized PA interventions and may result in a higher effectiveness, particularly in nursing homes. Our findings are relevant for therapists and nursing staff who design or deliver PA interventions in nursing homes or similar settings.","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41217197","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}
Rafaella Silva Dos Santos Aguiar Gonçalves, Karyna Myrelly Oliveira Bezerra de Figueiredo Ribeiro, Sabrina Gabrielle Gomes Fernandes, Luiz Eduardo Lima de Andrade, Maria das Graças de Araújo Lira, Rafaela Andrade do Nascimento, Mariana Carmem Apolinário Vieira, Álvaro Campos Cavalcanti Maciel
{"title":"Diagnostic Accuracy of the Short Physical Performance Battery in Detecting Frailty and Prefrailty in Community-Dwelling Older Adults: Results From the PRO-EVA Study.","authors":"Rafaella Silva Dos Santos Aguiar Gonçalves, Karyna Myrelly Oliveira Bezerra de Figueiredo Ribeiro, Sabrina Gabrielle Gomes Fernandes, Luiz Eduardo Lima de Andrade, Maria das Graças de Araújo Lira, Rafaela Andrade do Nascimento, Mariana Carmem Apolinário Vieira, Álvaro Campos Cavalcanti Maciel","doi":"10.1519/JPT.0000000000000352","DOIUrl":"10.1519/JPT.0000000000000352","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Short Physical Performance Battery (SPPB) is widely used for older adults since it has a high level of validity, reliability, and responsiveness in measuring function in this population. However, only a few studies of diagnostic accuracy have assessed SPPB capacity in detecting frailty and prefrailty by estimating more detailed measurement properties. Thus, the present study aimed to evaluate the SPPB's diagnostic accuracy in detecting frailty and prefrailty, in addition to identifying cut-off points for walking time and chair stand time.</p><p><strong>Methods: </strong>This is a cross-sectional study composed of 786 community-dwelling older adults 60 years or older, in which sociodemographic and anthropometric data, frailty phenotype, and total SPPB score, as well as walking time and chair stand time, were assessed. Analysis of a receiver operating characteristic curve was performed to identify the cut-off point, sensitivity, and specificity in the total SPPB score, as well as the walking time and chair stand time for frailty and prefrailty screening. Accuracy and positive and negative predictive values were subsequently calculated.</p><p><strong>Results and discussion: </strong>The cut-off points identified for the total SPPB score, walking time, and chair stand time were 9 points or less (accuracy of 72.6%), 5 seconds or less, and 13 seconds or less, respectively, for frailty screening and 11 points or less (accuracy of 58.7%), 4 seconds or less, and 10 seconds or less, respectively, for prefrailty screening. The walking time showed greater frailty discriminatory capacity compared with the chair stand time (effect size = 1.24 vs 0.64; sensitivity = 69% vs 59%; and specificity = 84% vs 75%).</p><p><strong>Conclusions: </strong>The total SPPB score has good diagnostic accuracy to discriminate between nonfrail and frail older adults using a cut-off point of 9 or less, being better to identify the true negatives (older adults who are not frail). Although the SPPB's diagnostic accuracy measures for detecting prefrailty were low to moderate, this instrument can help in screening prefrail older adults from the cutoff point of 11 or less in the total SPPB score. Identification of prefrail older adults enables implementing early treatment in this target audience and can prevent their advance to frailty.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 4","pages":"E127-E136"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10294688","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}
Mariana Wingood, Michelle G Criss, Kent E Irwin, Christina Freshman, Emma L Phillips, Puneet Dhaliwal, Kevin K Chui
{"title":"Screening for Osteoporosis Risk Among Community-Dwelling Older Adults: A Scoping Review.","authors":"Mariana Wingood, Michelle G Criss, Kent E Irwin, Christina Freshman, Emma L Phillips, Puneet Dhaliwal, Kevin K Chui","doi":"10.1519/JPT.0000000000000381","DOIUrl":"10.1519/JPT.0000000000000381","url":null,"abstract":"<p><strong>Background and purpose: </strong>Due to potential health-related consequences of osteoporosis (OP), health care providers who do not order imaging, such as physical therapists, should be aware of OP screening tools that identify individuals who need medical and rehabilitation care. However, current knowledge and guidance on screening tools is limited. Therefore, we explored OP screening tools that are appropriate and feasible for physical therapy practice, and evaluated tools' effectiveness by examining their clinimetric properties.</p><p><strong>Methods: </strong>A systematic search of the following databases was performed: PubMed, PEDro, PsycINFO, CINAHL, and Web of Science. Articles were included if the study population was 50 years and older, had a diagnosis of OP, if the screening tool was within the scope of physical therapy practice, and was compared to either a known diagnosis of OP or bone densitometry scan results. Included articles underwent multiple reviews for inclusion and exclusion, with each review round having a different randomly selected pair of reviewers. Data were extracted from included articles for participant demographics, outcome measures, cut-off values, and clinimetric properties. Results were categorized with positive and negative likelihood ratios (+LR/-LR) based on the magnitude of change in the probability of having or not having OP.