Journal of Geriatric Physical Therapy最新文献

{"title":"Mild Cognitive Impairment Is Associated With Reduced Dynamic Balance Performance and Altered Lower-Extremity Kinematics During the Four Square Step Test.","authors":"Meghan E Kazanski, Clara E LaFollette, Meredith D Wells, Michael C Rosenberg, J Lucas McKay, Ihab Hajjar, Madeleine E Hackney","doi":"10.1519/JPT.0000000000000456","DOIUrl":"10.1519/JPT.0000000000000456","url":null,"abstract":"<p><strong>Background purpose: </strong>Cognitive deficits associated with mild cognitive impairment (MCI) likely impact balance control, especially during dynamic tasks. The Four Square Step Test (FSST) presents concurrent obstacle step-over and multi-directional stepping tasks to clinically interrogate dynamic balance. The primary FSST outcome, completion time , delivers a coarse measure of dynamic balance control, but cannot reveal underlying kinematic strategies that may further characterize MCI-related balance deficits. The objective of this study was to use an augmented FSST to characterize aging and MCI effects on both dynamic balance performance and lower-extremity kinematic execution strategies.</p><p><strong>Methods: </strong>Younger adults (YA, mean age = 23.7y; n = 7), older adults (OA, mean age = 67.4y; n = 20), and individuals with MCI (MCI, mean age = 71.7y; n = 17) performed the FSST in an observational study. We compared overall group effects, then performed 2-way, post-hoc comparisons to identify age (YA vs OA) and cognitive (OA vs MCI) differences in: (1) FSST completion times indicating dynamic balance performance , and (2) lower-extremity peak joint angles during leading and trailing steps in anterior-posterior and lateral directions, indicating kinematic execution strategies .</p><p><strong>Results discussion: </strong>The FSST completion time was impaired in OA compared to YA (31% slower; p < .001) and in MCI compared to OA (18% slower, p = .008). Both YA and OA exhibited similar kinematics throughout. Individuals with MCI exhibited reduced knee flexion across steps compared to OA ( p ≤ .002). Reduced knee flexion was associated with degraded FSST performance (Pearson's r < -0.44) and is generally less amenable to the obstacle step-over sub-task. While longer FSST completion times revealed aging-and MCI-related impacts on dynamic balance performance, kinematic analyses further revealed altered dynamic balance strategies only in individuals with MCI.</p><p><strong>Conclusions: </strong>Deficits associated with MCI impair FSST performance. Altered lower-extremity kinematics suggest that individuals with MCI may be especially challenged by the complexity of concurrent multi-directional stepping and obstacle step-over FSST sub-tasks. Clinicians should consider both impaired overall performance and underlying kinematic strategies when characterizing altered dynamic balance control during complex tasks (eg, FSST) in individuals with MCI.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"210-222"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994278","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 Exercise on Gait and Functional Performance in Individuals With Idiopathic Normal Pressure Hydrocephalus: A Scoping Review.","authors":"Sunee Bovonsunthonchai, Theerapol Witthiwej, Ninwisan Hengsomboon, Dusit Tongkongharn, Nonthaphat Siriwannaphar, Noppanun Sanguankwamdee, Jeerati Rattanatreyanupab, Piyawan Chokchaijaroensin, Jim Richards","doi":"10.1519/JPT.0000000000000464","DOIUrl":"10.1519/JPT.0000000000000464","url":null,"abstract":"<p><strong>Background and purpose: </strong>Exercise is recommended for individuals with idiopathic normal pressure hydrocephalus (iNPH), but its effects on gait and functional performance remain underexplored. This scoping review aimed to search (1) effects of exercise or physical therapy on gait and functional outcomes in individuals with iNPH, along with its underlying physiological and biomechanical mechanisms; (2) challenges to exercise implementation; and (3) replication potential of interventions.</p><p><strong>Methods: </strong>Five databases (PubMed, Embase, Latin American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, and SpringerLink) were searched for full-text, peer-reviewed articles (2010-2023) on exercise or physical therapy for individuals with iNPH, with all types of study design. Two reviewers independently screened, extracted, and tabulated the search results. Research quality was assessed using the Joanna Briggs Institute critical appraisal checklist. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews and the Template for Intervention Description and Replication checklists were used as reporting guidelines.</p><p><strong>Results: </strong>Six articles met the criteria, covering exercise interventions such as the Lee Silverman Voice Treatment-BIG exercise program, Dynamic Equilibrium Gait Training, High-Intensity Functional Exercise, Action Observation, and home-based physical exercise program (stretching exercises for back, gluteal, and trunk; strengthening exercise for shoulder, arm, and leg; and balance training). These exercises indicated positive effects on gait, sit-to-stand, mobility, balance, balance confidence, and disability, but did not significantly improve quality of life. All six articles provided sufficient details for replication; however, two were based on the same study project, leaving five unique studies included.