Journal of Geriatric Physical Therapy最新文献

{"title":"Longitudinal Analysis of Functional Capacity in Nursing Home Residents During the COVID-19 Pandemic.","authors":"Pau Moreno-Martin, Eduard Minobes-Molina, Anna Escribà-Salvans, Vinicius Rosa Oliveira, Sandra Rierola-Fochs, Pau Farrés-Godayol, Pol Gràcia-Micó, Dyego Leandro Bezerra de Souza, Dawn A Skelton, Javier Jerez-Roig","doi":"10.1519/JPT.0000000000000418","DOIUrl":"10.1519/JPT.0000000000000418","url":null,"abstract":"<p><strong>Background and purpose: </strong>The COVID-19 pandemic has raised concerns about nursing home (NH) residents' well-being, with recent studies indicating a significant increase in functional decline rate during this critical period. However, a comprehensive exploration of functional capacity trajectories in NH residents during the pandemic remains unexplored. This study aims to address this research gap by conducting an in-depth analysis of the impact of the COVID-19 pandemic on NH residents' functional capacity.</p><p><strong>Methods: </strong>A 24-month multicenter prospective study involving 123 NH residents from Spain, with data collected at 6-month intervals over 5 waves, starting just before the pandemic's onset. Functional capacity was assessed using the Modified Barthel Index, and data were analyzed employing the actuarial method, log-rank test, and Cox's regression.</p><p><strong>Results and discussion: </strong>The likelihood of maintaining functional capacity was unfavorable, with only a 19.3% chance of preservation for a 1-point decline (FD-1) in Barthel scores and a 50.5% probability for a 10-point decline (FD-10). Personal hygiene, eating, and toilet use were identified as the most affected activities of daily living. Urinary continence decline emerged as a risk factor for FD-1, while fecal continence decline was associated with FD-10. The probability of maintaining functional capacity in the initial 6 months of a pandemic was comparable to a 2-year non-pandemic follow-up. Pandemic-induced isolation strategies significantly impacted toileting and personal hygiene. Urinary decline was associated with minor functional decline (FD-1), while fecal decline correlated with major functional decline (FD-10). Notably, the number of days spent in room confinement did not significantly contribute to the observed decline.</p><p><strong>Conclusions: </strong>A substantial increase in the risk of FD among NH residents during the COVID-19 pandemic compared to the pre-pandemic period was found. It is crucial to implement urgent, targeted interventions that prioritize promoting physical activity and the implementation of mobility and toileting programs. These measures are pivotal for mitigating functional decline and enhancing the overall health and well-being of NH residents in a pandemic context.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"98-110"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983618","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":"Functional Mobility and Its Relationship With Cognition in Older Adults With Normal Cognition, Motoric Cognitive Risk Syndrome, and Mild Alzheimer's Disease.","authors":"Sang-I Lin, Pei-Hao Chen, Ying-Yi Liao, Jhih-Yu Huang, Fang-Yu Cheng","doi":"10.1519/JPT.0000000000000455","DOIUrl":"10.1519/JPT.0000000000000455","url":null,"abstract":"<p><strong>Background and purpose: </strong>Motoric cognitive risk syndrome (MCR) is a predementia syndrome and is a strong predictor of Alzheimer's disease (AD). Functional mobility, such as balance, sit-stand transitions, and turning, has not been clearly investigated in this population. This study aimed to compare functional mobility among older adults with normal cognition (NC), MCR, and mild AD. Cognitive-motor interactions were also investigated in all the groups.</p><p><strong>Methods: </strong>This cross-sectional study included 91 older adults, including 36 with NC, 32 with MCR, and 23 with mild AD. A battery of neuropsychology tests encompassing several domains, including general cognition, executive function, attention, episodic memory, visuospatial performance, and language, was administered, and functional mobility tasks, including the Short Physical Performance Battery (SPPB) and the Timed Up and Go Test (TUG), were also carried out. Differences between groups were analyzed with MANCOVAs (post hoc Bonferroni correction). Partial correlation analysis adjusted for age and education levels was used to examine correlations between functional mobility and cognitive function in each group. Canonical correlation analyses were used to determine the extent of the relationship between a set of cognitive variables (executive function, attention, and visuospatial performance) and a set of functional mobility variables (the SPPB and TUG) in the NC, MCR, and mild AD groups.</p><p><strong>Results and discussion: </strong>The SPPB and TUG performance of the MCR and mild AD groups was significantly worse than that of the NC group. Visuospatial performance and depression were significantly correlated with functional mobility in the MCR group, while depression was the only specific cognitive aspect associated with functional mobility in the mild AD group. Canonical analysis demonstrated a significant relationship between cognition and mobility, explaining approximately 28.4% of the variance, in the NC group. However, the other two groups showed no significant correlation between cognition and mobility.