</p><p><strong>Results: </strong>+LRs ranged from 0.15 to 20.21, with the Fracture Risk Assessment Tool (FRAX) and Study of Osteoporotic Fractures (SOF) having a large shift in posttest probability. -LRs ranged from 0.03 to 1.00, with the FRAX, Male Osteoporosis Risk Estimation Scores, Osteoporosis Self-Assessment Tool (OST), and Simple Calculated Osteoporosis Risk Estimation having a large shift in posttest probability.</p><p><strong>Conclusion: </strong>Tools with moderate-large shift for both +LR and -LR recommended for use are: (1) OST; (2) FRAX; and (3) SOF. The variability in cut-off scores and clinimetric properties based on gender, age, and race/ethnicities made it impossible to provide one specific recommendation for an OP screening tool. Future research should focus on OP risk prediction among males and racial and ethnic groups.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 4","pages":"E137-E147"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10294831","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}
Javier Martín-Núñez, Andrés Calvache-Mateo, Laura López-López, Alejandro Heredia-Ciuró, Irene Cabrera-Martos, Janet Rodríguez-Torres, Marie Carmen Valenza
{"title":"Effects of Exercise-Based Interventions on Physical Activity Levels in Persons With Parkinson's Disease: A Systematic Review With Meta-analysis.","authors":"Javier Martín-Núñez, Andrés Calvache-Mateo, Laura López-López, Alejandro Heredia-Ciuró, Irene Cabrera-Martos, Janet Rodríguez-Torres, Marie Carmen Valenza","doi":"10.1519/JPT.0000000000000373","DOIUrl":"10.1519/JPT.0000000000000373","url":null,"abstract":"<p><strong>Background and purpose: </strong>Parkinson's disease (PD) is the most common neurodegenerative movement disorder. Symptom severity leads to devastating consequences such as falls, immobility, impaired quality of life, and reduced general activity. Adopting a sedentary lifestyle creates a vicious circle, as physical inactivity can negatively affect the clinical domains of PD. Despite the recognition of the disease-modifying potential of physical activity (PA), achieving adequate exercise levels can be challenging for individuals with PD. This study aimed to investigate the repercussions of exercise-based interventions to improve PA levels in persons with PD through a systematic review with meta-analysis.</p><p><strong>Methods: </strong>A search was conducted from database inception to February 2021 across 3 databases: PubMed, Web of Science, and Scopus. Randomized controlled trials were included if they involved persons with PD, outcome measures associated with PA levels, and an exercise-based intervention. Two reviewers performed independent data extraction and methodologic quality assessment of the studies using the Downs and Black quality checklist.</p><p><strong>Results: </strong>A total of 6 studies were included in the study (1251 persons with PD). Four intervention types were identified: balance, strength, aerobic, and multimodal exercise (combination of several types of exercise programs). The meta-analysis showed that exercise interventions have a positive effect on PA (standard mean difference = 0.50, 95% CI =-0.02, 1.00; P = .06). The risk of bias was generally low.</p><p><strong>Conclusions: </strong>The findings support the use of exercise-based interventions (aerobic exercise, balance exercise, strength exercise, and/or multimodal exercise) to improve PA levels. However, the limited number of studies and the heterogeneity of the interventions do not allow us to draw a definitive conclusion.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 4","pages":"207-213"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10642818","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}
Rachel A Prusynski, Sean D Rundell, Sujata Pradhan, Tracy M Mroz
{"title":"Some But Not Too Much: Multiparticipant Therapy and Positive Patient Outcomes in Skilled Nursing Facilities.","authors":"Rachel A Prusynski, Sean D Rundell, Sujata Pradhan, Tracy M Mroz","doi":"10.1519/JPT.0000000000000363","DOIUrl":"10.1519/JPT.0000000000000363","url":null,"abstract":"<p><strong>Background and purpose: </strong>Physical and occupational therapy practices in skilled nursing facilities (SNFs) were greatly impacted by the 2019 Medicare Patient-Driven Payment Model (PDPM). Under the PDPM, the practice of multiparticipant therapy-treating more than one patient per therapy provider per session-increased in SNFs, but it is unknown how substituting multiparticipant therapy for individualized therapy may impact patient outcomes. This cross-sectional study establishes baseline relationships between multiparticipant therapy and patient outcomes using pre-PDPM data.