</p><p><strong>Conclusion: </strong>Exercise interventions, when carefully prescribed by physical therapists, represent a promising approach for improving gait and balance in individuals with iNPH. However, the current paucity of well-powered randomized controlled trials highlights the urgent need for further research to identify the most effective exercise protocol. Future studies should focus on specific exercise modalities and their long-term impact to improve management and rehabilitation of individuals with iNPH.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"E175-E187"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745646","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":"Development of the Revised Entry-Level Essential Competencies in the Care of Older Adults: Linking Domains of Competence, Commission on Accreditation in Physical Therapy Education Standards, and the Geriatric 5Ms.","authors":"Karen M Blood, Justin T Mierzwicki, Barbara Billek-Sawhney, Jill Heitzman, Lisa R Dehner, Nicole Dawson, Gregory W Hartley","doi":"10.1519/JPT.0000000000000436","DOIUrl":"10.1519/JPT.0000000000000436","url":null,"abstract":"<p><strong>Purpose: </strong>Geriatric physical therapy (PT) has evolved since 2011, when the Essential Competencies (ECs) in the Care of Older Adults at the Completion of the Entry-level Physical Therapy Professional Program of Study were published. The purpose of the ECs was to ensure that all entry-level physical therapists were prepared to meet the unique needs of the growing older adult population. Changes in population demographics, medical and research advances, coupled with advancements in the profession of PT, necessitate a revision of the ECs.</p><p><strong>Process: </strong>The Academic Education Committee of APTA Geriatrics was convened to revise the original ECs. Participation was solicited and obtained from experts in clinical and academic geriatric PT; committee work lasted from 2021 to 2024. The committee recognized the intersection of the Domains of Competence Framework developed by the American Physical Therapy Association (APTA), American Council of Academic Physical Therapy, and the Academy of Education partnership, the geriatric medicine 5Ms model, and the Commission on Accreditation in Physical Therapy Education (CAPTE) standards in guiding entry-level PT education. The committee determined that the Domains of Competence, Geriatric 5Ms, and CAPTE standards could synergistically enhance the establishment of contemporary ECs. Input from a nonresearch-based informational survey of APTA Geriatrics members, supported by feedback from discussion at a platform presentation at the APTA's Combined Section Meeting San Diego 2023, informed the revised ECs presented in the current manuscript.</p><p><strong>Outcome: </strong>This manuscript presents the revised ECs and describes how each EC links to the Domains of Competence, the Geriatric 5Ms, and CAPTE standards. The updated ECs aim to promote best practices in entry-level PT education by providing all stakeholders clear and concise competency statements for the physical therapy examination and treatment of older adults.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"202-209"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899780","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":"A Movement Framework for Older Adults: Application of the Geriatric 5Ms.","authors":"Susan J Leach, Marni Larkin, Laura Z Gras, Myla U Quiben, Kenneth L Miller, Michelle M Lusardi, Gregory W Hartley","doi":"10.1519/JPT.0000000000000473","DOIUrl":"10.1519/JPT.0000000000000473","url":null,"abstract":"<p><p>Physical therapy for older adults must evolve to address the increasingly complex needs of older adults, who are living longer and managing multiple chronic conditions within challenging psychosocial and environmental contexts. Foundational models, such as the International Classification of Functioning, Disability and Health and the Patient/Client Management model provide structural guidance but fail to fully integrate critical components necessary for comprehensive geriatric care. These models often emphasize immediate medical concerns rather than considering the broader, multifaceted influences on function and overall well-being. The prevailing focus remains on restorative approaches rather than proactive prevention and individualized management strategies, limiting their effectiveness in optimizing movement, function, and quality of life. The Movement Framework for Older Adults (MFOA) offers a paradigm shift in geriatric physical therapy by bridging these gaps and prioritizing a holistic, movement-centered approach. Rooted in the Geriatric 