Background: Physical activity for persons with Parkinson Disease (PD) is recommended yet little is known about the physical activity levels in this patient population. The primary aim was to assess the feasibility of ...Background: Physical activity for persons with Parkinson Disease (PD) is recommended yet little is known about the physical activity levels in this patient population. The primary aim was to assess the feasibility of using a direct measurement and self-report measure of physical activity in patients with PD. Methods: Physical activity was recorded in 11 out-patients with mild to moderate PD. An accelerometer based sensor system (SenseWear Pro Armband?) which was worn continuously over 2 days was used to measure physical activity. Minute by minute energy expenditure and steps per day were recorded. Self-report physical activity was measured using the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH) which assessed average weekly activity. Results: Using the accelerometer based sensor system, 83% of the day was spent in sedentary activity with the majority active time spent at a light intensity (2.7 [SD 2.0] hrs/day). Self-reported mean number of hours for activities greater than 2.0 METs was 3.4 (SD 1.5) hrs/day. Although the overall time spent in activity did not differ between the accelerometer and SQUASH, partici- pants reported a higher proportion of activities at the moderate and vigorous intensities than the accelerometer recorded. Conclusions: Measurement of physical activity is a challenge in persons with PD given the disease-related symptoms. We found that, by all accounts, a self-report measure of physical activity should be complemented with a direct measure of physical activity.展开更多
Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Reside...Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services;2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.展开更多
文摘Background: Physical activity for persons with Parkinson Disease (PD) is recommended yet little is known about the physical activity levels in this patient population. The primary aim was to assess the feasibility of using a direct measurement and self-report measure of physical activity in patients with PD. Methods: Physical activity was recorded in 11 out-patients with mild to moderate PD. An accelerometer based sensor system (SenseWear Pro Armband?) which was worn continuously over 2 days was used to measure physical activity. Minute by minute energy expenditure and steps per day were recorded. Self-report physical activity was measured using the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH) which assessed average weekly activity. Results: Using the accelerometer based sensor system, 83% of the day was spent in sedentary activity with the majority active time spent at a light intensity (2.7 [SD 2.0] hrs/day). Self-reported mean number of hours for activities greater than 2.0 METs was 3.4 (SD 1.5) hrs/day. Although the overall time spent in activity did not differ between the accelerometer and SQUASH, partici- pants reported a higher proportion of activities at the moderate and vigorous intensities than the accelerometer recorded. Conclusions: Measurement of physical activity is a challenge in persons with PD given the disease-related symptoms. We found that, by all accounts, a self-report measure of physical activity should be complemented with a direct measure of physical activity.
文摘Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services;2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.
