scholarly journals Effect of Physical Therapy on Fall-Risk and Physical Status in Older Adults with Frailty and Metabolic Syndrome

2020 ◽  
Vol 5 (6) ◽  
pp. 282-291
Author(s):  
N. P. Koval ◽  
◽  
M. G. Aravitska
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
Physical Therapy ◽  
Therapeutic Alliance ◽  
Fall Risk ◽  
Physical Therapist ◽  
Main Group ◽  
Frailty Syndrome ◽  
Physical Status

The constant increase in the proportion of the disabled or partially disabled elderly population and, accordingly, patients of this age contingent, leads to the need for rehabilitation and physical therapy of persons with geriatric syndromes and various comorbid pathologies. The purpose of the study was to determine the effectiveness of a physical therapy program based on the dynamics of indicators of the fall-risk and physical status in older adults with frailty syndrome and metabolic syndrome. Material and methods. 96 older adults were examined. The control group consisted of persons without metabolic syndrome and without frailty syndrome. The main group 1 consisted of persons with metabolic syndrome and frailty syndrome who did not express a desire to cooperate with a physical therapist and / or actively improve their health on their own (low level of therapeutic alliance). They were provided with recommendations on the WHO CINDI program (diet modification, extension of household and training physical activity). Main group 2 included patients who showed consent to take active steps to improve their own health under the supervision of a physical therapist (high level of therapeutic alliance). We developed a physical therapy program for them using kinesitherapy, massage, nutritional correction, education of the patient and his family, elements of cognitive training and occupational therapy for one year. The dynamics of the state was assessed according to the results of the Short Physical Performance Battery, hand dynamometry, Senior Fitness Test, the Berg Balance Scale. Results and discussion. Older adults with metabolic syndrome and frailty syndrome demonstrated a high fall-risk (according to the results of a Short battery of physical activity tests and the Berg scale) and a statistically significant lag in physical status parameters (coordination, balance, strength, flexibility, endurance, agility) according to the parameters of the Senior Fitness Test, hand dynamometry, Short battery of physical activity tests) from their peers. These results increase the risk of adverse health effects, loss of autonomy and death. The use of physical therapy in main group 1 subjects led to a statistically significant (р<0.05) improvement in physical qualities, a decrease in the intensity of frailty signs; leveling the fall-risk in them. The low level of therapeutic alliance of persons in the main group 2 led to unsatisfactory fulfillment or non-fulfillment of the recommendations provided and is associated with a lack of improvement in their physical status and a high fall-risk. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology of frailty and metabolic syndrome

scholarly journals DYNAMICS OF PHYSICAL FUNCTIONING PARAMETERS IN THE ELDERLY ADULTS WITH FRAILTY AND INSULIN RESISTANCE UNDER THE INFLUENCE OF THE PHYSICAL THERAPY PROGRAM

2020 ◽  
Vol 4 (14) ◽  
pp. 79-87
Author(s):  
N.P. Koval
Keyword(s):  
Insulin Resistance ◽  
Older Adults ◽  
Physical Therapy ◽  
Therapeutic Alliance ◽  
Physical Functioning ◽  
Fall Risk ◽  
Physical Therapist ◽  
Frailty Syndrome ◽  
Therapy Program ◽  
Physical Therapy Program

Aim: to determine the effectiveness of physical therapy program according to the parameters of physical functioning in older adults with frailty syndrome and insulin resistance. Material and methods. Ninety six older adults were examined. The control group consisted of individuals without signs of insulin resistance and frailty syndrome. The main group 1 (MG 1) consisted of persons with insulin resistance and frailty syndrome who did not want to cooperate with a physical therapist and / or actively improve their health on their own (low level of therapeutic alliance). They were provided with recommendations according to the WHO CINDI program (modification of nutrition, expansion of household and training physical activity). The main group 2 (МG2) included patients who agreed to take active steps to improve their own health under the supervision of a physical therapist (high level of therapeutic alliance). A program of physical therapy with the using of kinesіоtherapy, massage, nutritional correction, education of the patients and their families, elements of cognitive training and occupational therapy for 1 year was developed for them. The dynamics of the condition was evaluated by the results of wrist dynamometry, Timed Up and Go test, a 6-minute test, Functional Mobility Assessmetn in Eldery Patients, Bartel index. Results. Older adults with frailty and insulin resistance demonstrated a statistically significant deterioration in physical function compared to peers (coordination, balance, strength, flexibility, endurance, agility skills according to the results of tests), which increases the risk of adverse health effects, loss of autonomy and death. The use of physical therapy in МG1 led to a statistically significant improvement in the parameters of physical functioning, reducing the intensity of signs of frailty and the fall-risk, reducing the degree of dependence in domestic functioning, indicating the biopsychosocial effect of the program. The low level of therapeutic alliance of МG2 individuals led to unsatisfactory implementation or non-implementation of the provided recommendations and was associated with a lack of improvement in their physical status and a high fall-risk. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology – frailty and metabolic syndrome.

