Journal of Geriatric Physical Therapy最新文献

{"title":"Geriatric Vulnerabilities Among Obese Older Adults With and Without Sarcopenia: Findings From a Nationally Representative Cohort Study.","authors":"Kathleen R Dondero, Jason R Falvey, Brock A Beamer, Odessa Addison","doi":"10.1519/JPT.0000000000000358","DOIUrl":"10.1519/JPT.0000000000000358","url":null,"abstract":"<p><strong>Background and purpose: </strong>Sarcopenic obesity is associated with loss of independence among older adults, but the epidemiology of sarcopenic obesity and associated geriatric vulnerabilities are poorly understood. Thus, our objectives were to: (1) estimate the prevalence of older adults with sarcopenic obesity and (2) examine rates of geriatric vulnerabilities among obese older adults, with and without sarcopenia.</p><p><strong>Methods: </strong>A nationally representative sample of 1600 community-dwelling older adults 65 years and older with obesity and documented measures of muscle function from the National Health and Aging Trends Study (NHATS) was identified as sarcopenic using sex-adjusted grip strength and Short Physical Performance Battery scores. Differences in the prevalence of geriatric vulnerabilities (including pain, depression, disability, and social isolation) were compared between obese older adults with and without sarcopenia.</p><p><strong>Results and discussion: </strong>Among obese older adults, 18% (n = 318/1600) were sarcopenic. After adjusting for age and sex, sarcopenic obese older adults had 3.7 times the odds of having 2 or more comorbid conditions (odds ratio [OR] = 3.7; 95% CI 2.2-5.0) and 6.4 times the odds of being frail (OR = 6.4; 95% CI 4.4-9.5) as compared with nonsarcopenic obese older adults. Sarcopenic obese older adults were also more likely to have 1 or more activities of daily living disabilities (OR = 3.7; 95% CI 2.5-5.4), be socially isolated (OR = 2.1; 95% CI 1.3-3.2), and report activity-limiting pain (OR = 2.0; 95% CI 1.5-2.7) as compared with nonsarcopenic obese older adults. These findings, in a nationally representative cohort, suggest obese older adults who are sarcopenic have higher rates of geriatric vulnerabilities that could impact delivery and outcomes of exercise and nutrition interventions.</p><p><strong>Conclusions: </strong>Concomitant obesity and sarcopenia are associated with higher rates of geriatric vulnerabilities among a nationally representative sample of older adults. More comprehensive interventions, beyond exercise and diet modifications, may be necessary to additionally address these newly identified social and physiological risks.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 3","pages":"168-173"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938079/pdf/nihms-1801161.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10398854","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":"Older Adults' Perceptions Regarding the Role of Physical Therapists in Fall Prevention: A Qualitative Investigation.","authors":"Jennifer L Vincenzo,&nbsp;Susan Kane Patton,&nbsp;Leanne L Lefler,&nbsp;Jason R Falvey,&nbsp;Pearl A McElfish,&nbsp;Geoffrey Curran,&nbsp;Jeanne Wei","doi":"10.1519/JPT.0000000000000304","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000304","url":null,"abstract":"<p><strong>Background and purpose: </strong>Falls are a leading cause of injury, morbidity, and mortality among older adults. Physical therapists are underutilized for fall prevention despite strong evidence and recommendations regarding their effectiveness. The purpose of this study was to explore older adults' awareness of and perceptions regarding the role of physical therapists for fall prevention. A secondary purpose of the study was to identify barriers to utilization of preventive rehabilitation services.</p><p><strong>Methods: </strong>A qualitative, descriptive, phenomenological approach was used. Participant demographics and fall history were obtained with a standard questionnaire. Four focus groups were conducted with 27 community-dwelling older adults (average age = 78 years). Focus groups were recorded, transcribed, and coded using thematic analysis.</p><p><strong>Results: </strong>Surveys indicated 37% of participants experienced a fall in the last year and 26% reported sustaining an injury. Four main themes and 5 subthemes about older adults' perceptions of physical therapy providers emerged: (1) awareness of fall prevention (subthemes: I can or have taken action to prevent falls, I don't think about it, and I am more careful); (2) learning how to fall and being able to get up from the floor; (3) limited knowledge regarding the role of physical therapists for fall prevention; and (4) a physical therapist should be seen for a specific problem, or after a fall (subthemes: perceived need and costs, and access requires a doctor's prescription).</p><p><strong>Conclusion: </strong>Older adults lack awareness about the role of physical therapists for fall prevention, believing they should only seek treatment from a physical therapist to address a specific problem, or after a fall. The profession should consider addressing misconceptions and underutilization by educating the public that physical therapists can and do play an important role in the prevention of falls. Being explicit about the prevention of falls throughout an older adults' episode of care may further help reinforce the role of physical therapists for fall prevention and improve dissemination of this knowledge.