Geroscience: The Intersection of Basic Aging Biology, Chronic Disease, and Health No abstract available

The Influence of Presurgical Factors on the Rehabilitation Outcome of Patients Following Hip Arthroplasty Purpose The aims of this study were to evaluate the relationship between sociodemographic information, anthropometric values, clinical and presurgery factors, and length of stay (LOS) in older adult patients undergoing total hip arthroplasty (THA) and to predict which factors can delay the start of the rehabilitation program and increase the corresponding LOS. Methods A prospective cohort study was conducted in an orthopedic inpatient unit with 40 patients undergoing THA. Findings The Morse Fall Scale scores and pain intensity scores delayed the commencement of the rehabilitation program. Gender and social support were important determinants of LOS and rehabilitation outcome following THA. The weight of the lower limb without osteoarthritis followed by pain intensity and overweight patients also influenced LOS. Conclusions/Clinical Relevance Functional outcomes after THA are variable, and the rehabilitation process is an important factor to regain their normal level of physical functioning. This factor can have an impact in the discharge of patients, in resource allocation and in health care of older adult patients.

Older Adults With Hip Arthroplasty: An Individualized Transitional Care Program Background Most older adults with hip fracture surgery experience functional decline (FD), causing devastating outcomes. However, few studies have examined the effects of nursing interventions to reduce FD for them. Purpose The aim of the study was to evaluate an individualized transitional care program (ITCP) to reduce FD for older adults with hip arthroplasty. Methods The study was quasiexperimental, with a nonequivalent control group design. A total of 37 participants scheduled for hip arthroplasty were recruited—21 in the experimental and 16 in the control group. Findings Two weeks following surgery (i.e., just prior to discharge), the ITCP group displayed less fear of falling than the usual care group. Moreover, the experimental group displayed objectively less FD with increased activities of daily living and Timed Up and Go scores, 6 weeks after hip arthroplasty. Conclusions This study provides evidence of the effectiveness of nurse-led rehabilitative practices to reduce FD in older adults with hip arthroplasty. Clinical Relevance The ITCP promoted individual physical functioning for older adults with hip arthroplasty. This study results can aid healthy transitions of elderly patients with other various diseases.

Reliability and Criterion-Related Validity of the Seated Posture Scale Purpose Earlier, we reported development and initial testing of a rapid, low burden measure of wheelchair seated posture (the Seated Posture Scale [SPS]) for research and clinical use. The purpose of this study was to test the intrarater reliability, interrater reliability, and criterion related validity of the SPS. Design We used a descriptive design to test and develop the instrument. Methods We used the method described by Walter, Donner, and Eliasziw to determine 46 participants were needed, from two Veterans Administration nursing homes or CLCs (community living centers). Using a digital goniometer to score rapidly and with two trained raters, we scored individual participants simultaneously and again in succession. For criterion related concurrent validity, we also scored each participant with Section 2 of the Seated Postural Control Measure for Adults. Intrarater reliability, interrater reliability, and criterion related, concurrent validity were assessed using kappa statistics for individual instrument items (and corresponding 95% confidence intervals where appropriate) and intraclass correlation coefficients (ICC) for total scores. Findings The intrarater intraclass correlation coefficient (ICC) was .995; interrater ICC was .80; interrater reliability kappas ranged from −.03 to .80. Criterion-related, concurrent validity kappas ranged from .13 to .91. ICC for total scores was .85. Conclusion The SPS has sufficient preliminary validity and reliability to support measurement of wheelchair-seated posture in outcomes research and clinical use. Clinical Relevance In the future, rehabilitation nurses may use the SPS to improve management of wheelchair seated posture, to improve clinical outcomes, particularly for those who do not reposition themselves.

Exploring the Adaptability of Tai Chi to Stroke Rehabilitation Purpose The aim of the study was to assess the feasibility, safety, and preliminary estimates of effectiveness of Tai Chi on functional outcomes in stroke survivors. Design A mixed-method study with a single-group repeated-measure design and in-depth interviews. Methods Fourteen stroke survivors with hemiplegia were recruited to participate in a Tai Chi program, twice weekly for 12 months. Outcomes included physical function, self-efficacy, and activity of daily living measured at 3-month intervals for 12 months. Findings Ten participants (mean age, 68.5 years) completed all assessments with significantly improved balance (χ2 = 14.08, p = .007), flexibility (χ2 = 11.70, p = .020), and self-efficacy (χ2 = 21.84, p < .001) over 12 months. Qualitative results highlighted the positive impact on physical improvement, psychological well-being, social support, and improved confidence in performing activities of daily living. Conclusion An adapted Tai Chi program was safe, feasible, and well received in community-dwelling stroke survivors. Clinical Relevance The Tai Chi-based rehabilitation program shows promise for improving function and balance outcomes related to fall prevention in stroke survivors.

An Exploration of Sensation Seeking in Persons With Disabilities in Rehabilitation Purpose This study reports the findings of a study about sensation-seeking or high-risk/challenging sports in persons who have disabilities. Design Exploratory, cross-sectional, and descriptive. Methods Two hundred and twenty-three recruitment e-mails were sent to potential participants. Data were collected through Qualtrics. Findings Mean score for Contextual Sensation Seeking Questionnaire for Skiing and Snowboarding (M = 30.21, SD = 8.18) was significantly lower than a sample of able-bodied skiers and snowboarders, t(239) = 2.75, p = .006. Mean for impulsive sensation seeking was lower than the same sample of able-bodied athletes cited in a previous study, t(240) = 4.56, p = .001. Means for the Zuckerman Kuhlman Personality Questionnaire subscales were impulsivity (M = 1.98, SD = 4.05) and sensation seeking (M = 6.75, SD = 2.68). Conclusions This group scored lower in sensation seeking compared to able-bodied high-risk/challenging sports activities participants. Sensation seeking is not a motivating factor in this sample. Clinical Relevance Nurses could encourage rehabilitation patients to engage in challenging activities for personal and group mastery.

Using Functional Independence Measure Subscales to Predict Falls—Rapid Assessment Background Falls remain a major issue in inpatient rehabilitation. Decreased scores on the Functional Independence Measure (FIM), given to every patient, have been shown to predict falls risk. Purpose The aim of the study was to extend previous research using FIM to predict falls by using only subscales assessed earliest during admissions to indicate high risk of falls. Design Retrospective cohort study. Methods Two consecutive samples of patients (n1 = 1,553, n2 = 12,301) admitted to a rehabilitation hospital over 9-month and 5-year periods, respectively, were used to evaluate the predictive utility of using only a small number of FIM subscales. Subscales were selected from those assessed earliest and were related to previously published research on falls risk factors. The metric was developed using a historical data set and was validated with a second, separate group of patients. Receiver operating characteristic curves were used to evaluate predictive utility. Findings The combination of Toileting and Expression subscales yielded a comparable area under the curve to the full FIM, and both were greater than the existing method of falls risk assessment. Likelihood of falling was strongly linearly related to score on the Toileting/Expression metric. Conclusions The sum of two FIM subscales can be used to predict which patients may fall during their stay in a rehabilitation hospital. Clinical Relevance The FIM scores are assessed early during a patient’s stay, are required for all Medicare patients, and may be useful for simple, rapid, and accurate assignment of falls risk.

The Influence of Presurgical Factors on the Rehabilitation Outcome of Patients Following Hip Arthroplasty No abstract available

Older Adults with Hip Arthroplasty: An Individualized Transitional Care Program No abstract available

Using Functional Independence Measure Subscales to Predict Falls – Rapid Assessment No abstract available