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Osteoarthritis (OA) is among the top 10 of most disabling diseases in the Western world. It is the major cause of pain and disability among the elderly. This book provides a contextual review of recent research on neuromuscular factors and behavioral risk factors for functional decline in OA, with a special emphasis on explanatory mechanisms. In addition, the book discusses innovative approaches to exercise and physical activity in OA, derived from research on behavioral and neuromuscular risk factors for functional decline in OA. Recent research has shown that neuromuscular factors (such as muscle strength, joint laxity) and behavioral factors (such as avoidance of activity, depressed mood) predict pain and disability in OA. Furthermore, exercise and physical activity are among the dominant interventions aiming at reducing pain and disability, and innovative interventions targeting neuromuscular and behavioral interventions have been recently developed. This research has been published as separate papers, with the result that the field is in need of an integrative contextual review that puts the research into theoretical perspective. TARGETED MARKET SEGMENTS Rehabilitation specialists, health psychologists, gerontologists, rheumatologists, pain specialists
Background: Osteoarthritis is a medical condition that has doubled since 1950 and is mostly prevalent in elderly individuals. Despite varied beneficial effects of physical activity, research has shown that people with osteoarthritis engage less in physical activities than persons without osteoarthritis. The purpose of this study is to examine the relationship between osteoarthritis, physical activity, and physical functioning. Methods: This study used cross sectional data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). Participants were 18 or older and completed survey sections on general health, physical functioning, and health conditions. Descriptive statistics were calculated to determine the prevalence of osteoarthritis, describe sociodemographic characteristics, functional limitations, and physical activity levels among the sample. Linear regression was to determine the association between osteoarthritis and physical activity among all participants and separately among participants 60 and older. Results: A total of 5106 participants (M=2763, F=2343) were included in this study with a mean age of 50.51±17.81 years and a mean body mass index of 29.71±7.40. A total of 711 (13.9%) of participants reported having osteoarthritis. On average, participants reported a median of 30 minutes (IQR=0 to180) of physical activity per week (mean 157.8 ±326.3). There was a significant difference in total physical activity weekly between participants with no arthritis (176.37±340.4) and participants with osteoarthritis (82.71±207.7). For all participants, those with osteoarthritis engaged in 24 (±15) less minutes of physical activity compared to those without osteoarthritis after adjusting for known confounders (p-value
Abstract: Osteoarthritis (OA) is a chronic, degenerative disease afflicting millions of older adults. Knee OA (KOA), specifically, is a leading cause of functional limitation in aged persons. With multiple etiologies and no cure, strategies to mitigate progression, improve physical function and ameliorate pain symptoms are of utmost importance in helping patients to maintain functional ability and independence. Physical activity (PA) is an efficacious, adjuvant treatment approach that is highlighted in literature as having high-quality evidence for improving pain symptoms and increasing functional ability. Indeed, exercise interventions consistently result in clinically meaningful improvements in salient outcomes for KOA patients. Despite these established benefits, successfully promoting maintenance of regular PA participation remains a daunting challenge. PURPOSE: The purpose of the Improving Maintenance of Physical Activity Trial - Pilot (IMPACT-P), a single-blind, randomized controlled pilot trial, was to compare the efficacy of a traditional exercise training (TRAD) and a group-mediated cognitive-behavioral exercise intervention (GMCB) in producing increased physical activity participation, improving functional ability, increasing SE and improving pain symptoms in older, KOA patients. METHODS: Eighty KOA patients (M age = 63 years) were randomly assigned to GMCB (n = 40) or TRAD (n = 40) interventions. Self-reported (Community Health And Maintenance Program for Seniors) PA participation, accelerometer-determined (Lifecorder) PA participation, pain symptoms (Western Ontario McMasters University Osteoarthritis Index), functional ability (stair climb and 400-meter walk) and self-efficacy measures for stair climb and 400-meter walk performances were obtained at baseline and 3-month follow-up assessments. Analysis was completed with 2 (Treatment) x 2 (Time) ANCOVA controlling for age. RESULTS: The GMCB approach was found to result in significant improvements (both CHAMPS and Lifecorder) in short-term, moderate or greater intensity exercise participation (PAMod+) when compared with a TRAD exercise intervention approach receiving the same exercise prescription and equivalent contact hours. While performance outcomes were not different, subjects were more confident in their ability to complete the functional tasks at the 3-month time point. Of great importance, the TRAD and GMCB interventions promoted decreased pain symptoms after only 3-months of exercise engagement. CONCLUSION: When considered in aggregate, the present findings demonstrate that the GMCB intervention can result in similar improvements in pain symptoms and confidence for completing various functional tasks while promoting more favorable changes in short-term PAMod+ participation when compared with a standard exercise approach. Consequently, an exercise intervention designed to provide training and practice in activity-related behavioral self-regulatory skills may augment changes associated with exercise participation. Evidence from IMPACT-P serves to promote the GMCB approach as a valuable intervention strategy for the design and delivery of future interventions targeting the promotion of PA participation in older, KOA patients.