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 3","pages":"E127-E136"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8589106/pdf/nihms-1674293.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10025174","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":"Association Between Physical Functioning and Time Until a New Hospitalization in Community-Dwelling Older Adults: A Prospective Cohort Study.","authors":"Anderson Martins Silva,&nbsp;Daniele Sirineu Pereira,&nbsp;Juliana Lustosa Torres,&nbsp;Maria Geracina de Souza,&nbsp;Darlene Graciele de Carvalho,&nbsp;Carolina Kosour,&nbsp;Joana Ude Viana,&nbsp;Silvia Lanziotti Azevedo da Silva","doi":"10.1519/JPT.0000000000000344","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000344","url":null,"abstract":"<p><strong>Background and purpose: </strong>Physical functioning refers to the ability to independently perform activities that require physical ability, and may be an important tool for predicting a higher risk of hospitalization. The objective of this study was to verify whether aspects of physical functioning are independently associated with the risk for new hospitalization in older adults seen in primary health care.</p><p><strong>Methods: </strong>This prospective cohort study consisted of 473 older adults 60 years and older who had not been hospitalized in the prior year. Hospitalization records were obtained with authorization from the hospital admission. Depending on physical functioning, the probability of a new hospital admission within the next 5 years was determined based on survival analysis and the Kaplan-Meier curve. Physical functioning was evaluated using 5 easy-to-administer tests: handgrip strength using a Jamar dynamometer, functional performance using the Short Physical Performance Battery, balance using the step test, mobility using the Timed Up and Go (TUG) test, and gait speed using the 4-m walk test. The association between poor physical functioning and new hospitalization was verified using a Cox regression model, adjusted for sex, age, number of comorbidities, number of medications, and BMI. Models were implemented separately for each physical functioning test.</p><p><strong>Results: </strong>In the sample, 32% had been hospitalized at least once in 5 years. The Kaplan-Meier curve showed a decrease in the probability of nonhospitalization within the next 5 years. Cox regression analysis showed an association between hospitalization within the next 5 years and mobility on the TUG test of more than 12.4 seconds in the crude (hazard ratio [HR] = 1.33, 95% CI = 1.10-1.60) and adjusted models (HR = 1.26, 95% CI = 1.02-1.56), and balance using the step test of more than 7.5 seconds in the crude (HR = 1.27, 95% CI = 1.03-1.56) model.</p><p><strong>Conclusions: </strong>Physical functioning tests demonstrated that poor physical performance predicts new hospitalization, and reinforced the importance of their application in physical therapy practice in primary health care settings.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 3","pages":"161-167"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052914","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 Therapy and Health Care Utilization for Older Adults With Lumbar Spinal Stenosis.","authors":"Catherine T Schmidt,&nbsp;Jessica Ogarek,&nbsp;Linda Resnik","doi":"10.1519/JPT.0000000000000328","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000328","url":null,"abstract":"<p><strong>Background and purpose: </strong>Lumbar spinal stenosis (LSS) is associated with high health care utilization for older adults. Physical therapy (PT) offers low medical risk and reduced cost burden with functional outcomes that appear to be equivalent to higher risk interventions such as surgery. However, it is unknown whether receipt of PT following incident LSS diagnosis is associated with reduced health care utilization. The objectives of this study were to: (1) compare health characteristics for Medicare beneficiaries who received outpatient PT within 30 days of incident LSS diagnosis to those who did not; (2) compare the 1-year utilization rates for specific health care services for these 2 groups; and (3) quantify the likelihood of progression to specific health services based on the receipt of PT.</p><p><strong>Methods: </strong>This was a retrospective cohort study using nationally representative claims data for Medicare Part B beneficiaries between 2007 and 2010. Lumbar spinal stenosis was determined using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Beneficiaries 65 years and older were classified into 2 groups (PT and no PT) based on receipt of PT within 30 days of initial diagnosis. Baseline characteristics were identified at incident diagnosis. Hazard ratios (HRs) were estimated for the risk of receiving health services outcomes including spinal surgery, spinal injections, chiropractic care, advanced imaging, spinal radiographs, opioid medication, nonopioid analgesics, and hospitalizations beginning on day 31 up to 1 year following incident LSS diagnosis.