</p><p><strong>Methods: </strong>We used Minimum Data Set assessments from all short-term Medicare fee-for-service SNF stays in 2018. Using generalized mixed-effects logistic regression adjusted for therapy volume and patient factors, we examined associations between the proportion of minutes of physical and occupational therapy that were received as multiparticipant sessions during the SNF stay and 2 outcomes: community discharge and functional improvement. Multiparticipant therapy minutes as a proportion of total therapy time were categorized as none, low (below the median of 5%), medium (median to <25%), and high (≥25%) to reflect the 25% multiparticipant therapy limit required by the PDPM.</p><p><strong>Results and discussion: </strong>We included 901 544 patients with complete data for functional improvement and 912 996 for the discharge outcome. Compared with patients receiving no multiparticipant therapy, adjusted models found small positive associations between low and medium multiparticipant therapy levels and outcomes. Patients receiving low levels of multiparticipant therapy had 14% higher odds of improving in function (95% CI 1.09-1.19) and 10% higher odds of community discharge (95% CI 1.05-1.15). Patients receiving medium levels of multiparticipant therapy had 18% higher odds of functional improvement (95% CI 1.13-1.24) and 44% higher odds of community discharge (95% CI 1.34-1.55). However, associations disappeared with high levels of multiparticipant therapy.</p><p><strong>Conclusions: </strong>Prior to the PDPM, providing up to 25% multiparticipant therapy was an efficient strategy for SNFs that may have also benefitted patients. As positive associations disappeared with high levels (≥25%) of multiparticipant therapy, it may be best to continue delivering the majority of therapy in SNFs as individualized treatment.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 4","pages":"185-195"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10008750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10294716","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}
Jennifer S Brach, Lori A Schrodt, Jennifer L Vincenzo, Subashan Perera, Colleen Hergott, Jennifer Sidelinker, Beth Rohrer, Jennifer Tripken, Tiffany E Shubert
{"title":"Knowledge and Use of Evidence-Based Programs for Older Adults in the Community: A Survey of Physical Therapy Professionals.","authors":"Jennifer S Brach, Lori A Schrodt, Jennifer L Vincenzo, Subashan Perera, Colleen Hergott, Jennifer Sidelinker, Beth Rohrer, Jennifer Tripken, Tiffany E Shubert","doi":"10.1519/JPT.0000000000000359","DOIUrl":"10.1519/JPT.0000000000000359","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Agency for Healthcare Research and Quality highlights the need for sustainable linkages between clinical and community settings to enhance prevention and improve care of people with chronic conditions. The first step in promoting linkages is understanding the knowledge and use of evidence-based programs by physical therapy (PT) professionals. Therefore, the objective of this study was to describe the knowledge of and referral to evidence-based programs in the community by a convenience sample of PT professionals and to examine the characteristics of those who refer to evidence-based programs.</p><p><strong>Methods: </strong>A cross-sectional web-based survey containing 36 questions regarding respondents' demographics and evidence-based program knowledge and referral practices was disseminated to a convenience sample of PT professionals via email, news-blasts, social media, and word of mouth.</p><p><strong>Results and discussion: </strong>A total of 459 PT professionals completed the survey. Approximately half reported practicing for more than 20 years and 75% are members of the American Physical Therapy Association (APTA). The majority (74%) are aware of evidence-based programs; however, fewer (56%) refer to these programs. Compared with individuals who do not refer to evidence-based programs, individuals who refer are more likely to be involved in PT organizations and be an APTA Geriatrics member. Of the individuals who do not refer to evidence-based programs, 21.5% reported not knowing they existed and 33% reported not knowing where the programs are located.</p><p><strong>Conclusions: </strong>Most survey respondents reported knowing about evidence-based programs and more than half reported being aware of the evidence-based programs available in their communities. These results indicate many PT professionals already have a knowledge of evidence-based programs to support clinic-community linkages. As survey respondents were a sample of convenience and likely do not represent all PT professionals in the United States, the results should be interpreted with caution. Additional research on a more representative sample is needed to fully understand the current utilization of evidence-based programs, which will enable us to design efforts to improve the clinic to community transition. Improving linkages between PT professionals and community resources has the potential to benefit both patients and clinicians and lessen the burden on the health care system.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 4","pages":"196-206"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9911552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10293789","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}