</p><p><strong>Conclusions: </strong>In addition to slow gait, deficits in sit-stand transitions and turning were also observed in the MCR and mild AD groups. We also found that motor-cognitive interactions may differ according to the level of cognitive impairment. Future studies should comprehensively assess functional mobility for different cognitive impairment populations.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 2","pages":"88-97"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027562","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":"Survey of Geriatric Competencies and Curricular Models in Entry-Level DPT Programs in the United States.","authors":"Justin T Mierzwicki, Karen M Blood","doi":"10.1519/JPT.0000000000000432","DOIUrl":"10.1519/JPT.0000000000000432","url":null,"abstract":"<p><strong>Background and purpose: </strong>Nearly 2 decades have elapsed since the last national survey examining entry-level PT geriatric content. Furthermore, no survey has been completed investigating the extent to which the \"Essential Competencies in the Care of Older Adults at the Completion of Entry-level Physical Therapist Professional Program of Study\" were incorporated into DPT programs. The purpose of this study is to identify the extent to which DPT programs include geriatric topics and the Essential Competencies within curricula and determine geriatric content requiring proficiency for entry-level practice.</p><p><strong>Methods: </strong>A survey was developed in Qualtrics™ and distributed via email 4 times over 2 months in 2023 to DPT program chairs and APTA social media platforms. The survey contained sections on geriatric curriculum models, environment of content coverage, incorporation of Essential Competencies, and skills requiring entry-level proficiency. Data analysis was completed using descriptive statistics.</p><p><strong>Results and discussion: </strong>Responses were received from 134/276 programs. Seventy-nine and nine tenths percent of responding programs have a dedicated geriatric course, 93.4% of which require 1 geriatric course, with a mean of 2.6 credits (SD 1.02). In programs without dedicated geriatric courses, a mean of 2.7 credit hours (SD 2.88) of geriatric content was reported. Eighty-nine percent of programs cover age-related changes to major body systems and balance and fall screening, with <60% addressing interventions for cognition and social isolation. Of the surveyed Essential Competencies, 80.4% were incorporated into >70% of programs. A total of 31.6% of the tests and measures were taught, 15.8% were practiced, and 10.5% were identified by >70% of programs as requiring proficiency for entry-level practice.</p><p><strong>Conclusions: </strong>There is variation in geriatric content incorporated into entry-level DPT programs and moderately robust uptake of Essential Competencies. Entry-level education may not meet APTA-Geriatrics Best Practice guidelines with relatively few tests, measures, and interventions recommended with consensus to be proficient prior to entry-level practice. Improved knowledge translation and curricular guidance may help reduce practice variation and enhance entry-level education in geriatric physical therapy.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"E138-E146"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899320","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":"2025 Carole B. Lewis Distinguished Lecture: Address to the APTA Geriatrics Membership Combined Sections Meeting, Houston, TX, February 13, 2025 I Get Great Results With My Patients-What Is Wrong With the Research?","authors":"Kathleen Kline Mangione","doi":"10.1519/JPT.0000000000000461","DOIUrl":"10.1519/JPT.0000000000000461","url":null,"abstract":"","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 2","pages":"55-61"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041587","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":"The Influence of Aging on Hip Abductor Muscle Torque, Power, Velocity and the Association With Lower Limb Physical Function.","authors":"Marcel Bahia Lanza, Carolina da Cruz de Souza, Vicki L Gray","doi":"10.1519/JPT.0000000000000431","DOIUrl":"10.1519/JPT.0000000000000431","url":null,"abstract":"<p><strong>Background and purpose: </strong>Muscle strength, power, and mass decline with aging, leading to functional loss highly correlated with balance and falls in older adults. Lower limb muscle function is critical for fall prevention in older adults, and hip abductor force and rapid force development have been shown to be important during stepping tasks. However, it remains unclear whether hip abductor muscle function changes with aging. Therefore, the primary aim of this study was to compare maximum torque, submaximal power, and submaximal velocity of hip abductor muscles, as well as hip abductor strength and power clinical assessments, between young and older adults. The secondary aim was to investigate whether there is a relationship between the clinical assessments and hip abduction maximum torque, submaximal power, and submaximal velocity in young and older adults.