</p><p><strong>Results and discussion: </strong>Among 60 646 Medicare beneficiaries with incident LSS who met the inclusion criteria, 1124 were classified in the PT group and 59 522 in the no PT group. Compared with the PT group, beneficiaries in the no PT group had a greater risk of having hospitalizations (HR = 1.40), opioid medications (HR = 1.29), spinal surgery (HR = 1.29), and spinal radiographs (HR = 1.19) within 1 year.</p><p><strong>Conclusions: </strong>Fewer than 2% of Medicare beneficiaries received PT within 30 days of initial LSS diagnosis. Receipt of PT was associated with less utilization of higher risk and costly health services for 1 year. These results may inform practitioners when making early decisions about rehabilitative care for older adults with LSS.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 3","pages":"E145-E154"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447561","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":"Gait Speed Reference Values for Adults Aged 90 and Older: The 90+ Study.","authors":"Katherine A Colcord, Claudia H Kawas, María M Corrada","doi":"10.1519/JPT.0000000000000340","DOIUrl":"10.1519/JPT.0000000000000340","url":null,"abstract":"<p><strong>Background and purpose: </strong>Slow gait speed has been associated with adverse outcomes in older adults, but little data exist for those 90 years and older, a group often referred to as the \"oldest old.\" We aimed to establish reference values for gait speed in men and women 90 years and older.</p><p><strong>Methods: </strong>The 90+ Study is a population-based longitudinal study of aging. Our analyses of gait speed included participants who were evaluated in person and were ambulatory. Gait speed was assessed using the 4-m walk test. We calculated means, standard deviations, and percentiles stratified by age, sex, and use of assistive device.</p><p><strong>Results and discussion: </strong>The 797 participants had a mean age of 93.5 years. Of these, 73.9% were women, 39.5% had a college education, and 98.6% were White. The overall mean gait speed was 0.58 m/s (women = 0.55 m/s, men = 0.65 m/s). In participants who did not use an assistive device, the overall mean gait speed was 0.66 m/s (women = 0.63 m/s, men = 0.71 m/s). In those who used a device, the overall mean gait speed was 0.38 m/s (women = 0.37 m/s, men = 0.43 m/s). Gait speed decreased with increasing age. Men had consistently higher average gait speeds compared with women across age categories. Men and women who used assistive devices had lower average gait speeds across age categories compared with men and women who ambulated with no device. Average gait speeds in our oldest-old cohort were slower than those of older adults younger than 90 years in previous studies.</p><p><strong>Conclusions: </strong>This study is the first to establish gait speed reference values specific to adults 90 years and older. Age-appropriate reference values are crucial to the accurate interpretation of clinical measures for patients in their 90s and above.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 3","pages":"E106-E112"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9898631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10081086","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":"Mobility Limitation in Older Adults Residing in Nursing Homes in Brazil Associated With Advanced Age and Poor Nutritional Status: An Observational Study.","authors":"José Rodolfo Torres de Araújo,&nbsp;Lidiane Maria de Brito Macedo Ferreira,&nbsp;Javier Jerez-Roig,&nbsp;Kenio Costa de Lima","doi":"10.1519/JPT.0000000000000301","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000301","url":null,"abstract":"<p><strong>Background and purpose: </strong>Mobility is a basic human need, and its limitation compromises health status, especially in older adults from developing countries and residing in nursing homes. This study aims to determine the prevalence and factors associated with mobility limitation in older adults residing in nursing homes.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 305 older adults (≥60 years) residing in 10 nursing homes in Northeast Brazil. Mobility limitation was evaluated using the \"walking\" item of the Barthel index. Sociodemographic/economic data concerning the participants and institutions, as well as conditions that could influence the mobility state of the older adults, were collected. The χ2 test and multiple logistic regression were performed using a significance level of 5%.</p><p><strong>Results and discussion: </strong>The prevalence of mobility limitation was 65.6% (95% confidence interval [CI], 59.6-70.4). Walking dependence was identified in 39.7% of the sample (26.9% wheelchair users and 12.8% bedridden), while 25.9% walked with assistance (16.7% with maximal assistance and 9.2% with minimal assistance). Mobility limitation was significantly associated with malnutrition/risk of malnutrition (1.86, 95% CI, 1.54-2.26, P < .001) and age ≥81 years (1.35, 95% CI, 1.12-1.63, P = .002).</p><p><strong>Conclusion: </strong>Mobility limitation has a high prevalence among older adults residing in nursing homes in Brazil, and is associated with advanced age and poor nutritional status. Health professionals should advocate for the maintenance of mobility and adequate nutritional support.