Effectiveness of a group exercise program in a long-term care facility: a randomized pilot trial.
Female; Male; Aged; Sensitivity and Specificity; Prospective Studies; Age Factors; Sex Factors; Analysis of Variance; Patient Compliance; Pliability; Frail Elderly; Nursing Homes; Confidence Intervals; Inpatients; Human; Descriptive Statistics; P-Value; Repeated Measures; Data Analysis Software; Pilot Studies; Clinical Trials; Summated Rating Scaling; Clinical Assessment Tools; Analysis of Covariance; Outcomes (Health Care); Range of Motion; Random Assignment; Treatment Outcomes; Gerontologic Care; Long Term Care; Functional Status; Geriatric Functional Assessment; Crossover Design; Housing for the Elderly; Muscle Strengthening; Recreation; 80 and Over; Group Exercise – In Old Age
Objective:The purpose of this pilot was to determine whether a strength and flexibility program in frail long-term care facility (LTC) residents would result in improved function.Design:A prospective, randomized, controlled, semicrossover trial was designed with participants assigned either to group exercise (EX) or recreational therapy (C). In the EX group, the intervention continued for 1 year. In the C group, recreation continued for 6 months; these controls were then crossed over to the same exercise intervention as the EX group and followed for an additional 6 months. Functional outcomes were measured at baseline and 3, 6, 9, and 12 months for both groups.Setting:A LTC facility, which included both assisted living (AL) and nursing home (NH) residents.Participants:Twenty frail residents (5 from NH, 15 from AL) aged 75 to 99 years at one LTC facility.Intervention:After random group assignment, the EX group met 1 hour three times per week. An exercise physiologist and LTC staff conducted sessions which included seated range of motion (ROM) exercises and strength training using simple equipment such as elastic resistance bands (therabands) and soft weights. The C group met three times per week and participated in activities such as painting during the first 6 months, before crossing over to exercise.Measurements and Methods:Objective measures of physical and cognitive function were obtained at baseline and 3, 6, 9, and 12 months using the timed get-up-and-go test (TUG), Berg balance scale, physical performance test (PPT), and mini-mental status exam (MMSE). Because we were interested in the impact of exercise on multiple endpoints and to protect the type I error rate, a global hypothesis test was used.Results:There was a significant overall impact across the four measures of the exercise intervention (P = 0.013). Exercise benefit as indicated by the difference between exercise and control conditions showed exercise decreased TUG by 18 seconds, which represents an effect size (in standard deviation units) of 0.50, increased PPT scores by 1.3, with effect size = 0.40, increased Berg scores by 4.8, with effect size of 0.32, and increased MMSE by 3.1, with effect size = 0.54. Except for the Berg, 90% confidence intervals on these exercise effects excluded 0.Conclusion:Frail elderly in a LTC facility were able to participate and benefit from a strength training program. The program was delivered with low-cost equipment by an exercise physiologist and LTC staff. The advantage of such a program is that it provides recreational and therapeutic benefits.
Baum EE; Jarjoura D; Polen AE; Faur D; Rutechi G
Journal of the American Medical Directors Association
2003
2003-04-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s1525-8610(04)70279-0" target="_blank" rel="noreferrer noopener">10.1016/s1525-8610(04)70279-0</a>
Enhanced cardiopulmonary reflex inhibition of heart rate during exercise [corrected] [published erratum appears in MED SCI SPORTS EXER 1996 Jan;28(1):154].
Rats; Funding Source; Repeated Measures; Analysis of Covariance; Paired T-Tests; Animal Studies; Statistical Significance; Chemoreceptor Cells; Mechanoreceptors; Two-Way Analysis of Variance; Lung – Physiology; Exertion – Physiology; Heart Rate – Physiology; Reflex – Physiology
Chen C; DiCarlo S E; Collins H L
Medicine & Science in Sports & Exercise
1995
1995-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Confronting the communication gap between conventional and alternative medicine: a survey of physicians' attitudes.
Adult; Female; Male; Human; Questionnaires; Descriptive Statistics; P-Value; Repeated Measures; Middle Age; Internal Consistency; T-Tests; Physician Attitudes; Alternative Therapies – Psychosocial Factors
Crock R D; Jarjoura D; Polen A; Rutecki G W
Alternative Therapies in Health & Medicine
1999
1999-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
The use of sensory electrical stimulation for pressure ulcer prevention.