scholarly journals Implementation of a Cost-Effective Physical Therapy Approach (Coach2Move) to Improve Physical Activity in Community-Dwelling Older Adults With Mobility Problems: Protocol for a Cluster-Randomized, Stepped Wedge Trial

2019 ◽  
Vol 100 (4) ◽  
pp. 653-661 ◽  
Author(s):  
Ward Heij ◽  
Steven Teerenstra ◽  
Lieke Sweerts ◽  
J Bart Staal ◽  
Maria W G Nijhuis-van der Sanden ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Therapy ◽  
Physical Therapist ◽  
Community Dwelling ◽  
Stepped Wedge ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults ◽  
Stepped Wedge Trial ◽  
Insight Into

Abstract Background Coach2Move is a personalized treatment strategy by physical therapists to elicit physical activity in community-dwelling older adults with mobility problems. Objective The primary objective of this study is to assess the effectiveness and cost-effectiveness of the implementation of Coach2Move compared with regular care physical therapy in daily clinical practice. Design, Setting, Participants, and Intervention A multicenter cluster-randomized stepped wedge trial is being implemented in 16 physical therapist practices (4 clusters of 4 practices in 4 steps) in the Netherlands. The study aims to include 400 older adults (≥70 years) living independently with mobility problems and/or physically inactive lifestyles. The intervention group receives physical therapy conforming to the Coach2Move strategy; the usual care group receives typical physical therapist care. Measurements Measurements are taken at baseline and 3, 6, and 12 months after the start of treatment. The primary outcomes for effectiveness are the amount of physical activity (LASA Physical Activity Questionnaire) and functional mobility (Timed Up and Go test). Trial success can be declared if at least 1 parameter improves while another does not deteriorate. Secondary outcomes are level of frailty (Evaluative Frailty Index for Physical Activity), perceived effect (Global Perceived Effect and Patient Specific Complaints questionnaire), quality of life (EQ-5D-5 L), and health care expenditures. Multilevel linear regression analyses are used to compare the outcomes between treatment groups according to an intention-to-treat approach. Alongside the trial, a mixed-methods process evaluation is performed to understand the outcomes, evaluate therapist fidelity to the strategy, and detect barriers and facilitators in implementation. Limitations An important limitation of the study design is the inability to blind treating therapists to study allocation. Discussion The trial provides insight into the effectiveness and cost-effectiveness of the Coach2Move strategy compared with usual care. The process evaluation provides insight into influencing factors related to outcomes and implementation.

scholarly journals Influence of Physical Therapy Means on Indicators of Cardiovascular System Activity, Metabolism and Psychoemotional Status of Elderly Individuals with Metabolic Syndrome and Frailty

2021 ◽  
Vol 6 (1) ◽  
pp. 271-279
Author(s):  
N. P. Koval ◽  
Keyword(s):  
Metabolic Syndrome ◽  
Heart Rate ◽  
Physical Therapy ◽  
Therapeutic Alliance ◽  
Cardiovascular System ◽  
Elderly People ◽  
Physical Performance ◽  
Biochemical Parameters ◽  
Adaptive Potential ◽  
Low Level