The Social Security Administration (SSA) administers two programs that provide disability benefits: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. SSDI provides disability benefits to people (under the full retirement age) who are no longer able to work because of a disabling medical condition. SSI provides income assistance for disabled, blind, and aged people who have limited income and resources regardless of their prior participation in the labor force. Both programs share a common disability determination process administered by SSA and state agencies as well as a common definition of disability for adults: "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." Disabled workers might receive either SSDI benefits or SSI payments, or both, depending on their recent work history and current income and assets. Disabled workers might also receive benefits from other public programs such as workers' compensation, which insures against work-related illness or injuries occurring on the job, but those other programs have their own definitions and eligibility criteria. Selected Health Conditions and Likelihood of Improvement with Treatment identifies and defines the professionally accepted, standard measurements of outcomes improvement for medical conditions. This report also identifies specific, long-lasting medical conditions for adults in the categories of mental health disorders, cancers, and musculoskeletal disorders. Specifically, these conditions are disabling for a length of time, but typically don't result in permanently disabling limitations; are responsive to treatment; and after a specific length of time of treatment, improve to the point at which the conditions are no longer disabling.
The first edition of Handbook of Human Factors and Ergonomics in Health Care and Patient Safety took the medical and ergonomics communities by storm with in-depth coverage of human factors and ergonomics research, concepts, theories, models, methods, and interventions and how they can be applied in health care. Other books focus on particular human
A basic easy guide to creating your own walking fitness plan, including how to get started and stay motivated.
This new edition of the comprehensive and renowned textbook Principles and Practice of Geriatric Medicine offers a fully revised and updated review of geriatric medicine. It covers the full spectrum of the subject, features 41 new chapters, and provides up-to-date, evidence-based, and practical information about the varied medical problems of ageing citizens. The three editors, from UK, USA and France, have ensured that updated chapters provide a global perspective of geriatric medicine, as well as reflect the changes in treatment options and medical conditions which have emerged since publication of the 4th edition in 2006. The book includes expanded sections on acute stroke, dementia, cardiovascular disease, and respiratory diseases, and features a new section on end-of-life care. In the tradition of previous editions, this all-encompassing text continues to be a must-have text for all clinicians who deal with older people, particularly geriatric medical specialists, gerontologists, researchers, and general practitioners. This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from Google Play or the MedHand Store. Praise for the 4th edition: "...an excellent reference for learners at all clinical and preclinical levels and a useful contribution to the geriatric medical literature." —Journal of the American Medical Association, November 2006 5th edition selected for 2012 Edition of Doody's Core TitlesTM
This book translates the new findings in exercise research for the elderly for busy practitioners, trainees, students and administrators. This book provides practical strategies that can be implemented immediately in the common settings in which practitioners care for adults. The format includes key points and case examples which showcase the strong evidence supporting exercise by older adults as a key tool to enhance health, prevent serious outcomes, such as hospitalization and functional loss, and as part of the treatment plan for diseases that are common in older adults. Written by experts in the field of exercise in older persons, this book is a guide to maintaining quality of life and functional independence from frail to healthy aging adults. Strategies and exercises are discussed for specific care settings and illustrated via links to video examples, to ensure readers can immediately apply described techniques. Exercise for Aging Adults: A Guide for Practitioners is a useful tool for physicians, residents in training, medical students, physical therapists, gerontology advance practice nurse practitioners, assisted living facility administrators, directors of recreation, and long-term care directors.
Those who are affected by osteoarthritis (OA) of the knee have shown decreased levels of functional capacity and quality of living. This disability has been linked to decreased levels of strength and physical activity caused by pain or fatigue. Resistance training and increased levels of physical activity have shown to improve these deficits. However, an efficient way to treat a large number of patients by increasing physical activity levels has not yet been determined. Furthermore, it is unknown if a simple, body weight-based exercise program is capable of achieving similar gains as previously-developed, machine-based programs. This thesis examined the effects of a group-based, eight-week therapeutic exercise regimen on functional performance, self-reported outcomes and physical activity levels in elderly female patients with knee OA. The study design for this pilot project was that of an observational study with an embedded case series. Seven patients (mean age = 56.0±5.42) were included in the group exercise regimen. The exercise regimen was performed once a week and included body weight exercises, balancing, and walking. Self-reported outcomes and pain were measured via the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Numeric Pain Rating Scale (NPRS). Functional performance was measured by use of the chair stand test (CST), timed up and go test (TUG), stair climb test (SCT), and the six-minute walk test (6MW). Physical activity levels were measured by use of accelerometers and the UCLA activity scale. All measures were collected one week previous to the eight-week exercise regimen and one week following the exercise regimen. Overall, WOMAC (34.57±15.52 to 23.42±11.96) and NPRS (5.43±1.81 to 2.29±2.93) scores improved as a result of the exercise regimen. Also, the CST (10.21±1.07 reps to 12.00±1.61 reps), TUG (9.65±1.42s to 8.23±1.44s), SCT (13.03±0.70s to 11.6±1.07s) and 6MW (454.09±59.77m to 504.21±54.64m) functional performance measures all improved as a result of the exercise regimen. All measures of self-reported outcomes, pain, and functional performance showed moderate to large effect sizes. However, only the NPRS, CST, and SCT had associated confidence intervals that did not cross zero. In general, physical activity levels did not show overall improvements as a result of the intervention. Only improvements seen in moderate levels of physical activity (211.08±68.57 min to 272.21±97.05 min) were distinguishable from the intervention. In conclusion, the implementation of an eight-week therapeutic exercise regimen resulted in gains in functional performance and self-reported outcomes. However, these gains did not translate to improvements in physical activity levels. This type of intervention shows promise in improving symptoms for women with knee OA.