Adult; Humans; Male; Middle Aged; Ohio; Aged; Double-Blind Method; Regional Blood Flow; *Electric Stimulation Therapy; Buttocks; Muscle Contraction; Paralysis/etiology/physiopathology/*therapy; Pressure Ulcer/etiology/physiopathology/*prevention & control; Sensory Thresholds; Spinal Cord Injuries/complications/physiopathology/*therapy; Treatment Failure; Tomography; Human; Funding Source; Repeated Measures; Outcome Assessment; Clinical Trials; Middle Age; X-Ray Computed; Muscle; Blood Gas Monitoring; Skeletal/blood supply/diagnostic imaging/*innervation; Transcutaneous; Double-Blind Studies; Interface Pressure; Spinal Cord Injuries; Time Series; Pressure Ulcer – Prevention and Control; Electric Stimulation – Methods; Electric Stimulation – Utilization; Skeletal – Radiography
Pressure ulcer prevention is critically important for many people with reduced mobility. The authors investigated whether sensory (sub-motor-threshold) electrical stimulation (ES) may provide a convenient preventive intervention. A double-blinded, repeated measures study design was used to test the hypothesis that repeated use of sensory surface ES improves tissue health status in individuals with motor paralysis. Six adult males with complete spinal cord injury (SCI) were randomly assigned to treatment or control groups. The treatment group received the ES intervention, whereas the control group received a control sham intervention. Repeated tissue health assessments included transcutaneous oxygen tension (T(c)PO(2)), interface pressure mapping, and gluteal computed tomography (CT) studies. An initial increase in T(c)PO(2) following use of subthreshold ES was observed but was not sustained at follow-up. No statistically significant changes before and after treatment were found in regional T(c)PO(2), gluteal muscle area or pressure distribution. Thus subthreshold ES does not appear to have any sustained effects on tissue health status indicative of reduced pressure ulcer risk for individuals with SCI. This implies that a contractile muscle response is critically important and further that subthreshold ES is unlikely to prevent pressure ulcers. Further studies are needed to find solutions for preventing pressure ulcers in high-risk populations.
Kim Jennifer; Ho Chester H; Wang Xiaofeng; Bogie Kath
Physiotherapy theory and practice
2010
2010-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3109/09593981003587037" target="_blank" rel="noreferrer noopener">10.3109/09593981003587037</a>
The Better Weight-Better Sleep Study: A Pilot Intervention in Primary Care.
Adult; Female; Male; Aged; Primary Health Care; Behavior Therapy; Human; Funding Source; Repeated Measures; Scales; Data Analysis Software; Middle Age; Adolescence; Regression; Treatment Outcomes; Randomized Controlled Trials; Cognitive Therapy; Sleep; Obesity – Prevention and Control; Sleep Disorders – Complications
Objective: To explore the feasibility of integrating sleep management interventions with dietary and exercise interventions for obesity in a 12-week randomized trial. Methods: We randomized 49 overweight or obese adult patients either to a better weight (BW) cognitive behavioral intervention, or to a combination of the BW intervention and a better sleep intervention, better weight-better sleep (BWBS). Results: The BWBS group lost weight faster (P=.04), and coping self-efficacy accelerated (P=.01). Conclusions: These preliminary results merit replication in a larger primary care-based trial with a longer continuous intervention and followup period.
Logue Everett E; Bourguet Claire C; Palmieri Patrick A; Scott Edward D; Matthews Beth A; Dudley Patricia; Chipman Katie J
American Journal of Health Behavior
2012
2012-06-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.5993/AJHB.36.3.4" target="_blank" rel="noreferrer noopener">10.5993/AJHB.36.3.4</a>
Effects of Ulnar Collateral Ligament Reconstruction on Pitch Selection in Major League Baseball Pitchers.
Adult; Analysis of Variance; Athletes; Baseball; Collateral Ligaments – Surgery; Descriptive Statistics; Human; Major League Baseball; pitcher; Post Hoc Analysis; Pretest-Posttest Design; Professional; Prospective Studies; Reconstructive – Methods; Repeated Measures; Retrospective Design; Surgery; T-Tests; Tommy John; Ulna – Surgery; ulnar collateral ligament reconstruction
Background: Ulnar collateral ligament (UCL) injuries represent one of the most common impairments to the throwing arm of professional pitchers. Return to play and postoperative performance metrics have been studied extensively, but pitch selection before and after surgery has not been evaluated. Purpose/Hypothesis: This study aimed to characterize the effects of UCL reconstruction on pitch selection in Major League Baseball (MLB) pitchers. We hypothesized that pitchers will throw fewer fastballs and a greater percentage of off-speed pitches after undergoing UCL reconstruction. Study Design: Retrospective cohort study; Level of evidence, 3. Methods: Using publicly available data, we evaluated MLB pitchers who underwent UCL reconstruction between 2003 and 2014. Pitching data were collected for the 2 seasons before UCL reconstruction as well as the first 2 seasons after reconstruction; the data consisted of the total number of pitches thrown and the percentage of fastballs, curveballs, changeups, and sliders. Repeated-measures analysis of variance was used with post hoc least significant difference pairwise t tests to evaluate for statistical significance at P \textless .05. Results: Overall, 87 pitchers (mean age, 28.2 +/- 3.5 years) met all inclusion and exclusion criteria. There was a statistically significant difference in the total number of pitches thrown before and after surgery (P \textless .01) as well as in the percentage of fastballs thrown before and after surgery (P = .02). There was also a statistically significant increase in the use of curveballs between 1 and 2 years postoperatively (7.5% and 8.8%, respectively; P = .01). No other findings were statistically significant. Conclusion: Pitchers who underwent UCL reconstruction were shown to have a statistically significant decline in the percentage of fastballs thrown postoperatively as compared with before injury, with a compensatory trend toward an increased use of curveballs and sliders.