</p><p><strong>Methods: </strong>The volunteers young (n = 20, 26.5 ± 3.9) and older (n = 20, 71.9 ± 5.3) adults performed a hip abduction estimated 1-repetition maximum (e1RM) and submaximal tests (40%, 60%, and 70% of e1RM) and clinical assessments (stair climb power test and the 30-second chair stand test).</p><p><strong>Results: </strong>Older adults exhibited a statistically significant decline in hip abduction torque, power, and velocity, accompanied by lower scores in clinical assessments in comparison to young adults. However, young adults did not exhibit any significant associations between clinical assessments and hip abduction maximum torque, power, and velocity, whereas older adults demonstrated strong correlations (r ≥ 0.52, P ≤ .02).</p><p><strong>Discussion: </strong>Older adults have a significant reduction in their ability to produce hip abduction torque, power, and velocity, as well as poor performance in clinical assessments compared to young adults. The declines in hip abductor maximum torque, power, and velocity with aging may be related to functional performance, as shown by the significant correlations between these variables and clinical assessments in older adults.</p><p><strong>Conclusion: </strong>Health care professionals should consider declines in the ability to generate muscle force rapidly, given its significance to lower limb function and overall physical capabilities.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"E129-E137"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957410","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":"Evaluation of the Single Leg Stance Test for an Annual Preventative Physical Therapy Visit and the Effect of Education on the Perceived Value of Test Results as a Health Indicator.","authors":"Dalerie Lieberz, Courtney Dittbenner, Hannah Koch, Tonya Paul, Mikalyn Sonterre","doi":"10.1519/JPT.0000000000000424","DOIUrl":"10.1519/JPT.0000000000000424","url":null,"abstract":"<p><strong>Background and purpose: </strong>A preventative model of physical therapy (PT) care to promote activity and minimize mobility loss with aging is not routine. Performance testing and patient education are recommended to increase the perceived value of results to inform health decision-making. This study evaluated (1) the Single Leg Stance (SLS) test for an annual visit based on a priori criteria and (2) the effect of education on the perceived value of SLS and walking speed test results as health indicators.</p><p><strong>Methods: </strong>In a cross-sectional study, ambulatory adults aged 55+ completed a pre-survey, performed SLS and walking speed tests, received education about their results, and completed a post-survey. The distribution of test results was displayed with histograms and analyzed for correlations. Participants used a Likert scale to rate how they perceived the value of their test results as health indicators before and after education and their satisfaction with the education received, including a novel pocket card.</p><p><strong>Results: </strong>On average, participants (n = 152) were 64 years old (age range 55-82), 91% white, and 61% female. Walking speed results were normally distributed, and SLS results demonstrated a ceiling effect. Participants were below published norms for SLS 33% of the time and 34% for walking speed. The SLS test took an average of 3.6 minutes to complete. Binarized results for the tests as at/above and below norms were correlated with χ2 (1, N = 152) = 10.48, P = .001. The test results were significantly more valued as health indicators after education. Seventy-two percent of participants agreed (median rating 4, range 1-5) that they would be interested in PT if their walking speed results were below the norm, and 76% agreed for SLS.</p><p><strong>Conclusion: </strong>The ceiling effect disadvantages the SLS test with an annual PT visit. Education on test results and comparison to norms increased how older adults valued physical performance measures as health indicators.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 1","pages":"E10-E18"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878627","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":"Factors Influencing the Outcome, Mechanism, and Implementation of Motivational Interviewing After Hip Fracture: A Qualitative Analysis.","authors":"Made Utari Rimayanti, Nora Shields, Paul D O'Halloran, Nicholas F Taylor","doi":"10.1519/JPT.0000000000000435","DOIUrl":"10.1519/JPT.0000000000000435","url":null,"abstract":"<p><strong>Background and purpose: </strong>Motivational interviewing, an evidence-based person-centered counseling style, may help to facilitate increased mobility and physical activity after hip fracture. We explored contextual factors influencing the outcome, mechanism, and implementation of motivational interviewing after hip fracture.</p><p><strong>Methods: </strong>A qualitative study was completed using an interpretive description framework. Data sources included verbatim transcriptions of interviews with purposively sampled patients (n = 18), clinicians (n = 6 including 3 physical therapists), and relevant physical therapy stakeholders (a trial coordinator, a manager, and physical therapists involved in trial recruitment; n = 4), and 128 randomly selected clinician diaries where clinicians recorded notes at the end of each motivational interviewing session. Data were independently coded by 2 researchers and mapped to the Medical Research Council process evaluation framework. Consensus discussions involving all researchers were completed to triangulate the data and develop an interpretive synthesis.