Abstract. Falls are a common problem among elderly persons, but the training for the fall prevention is not well established. Therefore, the effectiveness of toe grasp training was examined in this study. Spontaneous postural sway was tested on elderly persons (N=19) with eyes open and eyes closed. Using a force plate, sway responses were quantified in terms of the total track length, the environmental areas, the maximum amplitude distance of X-axis, and the maximum amplitude distance of Y-axis. The data was compared between the toe grasp training group and the control group. Total track length (eyes open and eyes closed), environmental areas (eyes open) and maximum amplitude distance of X-axis (eyes open and eyes closed) were improved significantly in the toe grasp training group. The activation of foot mechanoreceptors and improvements of the eye-leg coordination were thought to be factors in this improvement and toe grasp training is expected to be effective for fall prevention of the aged.
IntroductionFrailty increases the risk of poor health outcomes, disability, hospitalization, and death in older adults and affects 7%–12% of the aging population. Secondary impacts of frailty on psychological health and socialization are significant negative contributors to poor outcomes for frail older adults.MethodThe My Active and Healthy Aging (My-AHA) consortium has developed an information and communications technology–based platform to support active and healthy aging through early detection of prefrailty and provision of individually tailored interventions, targeting multidomain risks for frailty across physical activity, cognitive activity, diet and nutrition, sleep, and psychosocial activities. Six hundred adults aged 60 years and older will be recruited to participate in a multinational, multisite 18-month randomized controlled trial to test the efficacy of the My-AHA platform to detect prefrailty and the efficacy of individually tailored interventions to prevent development of clinical frailty in this cohort. A total of 10 centers from Italy, Germany, Austria, Spain, United Kingdom, Belgium, Sweden, Japan, South Korea, and Australia will participate in the randomized controlled trial.ResultsPilot testing (Alpha Wave) of the My-AHA platform and all ancillary systems has been completed with a small group of older adults in Europe with the full randomized controlled trial scheduled to commence in 2018.DiscussionThe My-AHA study will expand the understanding of antecedent risk factors for clinical frailty so as to deliver targeted interventions to adults with prefrailty. Through the use of an information and communications technology platform that can connect with multiple devices within the older adult's own home, the My-AHA platform is designed to measure an individual's risk factors for frailty across multiple domains and then deliver personalized domain-specific interventions to the individual. The My-AHA platform is technology-agnostic, enabling the integration of new devices and sensor platforms as they emerge.
In this study, the effect of weightlessness on mechanoreceptors in ACL was investigated in rats with hindlimb suspension. The animals used in the present study were 20 Wistar male rats (weight: 278 ± 16 g). The animals were divided into 2 groups: the Suspension group (n=10, suspended for 4 weeks) and Control group (n=10, non-suspended for 4 weeks). ACL was stained with gold chloride. The frozen section was sliced to be approximately 45 µm in thickness using a cryostat. The tissue preparations were observed through an optical microscope. Based on the criteria proposed by Freeman and Wyke, mechanoreceptor was specified and counted. Four types of nerve endings, Pacinian corpuscle, Ruffini corpuscle, Golgi tendon organ-like receptor, and free nerve ending were observed. In the Susupension group, atypical Pacinian corpuscle, and Ruffini corpuscle were observed. The number of mechanoreceptors were significantly decreased in the Suspension group (median 10) compared with the Control group (median 17) (Mann Whitney U test; Z=-2.65, P<0.01). It might be necessary to perform also to early rehabilitation to prevent the degeneration of mechanoreceptors and take into consideration the nerve control system in the clinical setting.
Abstract. We conducted a prospective study on the actual state of fall occurrence and the related fall factors of some dementia patients admitted to a certain geriatric hospital. Information on falls was obtained from the fall assessment recorded by staff. The number of these subjects totaled 110 (20 males and 90 females), The period of this study was 6 months. Their fall rate during that period was as high as 56%. The frequently occurring places and peak time of fall coincided with the places and times slots in which their activity was enhanced. Most of the injuries suffered due to falls were minor ones, and there were no bone fractures stemming from falls. As for the factors related to a fall, sex, age, complication, MMS score and administered internal medicine was no significant between fallers and nonfallers. Of the subjects affected with cerebrovascular diseases during or before this study period, those with vascular dementia showed the most remarkable trend to fall. It was thought that the results will be useful when applied to the carried out care of elderly persons with dementia.
To clarify the cutoff point of the Functional Independence Measure tool for predicting home discharge of patients in convalescent rehabilitation wards. [Participants and Methods] This retrospective observational study analyzed the data of 91 inpatients with cerebrovascular disease who received rehabilitation treatment at a convalescent rehabilitation ward. We categorized the participants into two groups: the home-discharged group and the non-home discharged group. We divided the outcome parameters in the two groups into different categories and compared them using the Mann-Whitney U test. To identify the relevant cutoff points in a clinical setting, we applied the receiver operating characteristic curve. [Results] In patients with cerebrovascular disease, the Functional Independence Measure motor, cognitive, and total scores were significantly higher in the home-discharged group than in the non-home discharged group. We statistically calculated the Functional Independence Measure motor score cutoff point that can predict home discharge, and the predicted Functional Independence Measure motor score at the time of hospitalization was 53.5-60.0 points. [Conclusion] It is important to start rehabilitation at an early stage and increase the amount of training to increase the likelihood of returning home.
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