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Mobility Impairment (mobility + impairment)
Selected AbstractsThe Contribution of Foot Problems to Mobility Impairment and Falls in Community-Dwelling Older PeopleJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2001Hylton B. Menz B Pod (Hons) OBJECTIVES: To investigate the relationship between foot problems, balance, and functional ability in community-dwelling older people and to determine whether older people with a history of multiple falls exhibit greater foot impairment than those who have not fallen or who have fallen once only. DESIGN: A cross-sectional, retrospective study. SETTING: Falls and Balance Laboratory, Royal North Shore Hospital, Sydney, Australia. PARTICIPANTS: One hundred thirty-five community-dwelling men and women age 75 to 93 (mean age ± standard deviation, 79.8 ± 4.1). MEASURES: Foot problem score; postural sway; coordinated stability; stair ascent and descent; an alternate stepping test; timed 6-meter walk; and tests of vision, sensation, strength, and reaction time. RESULTS: Eighty-seven percent of the sample had at least one foot problem. Women had a significantly higher foot problem score than did men. The foot problem score was significantly associated with performance on the coordinated stability test, stair ascent and descent, alternate stepping test, and timed 6-meter walk. Multiple regression analyses revealed that the foot problem score was a significant independent predictor of performance in the coordinated stability test, stair ascent and descent, and the alternate stepping test. Subjects with a history of multiple falls had a significantly higher foot problem score than did those who had not fallen or who had fallen once only, but the prevalence of individual foot conditions or the presence of foot pain did not differ between these groups. CONCLUSIONS: Foot problems are common in older people and are associated with impaired balance and performance in functional tests. Furthermore, older people with a history of multiple falls have greater foot impairment than non- or once-only fallers. These findings provide further evidence that foot problems are a falls risk factor and suggest that the cumulative effect of multiple foot problems is more important in increasing falls risk than the presence or absence of individual foot conditions. [source] Obesity as a Confounding Health Factor Among Women With Mobility ImpairmentJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2003FAAN, Nancy C. Sharts-Hopko PhD Purpose To examine the relationships between self-reported height and weight and factors associated with disabilities that impair mobility among adult women. Data Sources Survey data were gathered from a convenience sample of 83 women with disabilities at community events targeting the disabled population. Height, weight, and factors associated with their disabilities were reported on a demographic questionnaire. Body mass index (BMI) was estimated using a conversion table and the self-reported height and weight of each participant. Conclusions The average self-reported weight was 168.3 lb. Only 38% of the women fell into the normal range on estimated BMI, but 62% of the women fell into the categories of overweight or obese. The incidence of overweight and obesity exceeded that reported for the general population of women in a national sample X2= 6.48, p= 03, 2 df). Self-reported weight was positively correlated with the number of comorbidities reported by the women (r= .419, p < .0001). Implications The issue of obesity is an important problem facing women with disabilities. Women who have mobility limitations need to be weighed periodically, and strategies should be devised for weight management, including both dietary plans and appropriate exercise regimens given their limitations. [source] Effect of ipriflavone on pain due to recent osteoporotic vertebral crush fractureINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2002Mohammad M. Rahman Abstract Aim:,Ipriflavone conserves bone mass in postmenopausal osteoporosis. Salmon calcitonin and alendronate, two other anti-resorptive drugs, have been found to have analgesic effects in osteoporotic acute vertebral fracture. This study aimed to determine if ipriflavone also possesses such an effect. Methods:,Thirty-two women with recent osteoporotic vertebral fractures were randomly assigned to ipriflavone treatment or placebo groups. Ipriflavone was given at the dose of 200 mg three times a day. Non-steroidal anti-inflammatory drugs were given ad libitum in both groups. Calcium carbonate (1 g daily) was administered to all subjects. Intensity of pain at rest, on movement and on pressure, pain rating on a 10-point visual analogue scale, degree of mobility impairment, and supplementary analgesic were assessed at the end of a 3-month period in both groups to assess the analgesic effect of ipriflavone. Results:,Fourteen subjects in the ipriflavone group and 12 in the placebo group completed the trial. After 3 months, all pain variables had decreased significantly in both groups. Intensity of pain at rest and on pressure and supplementary analgesic use were significantly lower in the ipriflavone group compared to the placebo group. Conclusion:,The study shows that ipriflavone has an analgesic adjuvant effect in acute osteoporotic vertebral fracture. [source] Epidemiology of Medicare Abuse: The Example of Power WheelchairsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2007James S. Goodwin MD OBJECTIVES: To determine the effect of neighborhood ethnic composition on power wheelchair prescriptions. DESIGN: The 5% noncancer sample of Medicare recipients in