5Ms-Mind, Mobility, Medication, Multicomplexity, and what Matters Most-the MFOA provides a structured yet adaptable model by integrating movement with the physiological, cognitive, psychosocial, and pharmacological factors influencing mobility and function. This approach compels clinicians to assess and address the unique needs of each older adult, moving beyond impairment-based care toward a more comprehensive, person-centered strategy. Developed by the APTA Academy of Geriatrics' Geriatric Movement System Task Force, the MFOA builds upon existing frameworks by explicitly incorporating movement and the Geriatric 5Ms into the assessment and intervention process. It aligns with hypothesis-driven clinical reasoning, equipping physical therapists with a systematic method to analyze movement impairments and functional limitations. This paper introduces the MFOA as a critical advancement in geriatric physical therapy, strengthening the foundation of current practice and enhancing its relevance to the evolving landscape of aging and health care. By emphasizing movement as a fundamental determinant of function and well-being, the MFOA empowers physical therapists to deliver targeted, effective, and person-centered care that aligns with what Matters Most to older adults.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"E161-E174"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080931","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":"Integrating the Geriatric 5Ms: Enhancing Physical Therapy Care of Older Adults.","authors":"Myla U Quiben, Michelle M Lusardi, Marni Larkin, Susan J Leach, Kenneth L Miller, Laura Z Gras, Gregory W Hartley","doi":"10.1519/JPT.0000000000000472","DOIUrl":"10.1519/JPT.0000000000000472","url":null,"abstract":"<p><p>The Geriatric 5Ms framework offers a comprehensive, person-centered approach to addressing the complex needs of older adults. Initially developed in geriatric medicine, the 4Ms strategy- Medications, Mind, Mobility , and what Matters Most to the patient-challenges clinicians to consider these dimensions in guiding care decisions. The Geriatric 5Ms builds on this framework and adds Multicomplexity , which emphasizes the management of multiple co-existing acute and chronic conditions, along with social and environmental factors and access to resources. The Geriatric Movement System Task Force recognizes the relevance of the 5Ms framework for addressing the functional movement needs of older adults with complex medical conditions. As movement experts, physical therapists are uniquely positioned to assess, monitor, and address Mobility issues while considering the impact of Medications, Mind, and Multicomplexity on movement and function. Engaging in meaningful conversations with older adults and their families about what Matters Most further ensures that care aligns with the individual's values and goals, forming the groundwork for successful outcomes. This article highlights the significance of the Geriatric 5Ms framework and advocates for its integration into physical therapy practice. By adopting this model, physical therapists can enhance examination, intervention planning, and rehabilitation outcomes, ultimately optimizing care for older adults.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"E156-E160"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081329","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":"Mobile Health Applications and Software for the Detection and Management of Sarcopenia Among Older Adults: A Scoping Review.","authors":"Meghna Suresh Prabhu, Sucheta V Kolekar, Girish Nandakumar","doi":"10.1519/JPT.0000000000000468","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000468","url":null,"abstract":"<p><strong>Background and purpose: </strong>Sarcopenia, a condition characterized by reduced muscle strength, mass, and physical performance, is commonly diagnosed using tools such as hand grip strength tests, dual-energy X-ray absorptiometry, bioelectrical impedance analysis, and gait speed measurements. Despite their reliability, these methods are often inaccessible due to high costs and low availability in many settings. Mobile Health (mHealth) and artificial intelligence tools can improve early disease detection. While some mHealth technologies have been developed for sarcopenia detection and management, a comprehensive review of their details is lacking. This review aims to identify and summarize the applications and software available for detecting and managing sarcopenia.</p><p><strong>Methods: </strong>A systematic search was conducted across six databases: Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PubMed, Scopus, and Web of Science, using a predefined set of validated keywords. Data extracted includes the names of applications and software, diagnostic criteria utilized, required sensors and external devices, operating systems, availability, cost, appraised components, and diagnostic precision. The methodological quality of the studies was assessed using the Joanna Briggs Institute checklist and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS 2).