An increase in the prevalence of insulin resistance in the elderly, associated with physiological changes in carbohydrate metabolism during the aging process, is associated with a high risk of cardiovascular accidents and endocrine diseases. This problem requires a solution by healthcare professionals with medication and non-medication. The purpose of the study was to determine the effectiveness of the program of physical therapy by the dynamics of indicators of the cardiovascular system, carbohydrate and lipid metabolism, psychoemotional status of elderly people with frailty and metabolic syndrome. Material and methods. 96 elderly people were examined. The control group consisted of persons without metabolic syndrome and without frailty. The main group 1 consisted of patients with metabolic syndrome and frailty with a low level of therapeutic alliance who did not want to cooperate with a physical therapist and / or actively improve their health on their own. The main group 2 included patients who agreed to undergo a developed program of physical therapy (a high level of therapeutic alliance) using kinesitherapy, massage, nutritional correction, education of the patient and his family, elements of cognitive training and occupational therapy for 1 year. The effectiveness of the program was assessed by the dynamics of systolic and diastolic blood pressure, heart rate, Kvass endurance coefficient, Baevsky's adaptive potential, Robinson's index, physical performance (based on the results of a 6-minute test), carbohydrate parameters (fasting blood glucose and after glucose load) and lipid (concentration of cholesterol, triglycerides, high density lipoproteins) metabolism, the level of depression according to the GDS-15 questionnaire. Results and discussion. In elderly people with frailty and metabolic syndrome, a statistically significant (p <0.05) deterioration in the parameters of the functioning of the cardiovascular system (according to the levels of DBP, heart rate at rest, Kvass endurance coefficient, Baevsky's adaptive potential, Robinson's index), physical performance (according to the results of a 6-minute test - distance, severity of fatigue, shortness of breath, cardialgia), biochemical parameters (fasting hyperglycemia, impaired glucose tolerance, atherogenic dyslipidemia), psycho-emotional state (depression) from their peers. The use of physical therapy tools led to a statistically significant improvement (p <0.05) of all the studied parameters of the functioning of the cardiovascular system, biochemical parameters in elderly people with metabolic syndrome and frailty, an increase in their physical performance, and an improvement in psycho-emotional status. A low level of therapeutic / rehabilitative alliance led to unsatisfactory fulfillment or non-fulfillment of the recommendations provided by patients and is associated with a lack of improvement in the state of the cardiovascular system, physical performance, age-associated depression. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology like frailty and metabolic syndrome for the prevention of cardiovascular accidents

scholarly journals Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students’ perceptions of geriatrics and geriatric education in the United States

2016 ◽  
Vol 13 ◽  
pp. 35 ◽  
Author(s):  
Jennifer C. Reneker ◽  
Kyra Weems ◽  
Vincent Scaia
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Student Perceptions ◽  
Geriatric Patients ◽  
Physical Therapist ◽  
The United States ◽  
Community Dwelling ◽  
Effect Sizes ◽  
Entry Level ◽  
Geriatric Education

This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21–33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Akron, Ohio, USA. Student perceptions were collected before and after participation in the 8-week balance class. The Wilcoxon sign-ranked test was used to identify differences in perceptions after participation in the group balance class. Cohen’s d-values were calculated to measure the size of the pre-participation to post-participation effect for each measure. At the conclusion of the group class, the DPT students demonstrated an increase in positive perceptions of geriatric physical therapy in 8 measures, with small effect sizes (d=0.15–0.30). Two perceptions of geriatric physical therapy demonstrated a significant positive increase (P<0.05) with moderate effect sizes (d=0.47 and d=0.50). The students’ perceptions of geriatric education in the curriculum demonstrated a large positive effect for quality (d=1.68) and enjoyment (d=1.96). Positive changes were found in most of the perceptions of geriatrics and geriatric education after participation, suggesting that integrated clinical experiences with geriatric patients are an effective way to positively influence perceptions of physical therapist practice with older adults.

Associations of Light, Moderate to Vigorous, and Total Physical Activity With the Prevalence of Metabolic Syndrome in 4,652 Community-Dwelling 70-Year-Olds: A Population-Based Cross-Sectional Study

2020 ◽  
pp. 1-9
Author(s):  
Marcel Ballin ◽  
Peter Nordström ◽  
Anna Nordström
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
Light Intensity ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Steps Per Day

