Journal of geriatric physical therapy
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J Geriatr Phys Ther · Jul 2018
Randomized Controlled TrialDetermining Whether a Dosage-Specific and Individualized Home Exercise Program With Consults Reduces Fall Risk and Falls in Community-Dwelling Older Adults With Difficulty Walking: A Randomized Control Trial.
The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the efficacy of a new practice model, incorporating Shubert's evidence-based fall prevention recommendations, with the usual ambulatory physical therapy (PT) at Rusk Rehabilitation, to decrease fall risk among older adults living in the community. The hypotheses were (1) the proposed program would decrease participants' fall risk, (2) it would be more effective than our usual PT, and (3) the addition of 4 consults after discharge would improve compliance with a home exercise program. ⋯ This study supports the efficacy of the experimental program in decreasing fall risk and being more effective than our usual care, as well as fostering greater compliance with an exercise regimen. It provides some preliminary evidence to support Shubert's recommendation on exercise prescription for fall prevention.
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J Geriatr Phys Ther · Jul 2018
Interrater and Test-Retest Reliability and Minimal Detectable Change of the Balance Evaluation Systems Test (BESTest) and Subsystems With Community-Dwelling Older Adults.
Falls are a common cause of injuries and hospital admissions in older adults. Balance limitation is a potentially modifiable factor contributing to falls. The Balance Evaluation Systems Test (BESTest), a clinical balance measure, categorizes balance into 6 underlying subsystems. Each of the subsystems is scored individually and summed to obtain a total score. The reliability of the BESTest and its individual subsystems has been reported in patients with various neurological disorders and cancer survivors. However, the reliability and minimal detectable change (MDC) of the BESTest with community-dwelling older adults have not been reported. The purposes of our study were to (1) determine the interrater and test-retest reliability of the BESTest total and subsystem scores; and (2) estimate the MDC of the BESTest and its individual subsystem scores with community-dwelling older adults. ⋯ The BESTest total and individual subsystem scores demonstrate good to excellent interrater and test-retest reliability with community-dwelling older adults. A change of 7.6% (8.2 points) or more in the BESTest total and a percentage change ranged from 11.7% to 19.0% (2.1-3.4 points) in the subsystem scores are suggested for clinicians to be 95% confident of true change when evaluating change in this population.
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J Geriatr Phys Ther · Jul 2018
Do Older Adults Who Meet 2008 Physical Activity Guidelines Have Better Physical Performance Than Those Who Do Not Meet?
An observed consequence of aging is a decline in muscle performance that includes a loss in both muscle strength and muscle power. This decline can lead to loss of function and independence and is a predictor of disability in older adults. Although the 2008 Physical Activity (PA) Guidelines for Americans provides a guideline for muscle strengthening, there is no evidence that performing muscle strengthening 2 times a week for all major muscle groups is related to better performance on measures known to be important factors in development or progression of frailty in older adults. The purposes of this study were to assess muscle-strengthening and aerobic PA behaviors in older adults and to determine the relationship between the PA behaviors and physical performance measures. ⋯ Meeting guidelines for both aerobic and muscle-strengthening activities may be the most effective way of preserving muscle strength, muscle power, and gait velocity in older adults, but this conclusion must be tested with an intervention study.