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 3","pages":"E137-E144"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10079301","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":"Stakeholder and Data-Driven Fall Screen in a Program of All-Inclusive Care for the Elderly: Quality Improvement Initiative.","authors":"Allison M Gustavson,&nbsp;Jason R Falvey,&nbsp;Cherie V LeDoux,&nbsp;Jennifer E Stevens-Lapsley","doi":"10.1519/JPT.0000000000000307","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000307","url":null,"abstract":"Background and Purpose: The Program of All-Inclusive Care for the Elderly (PACE) delivers community-based long-term care services to low-income, nursing home eligible adults. In the PACE population, one of the most common reasons for hospitalizations is falls. The purpose of this quality improvement study was to create a stakeholder-driven process for developing a fall risk screen and evaluate how well this process discriminated injurious and noninjurious fallers. Methods: The quality improvement design was a prospective, longitudinal data collection for 5 PACE programs in Colorado. Physical therapists collected the Short Physical Performance Battery (SPPB) on participants at least annually. The Kotter practice change framework guided the processes for practice and organizational change in developing and implementing a fall screen. Results and Discussion: An iterative, stakeholder, and data-driven process allowed our team of researchers and a PACE program to establish a fall risk screen to stratify PACE participants. We provided feedback to PACE staff regarding screening rates and results on discrimination of faller status to promote continued uptake of screening and discussion regarding next steps. Rehabilitation therapists screened 66% of the PACE population, and participants were stratified into high risk (1-7 points) or low risk (8-12 points) based on the SPPB. Participants with low SPPB scores had 79% greater risk of a fall (risk ratio [RR] = 1.8; 95% confidence interval [CI], 1.5-2.1) and 86% greater risk of an injurious fall (RR = 1.9; 95% CI, 1.4-2.4), compared with those with high SPPB scores. Conclusions: Our study describes a collaboration to address fall rates in a PACE population. Program of All-Inclusive Care for the Elderly clinicians can use the identified cut-offs to stratify PACE populations at risk for falls and allocate scarce rehabilitation resources efficiently to best serve participants at highest risk, while using less resource-intensive interventions for those at lower risk.","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 3","pages":"154-159"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544608/pdf/nihms-1676630.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10025175","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 Therapists' and Physical Therapist Students' Experiences and Views on the Provision of Physical Therapy Services to People With Dementia: A Scoping Review.","authors":"Laura W White,&nbsp;Nicole Dawson,&nbsp;Blair P Saale,&nbsp;Trey Lemley","doi":"10.1519/JPT.0000000000000351","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000351","url":null,"abstract":"<p><strong>Background and purpose: </strong>Physical therapists (PTs) require specialized education and training to increase the capacity and competence of the dementia care workforce. Four areas of critical dementia workforce education and training gaps that apply to the physical therapy profession have been identified, including recruitment/retention, financing and cost of training, interprofessional education, and translation/implementation of effective dementia care. A critical step in developing effective training programs and educational curricula is to understand PTs' and PT students' experiences and views on working with people with dementia (PwD). Therefore, the purpose of this scoping review was to examine the extent and types of evidence that explore the experiences and views of PTs and PT students on the provision of physical therapy services to PwD.</p><p><strong>Methods: </strong>The Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, ERIC, PEDro, Web of Science, and Medline databases and sources of gray literature were searched for sources of evidence that met the inclusion criteria of the review protocol. The literature was mapped according to author, participant role, setting, publication type, study design, study aim, key findings, and dementia workforce training gaps addressed.</p><p><strong>Results and discussion: </strong>A total of 552 sources of evidence were screened for eligibility, and 16 studies were selected for inclusion. Twelve studies included PTs as participants, and 5 included PT students. Included sources explored PTs' experiences, behaviors, knowledge, attitudes, and confidence in working with PwD and the influence of educational, organizational, and other factors on these domains. Challenges to and strategies for delivering effective care to PwD were examined in multiple sources. The 4 areas of critical dementia workforce education and training gaps were each addressed by at least 1 of the included studies.</p><p><strong>Conclusions: </strong>The current body of literature identifies several gaps in both research and education that need to be addressed before our profession is truly prepared to effectively manage this challenging population of patients with specialized needs.