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Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: 31 May 2024 | Viewed by 15992

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Prof. Dr. Marek Zak

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Guest Editor

Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Zeromskiego 5, 25-369 Kielce, Poland
Interests: physiotherapy; postural control and foot deformities; functional capacity and dual-task activities in older adults; physical activity; frailty; body composition and dietary supplementation; lifestyle and public health; geriatrics
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Prof. Dr. R. Scott Ward

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Assistant Guest Editor

Department of Physical Therapy and Athletic Training, College of Health, University of Utah, Salt Lake City, UT 84112, USA
Interests: physical therapy; burn injury and rehabilitation; muscle loss and recovery
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Prof. Dr. Jorunn L. Helbostad

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Assistant Guest Editor

Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
Interests: movement disorders and falls at old age; prevention of functional decline at old age; measurement and interventions related to balance, gait and physical activity; development of mobile health technology solutions for promotion of movement
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The steady aging of the world’s population poses a widely acknowledged challenge to many domains of human life. This has prompted academic researchers to seek viable, technologically aided solutions to make the individual aging process a far more positive experience. The main focus is enhancing overall functional self-reliance in seniors and eliminating any undue anxiety from their daily life. This is why we aim to present a wide scope of research, mostly addressing innovative applications of modern technologies, e.g., virtual reality (VR). Such an approach drives overall development and promotes appreciable advances in geriatric physiotherapy and rehabilitation worldwide.

We strongly believe this Special Issue will offer a perfect platform for sharing professional experience gained in different domains of geriatric medicine. Both academic investigators and hands-on clinical practitioners will thus be offered an excellent opportunity to compare their insights into patients from this particular age group. Technologically aided solutions, as developed by academic researchers, therefore stand a good chance of being readily introduced and applied in mainstream physiotherapeutic management, especially once they have been proven easy to handle, portable, and shown to offer patients a welcome, radical change from a dreary exercise routine through all-round sensory stimulation, e.g., versatile VR technology solutions. Innovations tend to move things forward. This also seems to hold true for practicing physiotherapy and rehabilitation in older adults.

With this purpose in mind, we welcome submissions of original research papers, reviews, and case reports to this Special Issue, which should prove this assertion beyond reasonable doubt.

This Special Issue is endorsed by the Polish Society of Physiotherapy:

It is the Society’s view that this Special Issue Project, as presently undertaken by IJERPH, does indeed aim to address a wide spectrum of topical issues in the domain of geriatric rehabilitation, while focusing at the same time on the steadily growing potential of virtual reality (VR) technological solutions, effectively coming to the aid of conventional rehabilitation management, as proposed until recently.

You may choose our Joint Special Issue in Journal of Clinical Medicine.

Prof. Dr. Marek Zak
Prof. Dr. R. Scott Ward
Prof. Dr. Jorunn L. Helbostad
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

physiotherapy
rehabilitation
falls
frailty
pain
cognitive problems
muscle and joint problems
neurological conditions
pulmonary problems
geriatrics

Related Special Issue

Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults in Journal of Clinical Medicine (2 articles)

Published Papers (7 papers)

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9 pages, 1672 KiB

Open AccessArticle

Early Heart Rate Recovery after a 6-min Walking Test Predicts Clinical Benefits in Patients after Percutaneous Aortic Valve Implantation

by Krzysztof Artur Aleksandrowicz, Katarzyna Maria Aleksandrowicz, Tomasz Grzegorz Witkowski, Michał Kosowski, Piotr Kübler, Karolina Grześkowiak, Grzegorz Piotr Golański, Damian Janusz Kulig, Maciej Filip Rachwalik, Roman Przybylski, Krzysztof Reczuch and Marcin Protasiewicz

Int. J. Environ. Res. Public Health 2023, 20(5), 4270; https://doi.org/10.3390/ijerph20054270 - 28 Feb 2023