</p><p><strong>Results: </strong>Thirteen studies were selected from the initial 2700 based on the specified inclusion criteria. Five applications and two software tools employing one or more surrogate measures, with/without external devices, were identified, and a few have adopted the diagnostic algorithm. Most studies did not report diagnostic accuracy, the available ones ranged from 76% to 94.9%. Three applications involving resistance exercise and remote monitoring for management were identified.</p><p><strong>Conclusion: </strong>This review identified five applications and two software tools for sarcopenia detection, and three applications for its management. Given the subpar methodological quality of the evidence, the review's findings should be interpreted cautiously. These results signify the need for the development of a comprehensive app to detect and manage sarcopenia based on a standard diagnostic algorithm and a tailor-made rehabilitation program based on the severity of sarcopenia.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 3","pages":"182-193"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876300","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":"Wearable Technology in Mobility and Falls Health Care: Finding Consensus on Their Clinical Utility and Identifying a Roadmap to Actual Use.","authors":"Meghan Ambrens, Kim Delbaere, Ken Butcher, Jacqueline Close, Peter Gonski, Friedbert Kohler, Nigel H Lovell, Daniel Treacy, Kimberley S van Schooten","doi":"10.1519/JPT.0000000000000434","DOIUrl":"10.1519/JPT.0000000000000434","url":null,"abstract":"<p><strong>Background: </strong>Despite the promise wearable technologies offer through detailed insight into mobility and fall risk, timely identification of high risk, assessment of risk severity, evaluation of clinical interventions, and potential to redefine the assessment of behaviours which influence health, they are not routinely used in clinical practice.</p><p><strong>Objective: </strong>Establish consensus on how wearable technology can be applied to support clinical care for people aged 50 and over experiencing changes to mobility and/or who are at increased risk of falling.</p><p><strong>Methods: </strong>A Delphi study was conducted among 17 hospital-based health professionals. Over three rounds, experts were asked about fall prevention, mobility assessment, the potential role of wearable sensors, and clinical considerations for implementing wearable technology into practice. Consensus was defined as 75% agreement. Data were analysed using qualitative and quantitative methods.</p><p><strong>Results: </strong>Experts found that wearable technology has short and long-term clinical utility, data should be shared with general practitioners to improve long-term health outcomes, and devices would need to fit all individuals with a preference for wrist or pendant-worn locations. Technological literacy was not a perceived barrier. However, cost and data accuracy were important for successful implementation.</p><p><strong>Conclusion: </strong>This study provides a group consensus statement and guidance on the clinical implementation of wearable technology to support care for people aged 50 and over experiencing changes to mobility and/or who are at increased risk of falling. Health professionals are receptive to using wearable technologies to advance fall risk and mobility assessment and believe wearable technology has a role in clinical practice.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"138-145"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957411","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":"Wearable-Sensor-Instrumented Assessment of Prolonged Walking Identifies Performance Deficits in Older Adults With Normal Clinical Presentation.","authors":"Julie Rekant, Bailey Rammling, Jeffrey Beans, Vicki Gray, Brock Beamer, Odessa Addison","doi":"10.1519/JPT.0000000000000458","DOIUrl":"10.1519/JPT.0000000000000458","url":null,"abstract":"<p><strong>Background and purpose: </strong>Wearable sensors provide robust, objective information about movement quality. The Kinesis Gait uses shin-mounted accelerometers to augment clinical assessment by capturing gait spatiotemporal characteristics and quantifying fall risk. When used during a Six-Minute Walk Test (6MWT), the Kinesis Gait may capture gait quality deterioration over longer distances akin to those navigated during community ambulation. This analysis investigated the value of an instrumented 6MWT compared to clinical measures of function and muscle quality to identify older adults at risk of difficulty with community mobility.</p><p><strong>Methods: </strong>Forty-two older adults completed functional assessments (Four Square Step Test [FSST], stair climb power [SCP], Five Times Sit-to-Stand [5xSTS]), a Kinesis-instrumented 6MWT, and received CT imaging of hip and thigh muscles. Gait performance was characterized during the first and last minute of the 6MWT with Kinesis risk scores and gait spatiotemporal characteristics. Muscle attenuation was calculated from CT images to quantify muscle quality with lower scores indicating more fatty infiltration.