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 3","pages":"174-182"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052915","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":"Feasibility of a 4-Week Manual Therapy and Exercise Intervention on Posture and Function in Community-Dwelling Older Adults: A Pilot Study.","authors":"Lynne C Hughes, Rebecca V Galloway, Steve R Fisher","doi":"10.1519/JPT.0000000000000360","DOIUrl":"10.1519/JPT.0000000000000360","url":null,"abstract":"<p><strong>Background and purpose: </strong>Thoracic hyperkyphosis is a common condition that progresses with aging and has been associated with impaired functional performance, increased risk of falls, and even mortality. Previous studies to improve posture primarily used exercise for durations of 3 months or longer. The purpose of this pilot study was to examine the feasibility of a manual therapy intervention in community-dwelling older adults over a 4-week time frame that is comparable to the typical clinical setting, to test the appropriateness and procedures for the measurement of posture and function in the older population with hyperkyphosis, and to collect preliminary data to describe change in posture and function measures.</p><p><strong>Methods: </strong>Twenty-four participants with hyperkyphosis or forward head posture were recruited, and 22 participants completed this pilot study. Feasibility was measured based on attendance, tolerance, safety, and retention. Issues with measurement procedures were recorded. The intervention included manual therapy and exercise 3 times a week for 4 weeks to target spinal and peripheral joint stiffness, muscle lengthening, and muscle activation. Outcomes included height, kyphotic index (KI), Block Test, Acromion to Table (ATT), Timed Up and Go (TUG), 5 times sit-to-stand (5XSTS), Functional Reach (FR), 2-minute walk test (2MWT), and Patient-Specific Functional Scale (PSFS). Data collected at visits 1, 6, and 12 were analyzed using 1-way repeated-measures multivariate analysis of variance.</p><p><strong>Results and discussion: </strong>Measurement and intervention protocols were found to be feasible. A significant effect for the aggregate dependent variables change over time was found. Univariate analysis of each dependent variable showed significance except for FR. All postural measures (height, KI, Block Test, and ATT) significantly improved statistically. The KI and ATT exceed the minimal detectable change for clinical significance. Function showed statistical improvements in the TUG, 5XSTS, 2MWT, and PSFS. Clinical significance was reached with the PSFS. Seven of 9 measures showed a statistically significant change in just 2 weeks.</p><p><strong>Conclusions: </strong>This pilot study suggests that manual therapy and exercise applied to older adults shows promise for improvement in measures of posture and functional performance in a clinically feasible 4-week time frame.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"46 3","pages":"151-160"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/16/jgpt-46-151.PMC10287051.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744010","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":"Identifying Factors That Influence Physical Activity Promotion in Outpatient Physical Therapist Practice Using the Theoretical Domains Framework","authors":"Zachary D. Rethorn, J. K. Covington, Chad E. Cook, J. Bezner","doi":"10.1519/JPT.0000000000000353","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000353","url":null,"abstract":"Background and Purpose: Physical activity (PA) promotion is not routine practice for physical therapists. Understanding the PA promotion beliefs of physical therapists may offer targets for behavior change interventions to improve PA promotion. The purpose of this study was to explore outpatient US physical therapists' beliefs about PA promotion and determine which Theoretical Domains Framework (TDF) domains can inform implementation efforts. Methods: We used a descriptive qualitative research design. A TDF-based interview guide was developed to identify beliefs about PA promotion. Twenty-six outpatient US physical therapists (13 regular PA promoters and 13 irregular PA promoters) completed semistructured interviews. Directed content analysis identified specific beliefs by grouping similar belief statements. Specific beliefs were mapped to TDF domains. Results and Discussion: Five TDF domains were identified as likely relevant to changing physical therapists' PA promotion behaviors. Key beliefs within those domains included conflicting comments about PA guidelines being evidence based, a lack of confidence to promote PA due to perceived deficits in communication skills, and time constraints as key barriers. Beliefs about improving PA promotion included incorporating screening for baseline PA and continuing education targeting confidence and communication. Conclusions: We identified key beliefs that influence outpatient US physical therapists' PA promotion. These beliefs identify targets for behavior change interventions to improve PA promotion rates among outpatient US physical therapists including incorporating baseline screening for PA and the development of continuing education training programs.","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"45 1","pages":"190 - 196"},"PeriodicalIF":2.4,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42212650","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}