</p><p><strong>Results: </strong>We found 3 main themes and 3 subthemes in the data. The main themes were: (a) It's about life, (b) Walking is not the goal, and (c) It's complicated. The last theme was further developed into a model depicting internal, external, and social factors influencing the outcome, mechanism, and implementation of motivational interviewing after hip fracture. Internal factors related to physical and psychological functioning. External factors included elements related to the environment and health services. Social factors included having a support system, receiving positive feedback, isolation, and feeling overwhelmed. Factors interplayed to create a multitiered model, with the person's life at the center. Traditional rehabilitation was perceived as addressing the physical factors of hip fracture, while motivational interviewing intervention was considered to address the whole person.</p><p><strong>Conclusion: </strong>Many contextual factors interplay to influence motivational interviewing intervention after hip fracture. For successful hip fracture rehabilitation, our results suggest physical therapists and other care providers address these factors in addition to physical rehabilitation and focus on the person at the center of the process.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 1","pages":"E1-E9"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878628","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":"Predicting Persistent Reduced Physical Performance in Adults 65+ in Emergency Departments: A Temporal Validation.","authors":"Inge H Bruun, Thomas Maribo, Christian B Mogensen, Berit Schiøttz-Christensen, Birgitte Nørgaard","doi":"10.1519/JPT.0000000000000439","DOIUrl":"10.1519/JPT.0000000000000439","url":null,"abstract":"<p><strong>Background and purpose: </strong>Targeted interventions to maintain physical performance in older adults are important. We aimed to validate an existing 4-item prediction model and, if necessary, develop a new model for early identification of adults aged 65+ with persistent reduced physical performance.</p><p><strong>Methods: </strong>A temporal validation study on adults aged 65+ admitted to the emergency department for medical reasons and who performed ≤8 repetitions in the 30-second chair-stand test (30s-CST) within the first 48 hours of admission. The primary outcome was the number of 30s-CST repetitions (≤8 or >8) performed at the older adults' homes 3 to 4 weeks after admission.</p><p><p>Physical performance and self-reported data were analyzed using univariate and multivariate logistic regressions. The optimal model was chosen based on the area under the curve.</p><p><strong>Results and discussion: </strong>The validation of a previously developed 4-item prediction model indicated that the model did not consistently apply to other populations of older adults. To develop a new model aimed at identifying acutely hospitalized older adults with persistent reduced physical performance, we combined 2 samples comprising 132 older adults with a 30s-CST score > 8 and 250 adults with a 30s-CST score ≤ 8 when measured 3 to 4 weeks after admission. The new model included 5 variables: age >80, female, self-reported difficulties in climbing a flight of stairs, less good/poor self-rated health, and a 30s-CST score ≤ 5. The model had an area under the curve of 84%. The model is expected to improve the identification of older adults with persistent reduced physical performance compared to health professionals' subjective assessments and/or adults' self-reported information.</p><p><strong>Conclusions: </strong>The initial 4-item prediction did not consistently apply to other populations of older adults. Consequently, 2 samples were combined and a 5-item model was developed. Since the model involves only 5 items, it is easy to implement and provides health professionals an opportunity for targeted intervention on older adults during and after acute hospitalization. A validation study for the 5-item model is necessary.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 1","pages":"14-23"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878629","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":"CSM 2025 Poster Abstracts.","authors":"","doi":"10.1519/JPT.0000000000000452","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000452","url":null,"abstract":"","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 1","pages":"E47-E128"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878625","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":"Words of Caution About Reference Values.","authors":"Richard W Bohannon","doi":"10.1519/JPT.0000000000000442","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000442","url":null,"abstract":"","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 1","pages":"4"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878631","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}