</p><p><strong>Results and discussion: </strong>No statistically significant differences in Kinesis-measured gait performance were found between the first to last minute of the 6MWT. However, clinically abnormal gait compared to age- and sex-matched normative data was identified in 7 participants (16.7%) only in the last minute of the 6MWT (\"gait deterioration\") and in 20 participants (47.6%) at both timepoints. Participants with gait deterioration were statistically similar to those with clinically normal gait (n = 15 [35.7%]) in terms of age, physical functioning, and muscle quality but were younger (P = .042), had better physical functioning (SCP-P = .030, FSST-P = .049, 6MWT distance-P = .003), and had better hip abductor muscle quality (left-P = .002; right-P = .008) compared to those with clinically abnormal gait at both timepoints.</p><p><strong>Conclusions: </strong>The instrumented 6MWT identified a subgroup with clinically significant gait deterioration during a longer walking task likely to experience functional decline and difficulty when navigating community distances. Future studies should evaluate if training cardiovascular fitness improves prolonged gait performance in this group and can thereby help decrease fall risk.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 3","pages":"146-152"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876388","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":"Guest Editor's Message: Special Topics Issue on Digital Health and Rehabilitation Technologies.","authors":"Bruce H Greenfield, Alan Chong Lee","doi":"10.1519/JPT.0000000000000476","DOIUrl":"10.1519/JPT.0000000000000476","url":null,"abstract":"","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 3","pages":"111-113"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876330","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":"Improvements in Physical Capacity via a Wearable Sensor May Not Indicate Reductions in Real-World Sedentary Activity: A Longitudinal Post-Total Hip Arthroplasty Study.","authors":"Rashelle M Hoffman, Lauren A Hinrichs-Kinney, Jeri E Forster, Michael Dayton, Douglas Dennis, Dana L Judd, Cory L Christiansen, Jennifer E Stevens-Lapsley","doi":"10.1519/JPT.0000000000000467","DOIUrl":"10.1519/JPT.0000000000000467","url":null,"abstract":"<p><strong>Background and purpose: </strong>Patients with end-stage hip osteoarthritis typically elect total hip arthroplasty (THA) to improve life activity performance while clinical outcomes focus on physical capacity. However, it is unclear how improvements in life activity performance relate to improvements in physical capacity following THA. This study aimed to assess the longitudinal relationship between improvement in life activity performance (ie, decreases in sedentary time) and improvements in physical capacity (ie, increases in 6-Minute Walk [6MWT] distance) from before THA to a 6-month post-THA follow-up time point.</p><p><strong>Methods: </strong>This is a secondary analysis of a double-blind randomized controlled trial that enrolled individuals 50 to 85 years of age with unilateral hip osteoarthritis who underwent THA. Longitudinal variables of interest included the % of active wear time in sedentary activity using a hip-mounted wearable accelerometer-based monitor [ActiGraph wGT3X-BT] and 6MWT distance. The variables were modeled to extract predicted change scores, and simulations were used to determine if each participant had a change in sedentary time and 6MWT distance. Participants were classified on whether they improved sedentary activity time (P+: decrease in sedentary time or P-: no improvement in sedentary time) and/or 6MWT distance (C+: increased 6MWT distance or C-: no improvement in 6MWT distance). Independent sample t-tests (continuous variables) and Fisher exact tests (categorical variables) were used to compare characteristics between classification groups.</p><p><strong>Results and discussion: </strong>All 76 participants (age: 63.9 ± 7.0 years, 64.5% male) were classified as C+, as all improved physical capacity. A majority (n = 45; 59.2%) were C+/P+, while 31 participants (40.8%) were classified as C+/ P-, and no participants were classified as C-/P+ or C-/ P-.</p><p><strong>Conclusions: </strong>There is a noted disagreement between improvements in life activity performance versus physical capacity suggesting gains in the 6MWT are not always associated with reductions in sedentary time during recovery from THA. Improving physical capacity does not equate to decreased sedentary time. Thus, different rehabilitation targets (ie, behavior change interventions) may need to be identified and explored to enhance life activity performance following THA that may better align with patient performance goals.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"153-159"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112429","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}