the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database, from 1994 to 2001. SETTING: SEER regions. PARTICIPANTS: Individuals covered by Medicare living in SEER regions without a cancer diagnosis. MEASUREMENTS: Individual characteristics (age, sex, ethnicity, justifying diagnosis, and comorbidity), primary diagnoses, neighborhood characteristics (percentage black, percentage Hispanic, percentage with <12 years education, and median income), and SEER region. RESULTS: The rate of power wheelchair prescriptions was 33 times greater in 2001 than in 1994, with a shift over time from justifying diagnoses more closely tied to mobility impairment, such as strokes, to less-specific medical diagnoses, such as osteoarthritis. In multilevel, multivariate analyses, individuals living in neighborhoods with higher percentages of blacks or Hispanics were more likely to receive power wheelchairs (odds ratios=1.09 for each 10% increase in black residents and 1.23 for each 10% increase in Hispanic residents) after controlling for ethnicity and other characteristics at the individual level. CONCLUSION: These results support allegations that marketers promoting power wheelchairs have specifically targeted minority neighborhoods. [source] Association Between Functional Status and Use and Effectiveness of Beta-Blocker Prophylaxis in Elderly Survivors of Acute Myocardial InfarctionJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2004Gail Vitagliano MD Objectives: To examine whether physical and cognitive impairments explain low use of beta-blockers in elderly patients and whether functionally impaired older adults have improved survival if a beta-blocker is prescribed at hospital discharge. Design: Cross-sectional and retrospective cohort study. Setting: Acute care hospitals in the United States. Participants: National cohort of 45,370 elderly acute myocardial infarction survivors, with no chart-documented contraindications to beta-blocker treatment. Measurements: The main outcome measures were beta-blocker prescription at hospital discharge and 1-year survival. Results: Fifty percent (n=22,683) of eligible patients were prescribed a beta-blocker at discharge. Older age and functional impairments (incontinence, mobility impairment, and cognitive impairment) were independently associated with decreased use of beta-blockers. The odds ratios for prescribing a beta-blocker at hospital discharge were 0.82 (95% confidence interval (CI)=0.77,0.86), 0.63 (95% CI=0.56,0.71), and 0.40 (95% CI=0.32,0.51) for persons with one, two, and three impairments, respectively, compared with those with no impairments. In survival analysis, patients prescribed a beta-blocker were 21% less likely than nonrecipients to die within 1 year of follow-up (relative risk=0.79, P=.0001). Similar survival benefit was observed in patients with and without functional impairments. Conclusion: This study shows a strong association between functional impairment and the use of beta-blockers after acute myocardial infarction in elderly patients. The results suggest that increasing use of beta-blockers in this group provides an opportunity to improve outcomes. [source] Self-esteem in children and adolescents with mobility impairment: impact on well-being and coping strategiesACTA PAEDIATRICA, Issue 3 2009L Jemtå Abstract Aim: The first aim was to investigate dimension-specific and global self-esteem in children and adolescents with mobility impairment and to analyse the relation between self-esteem and demographic data and disability characteristics. The second aim was to identify the impact of five self-esteem dimensions on well-being and coping strategies. Methods: A total of 138 children and adolescents aged 7,18 years with mobility impairment took part in a semi-structured interview. Demographic and disability characteristics were recorded and motor function was assessed. Self-esteem was measured by the ,I think I am' inventory. Perceived overall well-being was measured by a nine-grade visual scale, the Snoopy scale, and coping strategies by the Children's Coping Strategies Checklist. Results: Although a majority estimated a relatively high level of dimension-specific and global self-esteem, several demographic and disability factors for lower self-esteem were identified. Those who estimated their ,physical characteristics' lower used the coping strategy ,distraction' more often. Three out of five dimensions of self-esteem were positively associated with perceived overall well-being: ,physical characteristics', ,psychological well-being' and ,relationships with others'. Conclusion: Awareness of vulnerability factors for lower self-esteem in children and adolescents with mobility impairment offer health care professionals specific opportunities to enhance self-esteem in this group. [source] On intimacy, sexual activities and exposure to sexual abuse among children and adolescents with mobility impairmentACTA PAEDIATRICA, Issue 5 2008L Jemtå Abstract Aim: The aim was to describe experiences of intimacy and sexual activity and exposure to sexual abuse among children and adolescents with mobility impairment, and to relate these experiences to socio-demographic data, disability characteristics and well-being. Methods: This study included semi-structured interviews with 141 children and adolescents aged 7,18 years with mobility impairment. Interpersonal experiences of intimacy and sexuality, socio-demographic data, disability characteristics and well-being were registered. Results: About half of the children and adolescents in the study had been in a boy- or a girlfriend relationship, and about a fifth had an ongoing relationship. Of the adolescents, 