Viewed by 1174

Abstract

Background: It was hypothesized that the time-appropriate return to a resting heart rate (HR) after cessation of exercise could be a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement among adults with severe aortic stenosis undergoing percutaneous aortic valve implantation (TAVI). Methods: We performed a 6 min walk test (6MWT) in 93 individuals before TAVI and 3 months after the procedure. The change in walking distance was calculated. During the pre-TAVI 6MWT, we analyzed the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd, and 3rd minute of recovery. Results: After 3 months, 6MWT distances improved by 39 ± 63 m and reached a total of 322 ± 117 m. Multiple linear regression proved the differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up. Conclusions: Our study suggests that analysis of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvements in exercise capacity after TAVI. This simple method can help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation. Full article

(This article belongs to the Special Issue Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults)

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9 pages, 561 KiB

Open AccessArticle

Validation of FES-I and Short FES-I Scales in the Polish Setting as the Research Tools of Choice to Identify the Fear of Falling in Older Adults

by Marek Zak, Marta Makara-Studzińska, Agnieszka Mesterhazy, Jacek Mesterhazy, Paweł Jagielski, Aneta Januszko-Szakiel, Tomasz Sikorski, Piotr Jaworski, Renata Miszczuk and Waldemar Brola

Int. J. Environ. Res. Public Health 2022, 19(24), 16907; https://doi.org/10.3390/ijerph192416907 - 16 Dec 2022

Cited by 2 | Viewed by 1641

Abstract

Fear of falling is associated with a clear hazard to individual self-reliance, reduced physical activity, as well as a sense of shame and loss of self-confidence. The present study aimed to complete the applicable translation and validation protocol for the Falls Efficacy Scale—International (FES-I) tool, following its prior adaptation to ensure full compatibility with the Polish setting. The FES-I questionnaire, along with its abridged version, was translated in line with the recommended standards of the MAPI Institute, taking into account both the cultural fabric and pertinent language specifics of the country. The survey was attended by 740 individuals (N = 740; 463 women, 277 men), over 60 years old. All respondents were required to complete both the FES-I and FES-I (Short) questionnaires twice, following an intervening period, and subsequently had their responses statistically assessed. The FES-I questionnaire, along with its abridged version, may be recommended as an effective assessment tool for addressing the fear of falling issue among the older adults, consequently allowing the teams of attending physicians, physiotherapists, psychologists, or psychiatrists to complete an unambiguous diagnosis, with a view to helping the patients overcome this particular type of anxiety. Full article

(This article belongs to the Special Issue Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults)

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15 pages, 752 KiB

Open AccessFeature PaperArticle

Assessing Sarcopenia, Frailty, and Malnutrition in Community-Dwelling Dependant Older Adults—An Exploratory Home-Based Study of an Underserved Group in Research

by Lauren Swan, Niamh Martin, N Frances Horgan, Austin Warters and Maria O’Sullivan

Int. J. Environ. Res. Public Health 2022, 19(23), 16133; https://doi.org/10.3390/ijerph192316133 - 02 Dec 2022

Cited by 3 | Viewed by 1814

Abstract

Background: Adults of advanced age, with functional dependency, socioeconomic disadvantage, or a need for home care, are expected to be at high risk of sarcopenia, frailty and malnutrition, yet are likely to be underrepresented in research. We aimed to explore the assessment of sarcopenia, frailty, and malnutrition in-home, and to describe the practicality of performing these assessments. Methods: Home-based health assessments and post-study feedback surveys were conducted among community-dwelling older adults ≥65 years in receipt of state-funded home care (n = 31). Assessments included probable sarcopenia [hand-grip strength (HGS), chair rise-test, and SARC-F case-finding tool], the Mini Nutritional Assessment (MNA), and the Clinical Frailty Scale (CFS). Results: The study group was of mean age 83.2 ± 8.2 years, 74% were female and 23% lived in socioeconomically disadvantaged areas. Almost all met the criteria for probable sarcopenia (94%, n = 29/31), were frail or vulnerable by the CFS (97%, n = 30/31), and over a quarter were at risk of malnutrition (26%, n = 8). Participants had low physical activity (71.0%, n = 22/31), with a mean daytime average of 11.4 ± 1.6 h spent sitting. It was possible to assess probable sarcopenia (by HGS and SARC-F, but not the chair rise test), malnutrition (MNA), and frailty (CFS). Home-based research was a complex environment, and unearthed significant unmet need, prompting referrals to health services (36%, n = 11), in addition to technology assistance. The majority of participants (93%) reported a willingness to partake in future research. Conclusions: Most community-dwelling older people in receipt of home support, assessed in this exploratory study, were at risk of probable sarcopenia, frailty, and low physical activity, with over a quarter were at risk of malnutrition. Our initial findings provide practical data for large scale studies and may inform the development of intervention studies aiming to support ageing in place. Full article

