Risks of falls among older adults are multifactorial in nature. A combined training program might be beneficial on fall-related outcomes. This study aimed to explore the effects of group-based physical-cognitive trainings on physical and psychological outcomes among older adults with type 2 diabetes mellitus (T2DM) and balance impairment. Fall incidence were also determined. Thirty-seven older adults with T2DM and balance impairment were randomly assigned to control and intervention groups. The intervention program comprised of 24 training sessions of 45-60 min exercise for 8 weeks. The exercise consisted of warm-up, aerobic exercise by nine square stepping, resistance exercise combined with cognitive training and cool down. All participants were assessed at baseline, 4 and 8 weeks after intervention, and 1-year follow-up. Both groups reported similar rates of falls. Global cognition, depressive symptoms, and fear of falling did not differ between groups at any time. The Timed Up & Go (TUG) test, alternate stepping test (AST), knee extensors, ankle plantarflexors, and dorsiflexors strength differed at 4 weeks. TUG, AST, hip abductors, knee flexors, ankle plantarflexors, and dorsiflexors strength differed at 8 weeks. The activity of daily living (ADL), TUG test (P= 0.002) and AST, hip extensors and abductors, knee extensors and flexors, ankle plantarflexors and dorsiflexors were different at 1-year follow-up. The group-based physical-cognitive training could benefit older adults with T2DM in terms of maintaining ADL. The intervention could reduce fall risk factors by improving balance and lower limb muscle strength among older adults with T2DM and balance impairment.

INTRODUCTION: Occupational imbalance of overloaded online education and sleep deprivation has been complained by Thai occupational therapy students (OTS) during the worldwide pandemic of coronavirus disease 2019 (COVID-19) e.g., feeling asleep in the classroom, inactive engagement in problem-based learning. METHODS: This cross-sectional study aims to survey the OTS (n = 52 out of 128) regarding many standardized tools: smartphone addiction, internet addiction, sleep quality, sleep hygiene, and emotional states. Data analysis includes Pearson’s and Spearman’s rank-order correlations, Chi-square tests, and calculation of point prevalence rates. RESULTS: A strong correlation of smartphone and internet addiction was found (r = 0.703, p < 0.001). Moderate correlations were addressed including sleep quality and smartphone addiction (r = 0.566), sleep quality and stress (r = 0.574), sleep quality depression (r = 0.554), and anxiety and smartphone addiction (r = 0.512). This study has reported point prevalence rates, such as 23.44% poor sleep quality, 17.96% smartphone addiction, and 7.81% anxiety. CONCLUSION: The unwell sleep OTS are gaining comorbidities of smartphone and internet addiction and negative emotional states than those well sleep OTS. A restoration of occupational balance will be required for those poor sleep quality and anxiety.

Online teaching might not assist Occupational Therapy Students (OTS) after Covid-19. This study identified strong predictors of sleep quality, sleep hygiene, and emotional states in two academic years of Thai OTS. A total of 42 samples were stratified and a longitudinal following-up was conducted. State and sleep variables were assessed using Thai version of the Pittsburgh Sleep quality Index (T-PSQI), Sleep Hygiene Index (SHI), and Depression Anxiety Stress Scales (DASS-21). Poor sleep hygiene and quality were not significantly changed for nine months, but anxiety, depression, and stress scores significantly increased. An overloaded online schedule of nine months can be a factor in poor scores on state and sleep assessments. Emotional states seemed to gain more than one predictor in longer period of online teaching included a high expectation while the OTS were facing with a transitional environment between academic classroom and clinical practice after the COVID-19 crisis. Therefore, online teaching may be combined with emotional support and case conference toward interprofessional collaboration. Overloaded online schedule can be a factor in poor state and sleep management in the OTS. Both academic and fieldwork educators should provide positive learning environments which enhance interpersonal communication with social relaxation.

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