adding action observation training to conventional inpatient physiotherapy is associated with a greater degree of recovery in patients who have undergone a primary total knee replacement.

Objective: The purpose of this study was to investigate the effectiveness of action observation therapy (AOT) compared with written information in patients submitted to a physical therapy program after primary total hip arthroplasty (THA). Methods: We conducted a prospective clinical trial. Twenty-four patients with THA, 62.5% female (aged 69.0 ± 8.5 years), received AOT in addition to conventional physical therapy (experimental group) or written information in addition to conventional physical therapy (exercise and information group) for 10 sessions. Outcomes used were visual analog scale, hip active and passive range of motion, Barthel Index, Short Form 36 (SF-36) Health Survey, Tinetti Scale, and Lequesne Index measurements. All measures were collected at baseline and at the end of the intervention. Repeated measures analysis of variance was used to examine the interventions effects within groups and between groups. Results: No relevant baseline differences were observed between groups. Both treatments produced statistically significant improvements on visual analog scale, active and passive range of motion, Barthel Index, SF-36, Tinetti Scale, and Lequesne Index immediately after the intervention (all, P b .001). SF-36 (physical functioning subscale) revealed a statistically significant intergroups difference (P = .02) after treatment. Conclusions: Both treatments were effective at improving pain, functional status, quality of life, and gait features in patients with primary THA. In addition to conventional physical therapy, AOT improved perceived physical function more than written information. Trial Registration Identifier: NCT02861638. (J Chiropr Med 2016;15:229-234)

[Purpose] In this study, we sought to evaluate the relationship between the Barthel Index and the Mini Nutritional Assessment Short Form in a cohort of elderly patients hospitalized in the General Rehabilitation Center. [Subjects and Methods] Three hundred and forty-four patients underwent an extensive evaluation, which included the following tests: 1) a Mini Nutritional Assessment Short Form to evaluate nutritional status; and 2) a Barthel Index assessment to evaluate functional status. We categorized patients into three age groups (65–74 yrs, 75–84 yrs, and >85 yrs). Barthel Index cutoff scores were defined as ≥45 out of 100 for better functional status and <45 for worse functional status. [Results] Significant associations between age distribution and the scores obtained with the Barthel Index and Mini Nutritional Assessment Short Form were found; nutritional status measured with Mini Nutritional Assessment Short Form and functional status measured with the Barthel Index were positively related. [Conclusion] This study shows that the Mini Nutritional Assessment Short Form value was associated with the Barthel Index score, and that these scores varied with age.

Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia

Background: As chronicity represents one of the major challenges in the healthcare of aging populations, the understanding of how chronic diseases distribute and co-occur in this part of the population is needed. Objectives: The aims of this study were to evaluate and compare patterns of diseases identified with cluster analysis in two samples of hospitalized elderly. Methods: Data were obtained from the multicenter ‘Registry Politerapie SIMI (REPOSI)' that included people aged 65 or older hospitalized in internal medicine and geriatric wards in Italy during 2008 and 2010. The study sample from the first wave included 1,411 subjects enrolled in 38 hospitals wards, whereas the second wave included 1,380 subjects in 66 wards located in different regions of Italy. To analyze patterns of multimorbidity, a cluster analysis was performed including the same diseases (19 chronic conditions with a prevalence >5%) collected at hospital discharge during the two waves of the registry. Results: Eight clusters of diseases were identified in the first wave of the REPOSI registry and six in the second wave. Several diseases were included in similar clusters in the two waves, such as malignancy and liver cirrhosis; anemia, gastric and intestinal diseases; diabetes and coronary heart disease; chronic obstructive pulmonary disease and prostate hypertrophy. Conclusion: These findings strengthened the idea of an association other than by chance of diseases in the elderly population.