Exercise Interventions, Gait, and Balance in Older Subjects with Distal Symmetric Polyneuropathy

Quigley, Patricia; Bulat, Tatjana; Schulz, Brian W.; Friedman, Yvonne; Hart-Hughes, Stephanie; Richardson, James K.; Barnett, Scott D.

doi:10.1097/phm.0000000000000052

Cited by 27 publications

(22 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Functional tests evaluated after rehabilitation, in line with other studies, evidenced a global improvement in all patients irrespective of their underlying disease 26,27 or age. 28 …”

Section: Discussionsupporting

confidence: 87%

Biodex Fall Risk Assessment in the Elderly With Ataxia

et al. 2016

View full text Add to dashboard Cite

The aim of this study was to evaluate if the Biodex Fall Risk Assessment could provide an age-adjusted index useful for classifying patients at “risk of fall.”This was a cohort study conducted on 61 chronic patients, in stable conditions, having a history of ataxia, difficulty in walking or loss of balance, and aged >64 years. These patients were coming from home to our Institute undergoing a period of in-hospital standard rehabilitation. Assessment of clinical parameters was performed at entry. Functional scales (Functional Independence Measure [FIM] for motor and cognitive function, Barthel G, Tinetti POMA), and the Biodex Fall Risk Index (FRI) were performed at entry and discharge. The Normalized FRI, obtained adjusting FRI to the reported maximum predictive FRI for the relevant age, identified 2 types of patients: those with a greater risk of fall than expected for that age, labeled Case 1 (Normalized FRI>1); and those with an equal or even lesser risk of fall than expected for that age, labeled Case 0 (Normalized FRI≤1).FRI, Normalized FRI as well as independent variables as age, sex, pathology group, FIM, BarthelG, were considered in a multiple regression analysis to predict the functional improvement (i.e., delta Tinetti Total score) after rehabilitation.Normalized FRI is useful in assessing patients at risk of falls both before and after rehabilitation. At admission, the Normalized FRI evidenced high fall risk in 46% of patients (Case 1) which decreased to 12% after rehabilitation, being greater than age-predicted in 7 patients (Case 1–1) despite the functional improvement observed after the rehabilitation treatment. Normalized FRI evidenced Case 1–1 patients as neurological, “very old” (86% in age-group 75–84 years), and with serious events at 18 to 24 months’ follow-up. Normalized FRI, but not FRI, at admission was a predictor of improvement in Tinetti Total scores.The normalized FRI effectively indicated patients at higher risk of fall, in whom health deterioration, falls, or cognitive decline was later documented at follow-up. The normalized FRI could be a standardized measure for identifying frailer patients becoming a further criterium of discharge home and marker of fall risk at home.

show abstract

“…Functional tests evaluated after rehabilitation, in line with other studies, evidenced a global improvement in all patients irrespective of their underlying disease 26,27 or age. 28 …”

Section: Discussionsupporting

confidence: 87%

Biodex Fall Risk Assessment in the Elderly With Ataxia

et al. 2016

View full text Add to dashboard Cite

show abstract

“…When compared to the reference group of VR-12 PCS greater than 50, LOS increased by an additional 0.40 adjusted days for VR-12 scores 20–29, and scores less than 20 increased by an additional 0.64 days. While preoperative physical function, as assessed by stair climbing and use of mobility aids, has been previously reported to predict LOS and discharge to an inpatient facility 17,19–21,30,32,40 , there is no reported association between preoperative patient-reported overall physical function, measured here by VR-12 PCS, and LOS and discharge to an inpatient facility.…”

Section: Discussionmentioning

confidence: 64%

Preoperative body mass index and physical function are associated with length of stay and facility discharge after total knee arthroplasty

et al. 2017

View full text Add to dashboard Cite

BACKGROUND Hospital length of stay (LOS) and facility discharge are primary drivers of the cost of total knee arthroplasty (TKA). The purpose of this study was to identify modifiable patient factors that were associated with increased LOS and facility discharge after TKA. METHODS Prospective data were reviewed from 716 consecutive, primary TKA procedures performed by 2 arthroplasty surgeons between 2006 and 2012 at a single institution. Preoperative body mass index (BMI), Veterans Rand-12 (VR-12) physical component score (PCS), and hemoglobin level were collected in addition to patient demographics and surgical details. Multivariate linear and logistic models were constructed to predict LOS and facility discharge, respectively. RESULTS After adjustment, higher BMI was associated with increased LOS in a dose-response effect: Compared to normal weight (BMI <25) overweight (25–29.9) was associated longer LOS by 0.32 days (P=0.038), class-I obesity (30–34.9) by 0.33 days (P=0.024), class-II obesity (35–39.9) by 0.67 days (P=0.012) and class-III obesity (>40) by 1.15 days (P<0.001). Class-III obesity also was associated with facility discharge (odds ratio=2.08, P=0.008). Poor PCS was associated with increasing LOS: compared to PCS≥50, PCS 20–29 was associated with a LOS increase of 0.40 days (P=0.014) and PCS<20 with a LOS increase of 0.64 days (P=0.031). CONCLUSION Patient BMI has a dose-response effect in increasing LOS. Poor PCS was associated with increased LOS in a similar dose-response manner. These associations for of BMI and PCS suggest that improvement preoperatively, by any amount, may potentially translate to decreased LOS and perhaps lower the cost associated with TKA.

show abstract

“…They report that the group participating in TC did improve in gait, specifi cally stride length and time spent in single-limb support, suggesting that TC, at least for a short-duration study, can improve gait parameters. 48 For purposes of comparison, it is unfortunate that the authors chose to use the 8-foot Up & Go as opposed to the more standard TUG because comparisons between studies cannot be made.…”

Section: Balance Exercisementioning

confidence: 99%