(This article belongs to the Special Issue Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults)

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18 pages, 733 KiB

Open AccessArticle

Enhancing Existing Formal Home Care to Improve and Maintain Functional Status in Older Adults: Results of a Feasibility Study on the Implementation of Care to Move (CTM) in an Irish Healthcare Setting

by Frances Horgan, Vanda Cummins, Dawn A. Skelton, Frank Doyle, Maria O’Sullivan, Rose Galvin, Elissa Burton, Jan Sorensen, Samira Barbara Jabakhanji, Bex Townley, Debbie Rooney, Gill Jackson, Lisa Murphy, Lauren Swan, Mary O’Neill and Austin Warters

Int. J. Environ. Res. Public Health 2022, 19(18), 11148; https://doi.org/10.3390/ijerph191811148 - 06 Sep 2022

Cited by 1 | Viewed by 2407

Abstract

Background: Care to Move (CTM) provides a series of consistent ‘movement prompts’ to embed into existing movements of daily living. We explored the feasibility of incorporating CTM approaches in home care settings. Methods: Feasibility study of the CTM approach in older adults receiving home care. Recruitment, retention and attrition (three time points), adherence, costs to deliver and data loss analyzed and differentiated pre and post the COVID-19 pandemic. Secondary outcomes, including functional status, physical activity, balance confidence, quality of life, cost to implement CTM. Results: Fifty-five home care clients (69.6% of eligible sample) participated. Twenty were unable to start due to COVID-19 disruptions and health issues, leaving 35 clients recruited, mostly women (85.7%), mean age 82.8 years. COVID-19 disruption impacted on the study, there was 60% retention to T2 assessments (8-weeks) and 13 of 35 (37.1%) completed T3 assessments (6-months). There were improvements with small to medium effect sizes in quality of life, physical function, balance confidence and self-efficacy. Managers were supportive of the roll-out of CTM. The implementation cost was estimated at EUR 280 per carer and annual running costs at EUR 75 per carer. Conclusion: Embedding CTM within home support services is acceptable and feasible. Data gathered can power a definitive trial. Full article

(This article belongs to the Special Issue Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults)

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13 pages, 791 KiB

Open AccessArticle

A Combination of Long-Duration Electrical Stimulation with External Shoulder Support during Routine Daily Activities in Patients with Post-Hemiplegic Shoulder Subluxation: A Randomized Controlled Study

by Chen Lavi, Michal Elboim-Gabyzon, Yuval Naveh and Leonid Kalichman

Int. J. Environ. Res. Public Health 2022, 19(15), 9765; https://doi.org/10.3390/ijerph19159765 - 08 Aug 2022

Cited by 1 | Viewed by 3520

Abstract

The study objective was to determine the effect of long-duration neuromuscular electric stimulation (NMES) on shoulder subluxation and upper-extremity function during the acute post-stroke stage. Twenty-eight subjects (mean age ± standard deviation −70.0 ± 14.0 years) were randomly assigned to an experimental or to a control group receiving NMES to the supraspinatus and posterior deltoid muscles or sham treatment for 6 weeks. All the subjects continued standard rehabilitation and external shoulder support (EST). Assessments were conducted pre- and post-intervention and at a 2 week follow-up session by an assessor blind to group allocation. Outcome measures included the degree of shoulder subluxation, Fugl–Meyer assessment-upper extremity (FMA-UE) test, FMA—hand and finger subscales, Functional Independence Measure (FIM), and shoulder pain (using the Numeric Pain Rate Scale). Shoulder subluxation was significantly lower, while the FMA-UE and FMA—hand and finger subscales were significantly improved in the experimental group post-intervention and at follow-up compared to the control group. FIM at follow-up improved more in the experimental group. No change was observed in pain level in both groups. Supplementing NMES to standard rehabilitation and EST is beneficial in reducing shoulder subluxation and improving upper-extremity function. Further research is necessary to determine effect of longer treatment duration and longer follow-up periods. Full article

