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Musculoskeletal health in the community
Published in Ben Y.F. Fong, Martin C.S. Wong, The Routledge Handbook of Public Health and the Community, 2021
The Pennsylvania’s Healthy Steps for Older Adults (HSOA), a global hybrid programme, has demonstrated about a 17% reduction in the rate of falls after adjusting for fall risk factors (Albert et al., 2014). HSOA is a combination of falls prevention and education. The Programme includes items such as balance performance tests, Timed Up and Go test, One-Legged Stand test and Chair Stand test, of which the Timed Up and Go test and Chair Stand test are validated tests in the CDC Stopping Elderly Accidents, Deaths, and Injuries (STEADI) falls assessment tool kit (Stevens & Phelan, 2013). Scores below age-and gender-based norms on balance assessments will be referred to medical care and home safety assessment by health care social service agencies. In addition, joint mobility training conducted by staff or trained volunteers requires participants to attend a 2-hour fall prevention class to recognise fall risk situations and home hazards as well as equipment-designed exercise to improve lower limb balance and mobility (Albert et al., 2014).
Perioperative issues
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Gordon A. G. McKenzie, David J. H. Shipway
Preoperative falls predict postoperative falls, functional dependence and perioperative complications [52]. The Timed Up and Go Test can be used to assess falls risks. Difficulty in sit-to-stand (or where time to complete is over 15 seconds) associates with high risk for falls; preoperative referral to physiotherapy may be beneficial [5]. Postoperative falls may extend beyond the inpatient admission where patients suffer functional decline after surgery, and counselling frail older patients of this risk is advised [52,53].
Malingering in Geriatrics
Published in Alan R. Hirsch, Neurological Malingering, 2018
If malingering is suspected which may relate to a patient’s mobility and functional performance, the physician may order a physical therapy or occupational therapy evaluation. If the patient is reluctant to see a physical therapist or occupational therapist, office testing can be done. The American College of Rheumatology has recommended the “Timed Up and Go” test as a rapid assessment of mobility. The patient is asked while seated, to stand, walk three meters, turn around and return to the chair and sit back down. A time of less than ten seconds is normal. Eleven to 20 seconds indicates some level of disability, and 21 to 30 seconds indicates that the patient requires assistance on uneven surfaces and outside, and requires additional testing. A score of more than 30 seconds suggests that the patient is at increased risk of falling (Panel on Prevention of Falls in Older Persons, American Geriatrics Society, and British Geriatrics Society, 2011).
Does Age-Related Macular Degeneration (AMD) Treatment Influence Patient Falls and Mobility? A Systematic Review
Published in Ophthalmic Epidemiology, 2022
Hannah Garrigan, Jacquelyn Hamati, Parth Lalakia, Rosemary Frasso, Brooke Salzman, Leslie Hyman
The Timed Up and Go test, which was not used by any of these studies, is a time-effective, accurate performance test that could be used to assess fall risk while studying AMD interventions.45 Participants taking 14 seconds or more to get out of their chair without using their arms, walking 3 m, and returning to sit in their chair have an abnormal result.46 An abnormal test demonstrates deficits in balance and gait, which are the most predictive risk factors for falls, and patients will need to be referred for a multifactorial falls risk assessment with their primary care provider.44 Those who have difficulty with this test due to debilitating visual impairment or unsteadiness could be alternatively assessed using a validated questionnaire. Although one of the articles identified used an in-office obstacle course as a performance test, this is not pragmatic for widespread use in research.
Effects of Action Observation Therapy with Limited Visual Attention on Walking Ability in Stroke Patients
Published in Journal of Motor Behavior, 2022
Junpei Tanabe, Motoyoshi Morishita
Regarding the maximum 10-m walking time, subjects were instructed to walk as fast as possible without falling. To match the measurement environment with that of mental chronometry, no preliminary path was set at the start of walking. Therefore, the walkway was 12 m long, with 2 m for deceleration. The time point from when the lifted leg on the paretic or non-paretic side crossed the start line to that when the lifted leg crossed the goal line and the number of steps during this period were measured. The maximum 10-m walking time was measured with a stopwatch. Subjects were asked to walk two times and the average time was recorded. In the timed up and go test, subjects sat on a chair, stood up, walked to a four-legged crutch placed 3 m ahead, turned around, walked back, and sat on the chair, and the time taken for this course was measured. Subjects were instructed beforehand to walk as fast as possible without falling. The seat height was 40 cm. The timed up and go test was measured with a stopwatch. Subjects were asked to walk two times and the average time was recorded.
What do men want? A review of the barriers and motivators that engage older men in physical activity
Published in Physical Therapy Reviews, 2020
Joshua Blankley, Victoria Ferreira Martins Garcia, Patrick McCurran, Eunice San Luis, Caroline Yimeng Wang, Allyson Calder, G. David Baxter
In this review, as in other studies, fear was found to be a barrier to participation in physical activity, [30,31]. Fear has also been noted as a barrier to physical activity in studies with older women [32,33] highlighting the importance of this issue in the general older adult population [31,33]. Across the included studies in our review, fear was described in different contexts: fear of falling, fear of injuring or reinjuring oneself, and fear of pain. Falling is a common and key issue in older populations which can lead to physical (e.g. injury) and psychological (e.g. pain, anxiety) effects on the individual [30,34]. Studies have found that men who have a fear of falling engaged in significantly less physical activity compared to those who were not fearful, [30] and that individuals who have a fear of falling have a higher risk of falling compared to those without fear [34]. Fear is an important barrier as it limits the amount of physical activity older men engage in, consequently restricting the associated health benefits. Therefore, in addition to quantitatively assessing the falls risk of an individual (such as ‘timed up and go’ test and functional reach test), health professionals should also screen for this fear as part of their falls risk assessment. Outcome measures such as the ‘Falls efficacy scale-international’ (FES-I) could be used in this instance to qualitatively assess fear of falling [34–36]. This way, by using both physiological and psychological assessments of risk of falling, it is possible to better design a personalized intervention for the individual, as part of their falls prevention plan [35].