In this cross-sectional study, the authors investigated the associations of objectively measured physical activity (PA) with the prevalence of metabolic syndrome (MetS) in older adults. Accelerometer-derived light-intensity PA, moderate to vigorous PA, and steps per day were measured in (N = 4,652) 70-year-olds in Umeå, Sweden, during May 2012–November 2019. The MetS was assessed according to the American Heart Association/ National Heart, Lung and Blood Institute criteria. The prevalence of MetS was 49.3%. Compared with the reference, the odds ratios for MetS in increasing quartiles of light-intensity PA were 0.91 (0.77–1.09), 0.75 (0.62–0.89), and 0.66 (0.54–0.80). For moderate to vigorous PA, the corresponding odds ratios were 0.79 (0.66–0.94), 0.67 (0.56–0.80), and 0.56 (0.46–0.67). For steps per day, the odds ratios were 0.65 (0.55–0.78), 0.55 (0.46–0.65), and 0.45 (0.36–0.55). In summary, this study shows that greater amounts of PA, regardless of intensity, are associated with lower odds of MetS. With the limitation of being an observational study, these findings may have implications for the prevention of MetS in older adults.

Clustering of Physical Activity and Sedentary Behavior Associated to Risk for Metabolic Syndrome in Older Adults

2019 ◽  
Vol 27 (6) ◽  
pp. 781-786
Author(s):  
Sofia W. Manta ◽  
Paula F. Sandreschi ◽  
Thiago S. Matias ◽  
Camila Tomicki ◽  
Tânia R.B. Benedetti
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
At Risk ◽  
Community Health ◽  
Community Health Centers ◽  
Sedentary Time ◽  
Health Centers ◽  
Active Cluster ◽  
Clustering Patterns

This study aimed to investigate the clustering patterns of physical activity, sedentary time (ST), and breaks in ST, and the association between the identified clusters at risk for metabolic syndrome associated with obesity in older adults. Participants included 212 users of community health centers in Brazil. A questionnaire about sociodemographic characteristics was used to describe the sample, and physical activity, ST, and breaks in ST were evaluated using accelerometers. Waist circumference was measured as an indicator of the risk for metabolic syndrome. A two-step cluster analysis and logistic regression analysis were conducted. The following four clusters were identified: sitters (37.7%), inactive (28.3%), active (25.5%), and all-day sitters/lightly active (8.5%). Participants in the active cluster were 60% less likely to be at risk for metabolic syndrome. This study may contribute to a comprehensive understanding of which older adult groups need more attention in the context of community health centers.

scholarly journals THE ASSOCIATION BETWEEN PHYSICAL ACTIVITY AND METABOLIC SYNDROME IN OLDER ADULTS WITH OBESITY

2018 ◽  
pp. 1-6
Author(s):  
F. Xu ◽  
S.A. Cohen ◽  
I.E. Lofgren ◽  
G.W. Greene ◽  
M.J. Delmonico ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
Lower Risk ◽  
Density Lipoprotein ◽  
Activity Levels ◽  
Cross Sectional ◽  
Physical Activity Levels ◽  
Physical Activity Recommendations ◽  
Activity Recommendations

Background: Physical activity reduces the likelihood of developing metabolic syndrome (MetS). However, the association between different physical activity levels and MetS remains unclear in older adults with obesity. Methods: This cross-sectional study used four waves of data (2007-2008, 2009-2010, 2011-2012, 2013-2014) from two datasets: The National Health and Nutrition Examination Survey and United Sates Department of Agriculture’s Food Patterns Equivalents Database. The sample included adults 60+ years of age (n= 613) with obesity who had physical activity and MetS data. Physical activity was assessed using the Global Physical Activity Questionnaire and categorized into three physical activity levels (low, medium, and high); and medium or high physical activity levels are aligned with or exceed current physical activity recommendations. Participants were classified as having MetS using a commonly agreed upon definition. Multiple logistic regression models examined the association between the three physical activity levels and MetS risk factors and MetS. All analyses adjusted for potential confounding variables and accounted for complex sampling. Results: Of 613 respondents, 72.1% (n=431) were classified as having MetS, and 44.3% (n = 263) had not met physical activity recommendations. Participants with high levels of physical activity had a lower risk of MetS (OR = 0.31, 95%CI: 0.13, 0.72) and more healthful levels of high-density lipoprotein cholesterol (OR = 0.39, 95%CI: 0.18, 0.84), blood pressure (OR = 0.39, 95%CI: 0.20, 0.77), fasting glucose (OR = 0.34, 95%CI: 0.15, 0.78) than participants categorized as having low physical activity. Conclusions: Physical activity is associated with lower risk of MetS only for participants with the highest level of physical activity, which suggests that physical activity dosage is important to reduce MetS risk in older adults with obesity.

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