- Email: [email protected]
Effect of progressive resistance training on motor performance in older adults with mild cognitive impairment
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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632
only showed significant improvements on self-care (p = .02) and social function (p = .00), but not mobility (p = .11). In addition, the treatment group had significant decreased scores of parenting stress level before and after the intervention (p = .03). The control group had no significant differences on parenting stress within group (p = .31). Conclusion(s): This is the first group study to examine the effects of using modified ride-on toy cars on mobility and socialization in the hospital environment. With increased independent mobility, toddlers with disabilities may have more opportunities to learn through observing behaviors and skills of others. These preliminary results demonstrate that this early power mobility training program is beneficial for improving independent mobility and functional skills in toddlers with disabilities. The increased functional skills may enhance parents’ perceptions on their children’s capabilities, which may lead to decreased parenting stress level. A future study with large sample size can be conducted to examine the effects of this training program on daily function and family perceptions in toddlers with different severity levels of mobility impairments. Implications: Clinicians can consider using the customized, low cost and fun toy cars as one option of early mobility training in a hospital-based environment. It can enhance independent mobility and socialization in toddlers with disabilities through active exploration and observing behaviors of others. Keywords: Modified ride-on toy cars; Mobility; Toddler with disability Funding acknowledgements: This study was supported by grants from National Science Council, Taiwan (NSC 1022314-B-182-002). Ethics approval: This study was approved by Institutional Review Board of Chang Gung Medical Foundation, Taiwan (101-3586A3). http://dx.doi.org/10.1016/j.physio.2015.03.3436
Research Report Poster Presentation Number: RR-PO-14-07-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 EFFECT OF PROGRESSIVE RESISTANCE TRAINING ON MOTOR PERFORMANCE IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT Y.-C. Huang 1 , P.-S. Lin 1,2 , M.-L. Chiu 1 , C.-C. Hsieh 1 1 College
of Medicine, Chang Gung University, Department of Physical Therapy & Graduate Institute of Rehabilitation Science, Taoyuan, Taiwan; 2 Chang Gung University, Health Aging Research Center, Taoyuan, Taiwan Background: Dementia and frailty may coexist in elderly persons because both diseases share several pathophysiological mechanisms and phenotypes and are different entities in the same disease spectrum. A systematic review on the effects of implementing physical exercise programs in institutionalized elderly indicated a strong positive effect on improving muscle strength and mobility. In recent studies, loss of muscle strength was reported commonly and associated with cognitive decline or Alzheimer’s disease in older adults. Evidence shown exercise interventions were effective in preventing, delaying, and even reversing the frailty process, but few study investigated the training effects on older adults with mild cognitive impairment (MCI). Purpose: The aim of this study is to investigate the effects of physical training for 3 months on motor performance in older adults with MCI. Methods: The subjects were sixty older adults with MMSE scored between 16 and 23 and were randomly assigned to participate in a progressive resistance training (RT) (n = 30) or a control group (n = 30). The RT group completed 40 min/session, twice weekly for 3 months of progressive resistance training program consisting of ten hydraulic circuit exercise stations targeting the major muscle groups of the upper and lower body. The motor performance outcome measures included Six-Minute Walk Test, Quadriceps Muscle Strength (measured by a hand-held dynamometer), 30 s Chair-Stand Test, Hand Grip Strength, Time Up and Go, One Leg Standing Test, Functional Reach Test, Sit & Reach Test, Drop Ruler Reaction Time Test, 5-Meter Walking Test, Arm Curl and 2-Min Steps Test. Descriptive statistics and one way ANOVA were used for baseline characteristics comparisons. The mean change of follow up Two-way repeated measure ANOVA was used to analyze the intervention effects. Post hoc analyses were performed by independent T tests and paired T tests of the mean changes in 2 time points. Results: There were 31 females and 29 males subjects with mean age ± SD = 82.8 ± 6.4 years. Their mean score
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632
