Use of Wii Fit for limited supervised balance training in the home was safe and feasible for a selected sample of older adults. Further research is needed to determine clinical efficacy in a larger, diverse sample and ascertain whether Wii Fit exergames can be integrated into physical therapy practice to promote health in older adults.

BackgroundInjury due to falls is a major problem among older adults. Decrements in dual-task postural control performance (simultaneously performing two tasks, at least one of which requires postural control) have been associated with an increased risk of falling. Evidence-based interventions that can be used in clinical or community settings to improve dual-task postural control may help to reduce this risk.PurposeThe aims of this systematic review are: 1) to identify clinical or community-based interventions that improved dual-task postural control among older adults; and 2) to identify the key elements of those interventions.Data sourcesStudies were obtained from a search conducted through October 2013 of the following electronic databases: PubMed, CINAHL, PsycINFO, and Web of Science.Study selectionRandomized and nonrandomized controlled studies examining the effects of interventions aimed at improving dual-task postural control among community-dwelling older adults were selected.Data extractionAll studies were evaluated based on methodological quality. Intervention characteristics including study purpose, study design, and sample size were identified, and effects of dual-task interventions on various postural control and cognitive outcomes were noted.Data synthesisTwenty-two studies fulfilled the selection criteria and were summarized in this review to identify characteristics of successful interventions.LimitationsThe ability to synthesize data was limited by the heterogeneity in participant characteristics, study designs, and outcome measures.ConclusionDual-task postural control can be modified by specific training. There was little evidence that single-task training transferred to dual-task postural control performance. Further investigation of dual-task training using standardized outcome measurements is needed.

BackgroundFalls are a major problem for older adults. Many falls occur when a person’s attention is divided between two tasks, such as a dual task (DT) involving walking. Most recently, the role of personality in walking performance was addressed; however, its association with DT performance remains to be determined.MethodsThis cross-sectional study of 73 older, community-dwelling adults explores the association between personality and DT walking and the role of gender in this relationship. Personality was evaluated using the five-factor model. Single-task (ST) and DT assessment of walking-cognitive DT performance comprised a 1-min walking task and an arithmetic task performed separately (ST) and concurrently (DT). Dual-task costs (DTCs), reflecting the proportional difference between ST and DT performance, were also calculated.ResultsGender plays a role in the relationship between personality and DT. Extraversion was negatively associated with DTC-motor for men (ΔR2 = 0.06, p < 0.05). Conscientiousness was positively associated with DTC-cognition for women (ΔR2 = 0.08, p < 0.01).ConclusionThese findings may lead to effective personality-based early detection and intervention for fall prevention.

Background In-hospital immobility of older adults is associated with hospital-associated functional decline (HAFD). This study examined the WALK-FOR program’s effects on HAFD prevention. Methods A quasi-experimental pre-post two-group (intervention group [IG] n = 188, control group [CG] n = 189) design was applied in two hospital internal medical units. On admission, patients reported pre-hospitalization functional status, which was assessed again at discharge and 1-month follow-up. Primary outcome was decline in basic activities of daily living (BADL), using the Modified Barthel Index. Secondary outcomes were decline in instrumental ADL (Lawton’s IADL scale) and community mobility (Yale Physical Activity Survey). All participants (75.1 ± 7 years old) were cognitively intact and ambulatory at admission. The WALK-FOR included a unit-tailored mobility program utilizing patient-and-staff education with a specific mobility goal (900 steps per day), measured by accelerometer. Results Decline in BADL occurred among 33% of the CG versus 23% of the IG (p = .02) at discharge, and among 43% of the CG versus 30% in the IG (p = .01) at 1-month follow-up. Similarly, 26% of the CG versus 15% of the IG declined in community mobility at 1-month follow-up (p = .01). Adjusted for major covariates, the intervention reduced the odds of decline in BADL by 41% (p = .05) at discharge and by 49% at 1-month follow-up (p = .01), and in community mobility by 63% (p = .02). There was no significant effect of the intervention on IADL decline (p = .19). Conclusions The WALK-FOR intervention is effective in reducing HAFD.

Among patients whose refill records suggested they had 7 days' supply or less on hand, patients in the anticipatory outreach group were more likely than controls to refill a medication within 7 days (26.9% vs 26.3%; OR, 1.03, 95% CI, 1.00-1.06) (Table 2). However, this effect was not consistent across medication types and was most notably observed among patients taking antiseizure medications (29.7% vs 26.1%; OR, 1.20; 95% CI, 1.02-1.41).Discussion | Building strong partnerships between public and private entities is critical to fostering public health resilience within communities, particularly in the face of natural disasters. 3 Such a partnership between the federal government and a large national retail pharmacy chain allowed for the rapid execution of a pragmatic intervention that was associated with small but clear increases in acquisition of chronic medications as Blizzard Jonas approached the Mid-Atlantic region in 2016. Our study has important limitations, including that outreach was provided by a single pharmacy chain, the study had a focus on medication acquisition as opposed to clinical outcomes, and it had smaller sample sizes for analyses by medication type. However, this experience highlights the promise of broader public-private partnerships to leverage retail pharmacies in preparing patients for future natural disasters.