Peterson Eric E; Handwork Patrick; Soloff Lonnie; Schickendantz Mark S; Frangiamore Salvatore J
Orthopaedic journal of sports medicine
2018
2018-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/2325967118810003" target="_blank" rel="noreferrer noopener">10.1177/2325967118810003</a>
Results of the promoting effective advance care planning for elders (PEACE) randomized pilot study.
*Quality of Life; 80 and over; Activities of Daily Living; Advance Care Planning; Advance Care Planning/*organization & administration; Aged; Case Management – Methods; Chi Square Test; Community-Institutional Relations; Comparative Studies; Decision Making; Descriptive Statistics; Disease Management; Family; Female; Frail Elderly; Geriatric Assessment/methods; Health Promotion; Health Resource Utilization; Health Services for the Aged/organization & administration; Home Care Services/*organization & administration; Human; Humans; Interdisciplinary Communication; Long Term Care; Long-Term Care/*organization & administration; Male; Medicaid – Ohio; Multidisciplinary Care Team; Ohio; Outcomes (Health Care); Palliative Care; Palliative Care/organization & administration; Patient; Physicians; Pilot Projects; Pilot Studies – Ohio; Program Evaluation; Psychological Tests; Quality of Life; Random Assignment; Reference Values; Repeated Measures; Scales; Spiritual Care; T-Tests; Treatment Outcome
The specific aim of the PEACE pilot study was to determine the feasibility of a fully powered study to test the effectiveness of an in-home geriatrics/palliative care interdisciplinary care management intervention for improving measures of utilization, quality of care, and quality of life in enrollees of Ohio's community-based long-term care Medicaid waiver program, PASSPORT. This was a randomized pilot study (n=40 intervention [IG], n=40 usual care) involving new enrollees into PASSPORT who were \textgreater60 years old. This was an in-home interdisciplinary chronic illness care management intervention by PASSPORT care managers collaborating with a hospital-based geriatrics/palliative care specialist team and the consumer's primary care physician. This pilot was not powered to test hypotheses; instead, it was hypothesis generating. Primary outcomes measured symptom control, mood, decision making, spirituality, and quality of life. Little difference was seen in primary outcomes; however, utilization favored the IG. At 12 months, the IG had fewer hospital visits (50% vs. 55%, P=0.65) and fewer nursing facility admissions (22.5% vs. 32.5%, P=0.32). Using hospital-based specialists interfacing with a community agency to provide a team-based approach to care of consumers with chronic illnesses was found to be feasible. Lack of change in symptom control or quality of life outcome measures may be related to the tools used, as these were validated in populations closer to the end of life. Data from this pilot study will be used to calculate the sample size needed for a fully powered trial.
Radwany Steven M; Hazelett Susan E; Allen Kyle R; Kropp Denise J; Ertle Denise; Albanese Teresa H; Fosnight Susan M; Moore Pamela S
Population Health Management
2014
2014-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1089/pop.2013.0017" target="_blank" rel="noreferrer noopener">10.1089/pop.2013.0017</a>
Effects of artifact rejection and Bayesian weighting on the auditory brainstem response during quiet and active behavioral conditions.
Adult; Female; Male; College; Analysis of Variance; Students; Artifacts; Evoked Potentials; Human; Descriptive Statistics; Repeated Measures; Post Hoc Analysis; Comparative Studies; T-Tests; Auditory; Brainstem; Noise – Prevention and Control
PURPOSE: To evaluate the effects of 2 noise reduction techniques on the auditory brainstem response (ABR). METHOD: ABRs of 20 normal hearing adults were recorded during quiet and active behavioral conditions using 2 stimulus intensity levels. Wave V amplitudes and residual noise root-mean-square values were measured following the offline application of artifact rejection and Bayesian weighting. Repeated measures analysis of variance and Bonferroni adjusted pairwise t tests were utilized to evaluate significant main effects and interactions between the 2 noise reduction techniques. RESULTS: ABRs recorded during the quiet behavioral condition resulted in minimal differences in wave V amplitude and noise reduction improvement, suggesting that the 2 techniques were equally effective under ideal recording situations. During the active behavioral condition, however, the techniques differed significantly in the ability to preserve the evoked potential and reduce noise. Consequently, strict artifact rejection levels resulted in an inherent underestimation of wave V amplitudes when compared with the Bayesian approach. CONCLUSION: Artifact rejection had a detrimental effect on waveform morphology of the ABR. This could lead to difficulty in ABR interpretation when patients are active and ultimately result in diagnostic errors.
Sanchez JT; Gans D
American Journal of Audiology
2006
2006-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1044/1059-0889(2006/019)" target="_blank" rel="noreferrer noopener">10.1044/1059-0889(2006/019)</a>