Τετάρτη 14 Φεβρουαρίου 2018

Hearing Loss in Nursing Homes

As audiologists, we are uniquely aware that the elderly are disproportionally impacted by hearing loss and are aware of solutions that might be beneficial for those with hearing loss. Is this knowledge shared by all professionals who work with the elderly?



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Dual-task Related Gait Changes in Individuals with Trans-Tibial Lower Extremity Amputation

Publication date: Available online 13 February 2018
Source:Gait & Posture
Author(s): Susan W. Hunter, Courtney Frengopoulos, Jeffrey Holmes, Ricardo Viana, Michael W.C. Payne
BackgroundThe improvement of gait and mobility are major rehabilitation goals following lower extremity amputations. However, when living in the community many daily activities require the multitasking of motor and cognitive tasks. The dual-task paradigm can be used to evaluate the concurrent performance of mobility and cognitive tasks.Research questionThe purpose of this study was to evaluate the effects of dual-task gait testing in older adults with trans-tibial amputations.MethodsTwenty-four people (15 men, mean age ± SD, 62.72 ± 8.59) with trans-tibial amputation walked on an electronic walkway at i) self-selected comfortable pace and ii) self-selected comfortable pace while counting backwards by threes from a number randomly selected between 100 and 150. Cognitive performance, in the form of corrected response rate, was also evaluated as a single-task.ResultsThe dual-task testing produced poorer performance in velocity (single-task = 58.15 ± 23.16 cm/s, dual-task = 50.92 ± 21.16 cm/s, p = 0.008), cadence (single-task = 76.65 ± 15.84 steps/min, dual-task = 67.85 ± 15.76 steps/min, p = 0.002) and stride time (single-task = 1094 ± 458.28 ms, dual-task = 1241.44 ± 513.73 ms, p = 0.005). Step length, stance time and single limb support time symmetry were also affected, such that less time was spent on the amputated limb during the dual-task testing.SignificanceDual-task testing demonstrated interference resulting in a poor performance in both gait and cognitive performance in trans-tibial amputees. Further research is suggested to evaluate the change in cognition-mobility effects over time and the relationship of this value to future adverse events such as falls and successful outcomes such as community ambulation and reintegration.



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Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

Publication date: Available online 13 February 2018
Source:Gait & Posture
Author(s): Matteo Zago, Chiarella Sforza, Daniela Rita Bonardi, Enrico Eugenio Guffanti, Manuela Galli
BackgroundGait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD.Research questionThus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD.MethodsIn line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool.ResultsSeven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level.SignificanceA convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.



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Dual-task Related Gait Changes in Individuals with Trans-Tibial Lower Extremity Amputation

Publication date: Available online 13 February 2018
Source:Gait & Posture
Author(s): Susan W. Hunter, Courtney Frengopoulos, Jeffrey Holmes, Ricardo Viana, Michael W.C. Payne
BackgroundThe improvement of gait and mobility are major rehabilitation goals following lower extremity amputations. However, when living in the community many daily activities require the multitasking of motor and cognitive tasks. The dual-task paradigm can be used to evaluate the concurrent performance of mobility and cognitive tasks.Research questionThe purpose of this study was to evaluate the effects of dual-task gait testing in older adults with trans-tibial amputations.MethodsTwenty-four people (15 men, mean age ± SD, 62.72 ± 8.59) with trans-tibial amputation walked on an electronic walkway at i) self-selected comfortable pace and ii) self-selected comfortable pace while counting backwards by threes from a number randomly selected between 100 and 150. Cognitive performance, in the form of corrected response rate, was also evaluated as a single-task.ResultsThe dual-task testing produced poorer performance in velocity (single-task = 58.15 ± 23.16 cm/s, dual-task = 50.92 ± 21.16 cm/s, p = 0.008), cadence (single-task = 76.65 ± 15.84 steps/min, dual-task = 67.85 ± 15.76 steps/min, p = 0.002) and stride time (single-task = 1094 ± 458.28 ms, dual-task = 1241.44 ± 513.73 ms, p = 0.005). Step length, stance time and single limb support time symmetry were also affected, such that less time was spent on the amputated limb during the dual-task testing.SignificanceDual-task testing demonstrated interference resulting in a poor performance in both gait and cognitive performance in trans-tibial amputees. Further research is suggested to evaluate the change in cognition-mobility effects over time and the relationship of this value to future adverse events such as falls and successful outcomes such as community ambulation and reintegration.



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Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

Publication date: Available online 13 February 2018
Source:Gait & Posture
Author(s): Matteo Zago, Chiarella Sforza, Daniela Rita Bonardi, Enrico Eugenio Guffanti, Manuela Galli
BackgroundGait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD.Research questionThus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD.MethodsIn line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool.ResultsSeven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level.SignificanceA convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.



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Dual-task Related Gait Changes in Individuals with Trans-Tibial Lower Extremity Amputation

Publication date: Available online 13 February 2018
Source:Gait & Posture
Author(s): Susan W. Hunter, Courtney Frengopoulos, Jeffrey Holmes, Ricardo Viana, Michael W.C. Payne
BackgroundThe improvement of gait and mobility are major rehabilitation goals following lower extremity amputations. However, when living in the community many daily activities require the multitasking of motor and cognitive tasks. The dual-task paradigm can be used to evaluate the concurrent performance of mobility and cognitive tasks.Research questionThe purpose of this study was to evaluate the effects of dual-task gait testing in older adults with trans-tibial amputations.MethodsTwenty-four people (15 men, mean age ± SD, 62.72 ± 8.59) with trans-tibial amputation walked on an electronic walkway at i) self-selected comfortable pace and ii) self-selected comfortable pace while counting backwards by threes from a number randomly selected between 100 and 150. Cognitive performance, in the form of corrected response rate, was also evaluated as a single-task.ResultsThe dual-task testing produced poorer performance in velocity (single-task = 58.15 ± 23.16 cm/s, dual-task = 50.92 ± 21.16 cm/s, p = 0.008), cadence (single-task = 76.65 ± 15.84 steps/min, dual-task = 67.85 ± 15.76 steps/min, p = 0.002) and stride time (single-task = 1094 ± 458.28 ms, dual-task = 1241.44 ± 513.73 ms, p = 0.005). Step length, stance time and single limb support time symmetry were also affected, such that less time was spent on the amputated limb during the dual-task testing.SignificanceDual-task testing demonstrated interference resulting in a poor performance in both gait and cognitive performance in trans-tibial amputees. Further research is suggested to evaluate the change in cognition-mobility effects over time and the relationship of this value to future adverse events such as falls and successful outcomes such as community ambulation and reintegration.



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Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

Publication date: Available online 13 February 2018
Source:Gait & Posture
Author(s): Matteo Zago, Chiarella Sforza, Daniela Rita Bonardi, Enrico Eugenio Guffanti, Manuela Galli
BackgroundGait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD.Research questionThus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD.MethodsIn line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool.ResultsSeven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level.SignificanceA convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.



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