of the Cognitive Ability Screening Instrument (CASI) was 65.8 ± 14.5, without group difference. The RT group completed the exercise program according to protocol with the average adherence rate of 70% and without adverse events. After training, the RT group showed significant groupby-time interactions on 30 s CST (p = .027) and 5-m WT (p = .027). Significant changes during 2 time points were found in many variables with mostly improve or maintain in RT group, but deteriorate in control group. Only 30 s CST (p = .029) showed significant between group effect. Conclusion(s): Three months resistance training program has beneficial effects on many motor performance tests, especially in improving lower extremity endurance and walking speed. Further studies may be needed to know if the training effects different between older adults with normal cognition and with MCI. Implications: Hydraulic circuit progressive resistance training can be implemented in a geriatric rehabilitation setting, which is feasible and effective in improving or maintaining motor performances in older adults with MCI. Keywords: Cognitive impairment; Motor performance; Resistance training Funding acknowledgements: This project was funded by Chang Gung Memorial Hospital Medical Research Fund (CMRPD1B0521). Ethics approval: Ethical approval was obtained from the Chang Gung Medical Foundation Institutional Review Board, Taoyuan, Taiwan. http://dx.doi.org/10.1016/j.physio.2015.03.3437 Special Interest Report Platform Presentation Number: SI-PL-1099 Sunday 3 May 2015 09:03 Room 334–335 THE CONTRIBUTION OF CONCEPTUAL FRAMEWORKS TO KNOWLEDGE TRANSLATION INTERVENTIONS IN PHYSICAL THERAPY A. Hudon 1,2 , M.-J. Gervais 3 , M. Hunt 2,4 1 Université
de Montréal, School of Rehabilitation, Montréal, Canada; 2 Centre for Interdisciplinary Research in Rehabilitation of Greater, Montréal, Canada; 3 Université du Québec à Montréal, Montréal, Canada; 4 McGill University, School of Physical and Occupational Therapy, Montréal, Canada Background: There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated in clinical practice. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used
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in physical therapy knowledge translation interventions and studies to date. Purpose: Knowledge translation in physical therapy implicates multiple stakeholders working in different settings, and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. In this presentation, we demonstrate why these frameworks should be considered important resources to promote the uptake of new evidence in physical therapy practice settings. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Methods: We conducted a literature review in January 2014, using CINAHL, MEDLINE, and EMBASE databases and key words pertaining to knowledge translation and physical therapy, in order to gauge the use of conceptual frameworks for knowledge translation interventions in physical therapy. This review allowed us to identify four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions and to consider limits related to their use. Through this review, we also identified diverse knowledge translation conceptual frameworks, which are used in physical therapy and healthcare. We evaluated five prominent conceptual frameworks and whether they address common barriers to knowledge translation in physical therapy. Results: The four advantages of using conceptual frameworks are that they (1) help map knowledge translation interventions to ensure that essential knowledge translation components are addressed; (2) support efforts to evaluate impacts of the intervention and to promote sustainability; (3) promote the establishment of common ground and enhance communication among stakeholders and (4) encourage transparency and clarity about knowledge translation methods. We also identified two important limitations. Concerns remain regarding the difficulty in demonstrating the benefits of conceptual frameworks in knowledge translation interventions. Also, conceptual frameworks can be misapplied or used in a simplistic or mechanistic fashion. Conclusion(s): In sum, knowledge translation conceptual frameworks have the potential to promote systematic and well-planned knowledge translation interventions in physical therapy. It has been argued that guidance is currently lacking to help healthcare researchers, practitioners, or managers make decisions about which implementation strategies to use, in which contexts, and with what groups of stakeholders. Indeed, planning how to integrate research into practice has been described as a “black box”. Conceptual frameworks for physical therapy knowledge translation can help signpost the process of knowledge translation design and implementation,
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632
only showed significant improvements on self-care (p = .02) and social function (p = .00), but not mobility (p = .11). In addition, the treatment group had significant decreased scores of parenting stress level before and after the intervention (p = .03). The control group had no significant differences on parenting stress within group (p = .31). Conclusion(s): This is the first group study to examine the effects of using modified ride-on toy cars on mobility and socialization in the hospital environment. With increased independent mobility, toddlers with disabilities may have more opportunities to learn through observing behaviors and skills of others. These preliminary results demonstrate that this early power mobility training program is beneficial for improving independent mobility and functional skills in