(This article belongs to the Special Issue Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults)

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18 pages, 3381 KiB

Open AccessArticle

Physiotherapy Programmes Aided by VR Solutions Applied to the Seniors Affected by Functional Capacity Impairment: Randomised Controlled Trial

by Marek Zak, Tomasz Sikorski, Szymon Krupnik, Magdalena Wasik, Katarzyna Grzanka, Daniel Courteix, Frederic Dutheil and Waldemar Brola

Int. J. Environ. Res. Public Health 2022, 19(10), 6018; https://doi.org/10.3390/ijerph19106018 - 15 May 2022

Cited by 8 | Viewed by 2914

Abstract

Modern technologies are presently harnessed in response to a complex challenge of providing physiotherapeutic management in older adults. Fully immersive virtual reality (VR) solutions are acknowledged to viably enhance the overall effectiveness of traditional physiotherapeutic methods. A total of 60 community-dwelling older adults (over 75 years of age) were recruited for the study protocol. They were subsequently randomly split into four equally sized study groups (VR, CVR, OCULUS, and the classic programme group (OTAGO), and the physiotherapy sessions were pursued in the subjects’ homes for 3 weeks, 3 times a week, for 30 min in each group. At the first measurement point, respective study groups differed significantly in functional performance, as expressed in gait (POMA G) and individual static balance. The post hoc analysis indicated significantly higher scores in POMA G for the classic programme group vs. the results of the VR and CVR groups. On the other hand, the OCULUS group held significantly higher scores in individual balance and TUG, as compared to the other groups (p < 0.001). Making use of a virtual reality (VR) environment in the physiotherapeutic management of community-dwelling older adults appreciably enhanced individual functional performance, especially in terms of static balance. Physiotherapy management aided by VR technology solutions offers a viable alternative to traditional physiotherapeutic regimens (e.g., OTAGO programme) in enhancing individual functional performance. The innovatively self-designed VIRTUAL REALITY COMPREHENSIVE REHABILITATION ROOMS (VRCRR) solution may help out in pursuing a complex physiotherapy programme on an individual basis within one’s own home environment. Full article

(This article belongs to the Special Issue Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults)

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4 pages, 266 KiB

Open AccessBrief Report

Hospital-Based Rehabilitation of Patients Who Had Undergone an Open Reduction and Internal Fixation of the Ribs Due to a Flail Chest: Case Series

by Nehama Milson, Iuly Treger, Michal Vered, Asaf Acker and Leonid Kalichman

Int. J. Environ. Res. Public Health 2022, 19(23), 16026; https://doi.org/10.3390/ijerph192316026 - 30 Nov 2022

Viewed by 1107

Abstract

Flail chest, a severe chest injury, is caused by multiple rib fractures. The open reduction and internal fixation (ORIF) of rib fractures is an effective treatment; however, the patients’ subsequent condition remains unsatisfactory in terms of the activities of daily living (ADL) and pain. No research study has, as yet, reported on hospital-based rehabilitation of patients who had undergone an ORIF. Our aim was to evaluate the efficacy of hospital-based rehabilitation of flail chest post-ORIF patients. Physical therapists assessed the pain, functional independence measure (FIM), and the Berg balance test. A total of three females and four males (mean age 59.43 ± 18.88) were hospitalized. A significant reduction in pain was observed (7.00 ± 1.83 upon admission to 4.10 ± 2.05 pre-discharge (Z = −2.07, p = 0.027). A significant improvement in FIM (69.43 ± 14.86 upon admission to 113.57 ± 6.40 pre-discharge, Z = −2.37, p = 0.018), and the Berg balance test (35.23 ± 5.87 upon admission to 49.50 ± 3.40 pre-discharge, Z = −2.37, p = 0.018), was observed. Upon admission, all the patients required moderate to complete ADL assistance. Upon discharge, all were independent for all ADL functions. Patients after flail chest post-ORIF can benefit from hospital-based rehabilitation. Full article

(This article belongs to the Special Issue Physiotherapy and Rehabilitation as Modern-Day Medical Challenge in Older Adults)

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