15% had at least one experience of a sexual relationship. Whereas no particular sexual dysfunction was reported, 15% had concerns about their future sexual activities, presumably related to mobility impairment. A history of sexual abuse was reported by 7% in the age cohort of 13,18 years. The socio-demographic and disability-related features had a marginal influence on the experiences of intimacy and sexual activities. Conclusion: Several aspects of sexual health are not fully realized for children and adolescents with impaired mobility, and there is a need for specialized sexual health care services to protect the sexual rights of this group. [source] Well-being among children and adolescents with mobility impairment in relation to demographic data and disability characteristicsACTA PAEDIATRICA, Issue 5 2005Lena Jemtä Abstract Aim: To describe the well-being of children and adolescents with mobility impairment in relation to demographic data and disability characteristics. Methods: The present study is based on interviews with 141 subjects aged 7 to 18 y with impaired mobility. Perceived overall well-being was measured by a nine-grade visual scale, the Snoopy scale. Independence or dependence was evaluated by the Index of Independence in Activities of Daily Living. Motor capacity was assessed with an instrument including active movements, rapidity, locomotion and balance as well as the presence and localization of pain. Results: Since there were no significant differences in well-being regarding the diagnostic-related group, additional disorder/disability or the degree of disability, the impairment per se did not necessarily influence well-being negatively. Even though the majority of the children and adolescents in the study indicated a high level of well-being, several risk factors for a lower level of well-being were identified: greater age, not living with both parents, being a first-generation immigrant, having an acquired disease/injury and experience of pain. Conclusion: These findings increase our limited knowledge of well-being among children/adolescents with mobility impairment and provide a basis for effective care and future research. [source] Functional ability in female leg ulcer patients , a challenge for physiotherapyPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2006Kirsti Skavberg Roaldsen Abstract Background and Purpose.,Venous leg ulceration represents a global health problem affecting predominantly elderly women. Traditionally, functional problems in this group of patients have attracted modest attention from wound care providers and physiotherapists. The aim of the present study was to describe and quantify disease consequences in female leg ulcer patients as a background for future physiotherapy interventions, using the nomenclature of the WHO International Classification of Functioning, Disability and Health (ICF).,Method.,A prospective study was conducted in 34 women aged 60,85 years with current or previous venous leg ulcer as compared to 27 age-matched non-ulcer subjects. The outcome variables were pain, ankle range of motion, walking speed, walking endurance, self-perceived exertion, mobility, activities of daily living (ADL), physical activity, general health, life satisfaction and use of walking aids and community services. Established instruments were utilized and categorized within ICF domains to provide a conceptual framework and basis for physiotherapeutic research.,Results.,Leg ulcer patients showed significantly reduced values of ankle range of motion, walking speed and endurance, self-perceived exertion, mobility, ADL and physical activity level as compared to control subjects. Patients suffering from active ulceration were more negatively affected, and more of them had pain than post-ulcer fellows. By contrast, general health and life satisfaction were similarly rated by the two study groups.,Conclusions.,Elderly females in our study with chronic leg ulcer of venous aetiology had significant mobility impairments, but the reasons and consequences of these impairments remain to be elucidated. The potential of preventive measures and physical rehabilitation to aid functioning and prospects of leg ulcer repair need to be investigated in future studies. Copyright © 2006 John Wiley & Sons, Ltd. [source] The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of cross-sectional and cohort studiesAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2010Lori Letts Background/aim:,Evidence that the physical environment is a fall risk factor in older adults is inconsistent. The study evaluated and summarised evidence of the physical environment as a fall risk factor. Methods:,Eight databases (1985,2006) were searched. Investigators evaluated quality of two categories (cross-sectional and cohort) of studies, extracted and analysed data. Results:,Cross-sectional: falls occur in a variety of environments; gait aids were present in approximately 30% of falls. Cohort:,Home hazards increased fall risk (odds ratio (OR) = 1.15; 95% confidence interval (CI): 0.97,1.36) although not significantly. When only the high quality studies were included, the OR = 1.38 (95% CI: 1.03,1.87), which was statistically significant. Use of mobility aids significantly increased fall risk in community (OR = 2.07; 95% CI: 1.59,2.71) and institutional (OR = 1.77; 95% CI: 1.66,1.89) settings. Conclusions:,Home hazards appear to be a significant risk factor in older community-dwelling adults, although they may present the greatest risk for persons who fall repeatedly. Future research should examine relationships between mobility impairments, use of mobility aids and falls. [source] | ||||||||||