toddlers with disabilities. The increased functional skills may enhance parents’ perceptions on their children’s capabilities, which may lead to decreased parenting stress level. A future study with large sample size can be conducted to examine the effects of this training program on daily function and family perceptions in toddlers with different severity levels of mobility impairments. Implications: Clinicians can consider using the customized, low cost and fun toy cars as one option of early mobility training in a hospital-based environment. It can enhance independent mobility and socialization in toddlers with disabilities through active exploration and observing behaviors of others. Keywords: Modified ride-on toy cars; Mobility; Toddler with disability Funding acknowledgements: This study was supported by grants from National Science Council, Taiwan (NSC 1022314-B-182-002). Ethics approval: This study was approved by Institutional Review Board of Chang Gung Medical Foundation, Taiwan (101-3586A3). http://dx.doi.org/10.1016/j.physio.2015.03.3436
Research Report Poster Presentation Number: RR-PO-14-07-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 EFFECT OF PROGRESSIVE RESISTANCE TRAINING ON MOTOR PERFORMANCE IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT Y.-C. Huang 1 , P.-S. Lin 1,2 , M.-L. Chiu 1 , C.-C. Hsieh 1 1 College
of Medicine, Chang Gung University, Department of Physical Therapy & Graduate Institute of Rehabilitation Science, Taoyuan, Taiwan; 2 Chang Gung University, Health Aging Research Center, Taoyuan, Taiwan Background: Dementia and frailty may coexist in elderly persons because both diseases share several pathophysiological mechanisms and phenotypes and are different entities in the same disease spectrum. A systematic review on the effects of implementing physical exercise programs in institutionalized elderly indicated a strong positive effect on improving muscle strength and mobility. In recent studies, loss of muscle strength was reported commonly and associated with cognitive decline or Alzheimer’s disease in older adults. Evidence shown exercise interventions were effective in preventing, delaying, and even reversing the frailty process, but few study investigated the training effects on older adults with mild cognitive impairment (MCI). Purpose: The aim of this study is to investigate the effects of physical training for 3 months on motor performance in older adults with MCI. Methods: The subjects were sixty older adults with MMSE scored between 16 and 23 and were randomly assigned to participate in a progressive resistance training (RT) (n = 30) or a control group (n = 30). The RT group completed 40 min/session, twice weekly for 3 months of progressive resistance training program consisting of ten hydraulic circuit exercise stations targeting the major muscle groups of the upper and lower body. The motor performance outcome measures included Six-Minute Walk Test, Quadriceps Muscle Strength (measured by a hand-held dynamometer), 30 s Chair-Stand Test, Hand Grip Strength, Time Up and Go, One Leg Standing Test, Functional Reach Test, Sit & Reach Test, Drop Ruler Reaction Time Test, 5-Meter Walking Test, Arm Curl and 2-Min Steps Test. Descriptive statistics and one way ANOVA were used for baseline characteristics comparisons. The mean change of follow up Two-way repeated measure ANOVA was used to analyze the intervention effects. Post hoc analyses were performed by independent T tests and paired T tests of the mean changes in 2 time points. Results: There were 31 females and 29 males subjects with mean age ± SD = 82.8 ± 6.4 years. Their mean score
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632
of the Cognitive Ability Screening Instrument (CASI) was 65.8 ± 14.5, without group difference. The RT group completed the exercise program according to protocol with the average adherence rate of 70% and without adverse events. After training, the RT group showed significant groupby-time interactions on 30 s CST (p = .027) and 5-m WT (p = .027). Significant changes during 2 time points were found in many variables with mostly improve or maintain in RT group, but deteriorate in control group. Only 30 s CST (p = .029) showed significant between group effect. Conclusion(s): Three months resistance training program has beneficial effects on many motor performance tests, especially in improving lower extremity endurance and walking speed. Further studies may be needed to know if the training effects different between older adults with normal cognition and with MCI. Implications: Hydraulic circuit progressive resistance training can be implemented in a geriatric rehabilitation setting, which is feasible and effective in improving or maintaining motor performances in older adults with MCI. Keywords: Cognitive impairment; Motor performance; Resistance training Funding acknowledgements: This project was funded by Chang Gung Memorial Hospital Medical Research Fund (CMRPD1B0521). Ethics approval: Ethical approval was obtained from the Chang Gung Medical Foundation Institutional Review Board, Taoyuan, Taiwan. http://dx.doi.org/10.1016/j.physio.2015.03.3437 Special Interest Report Platform Presentation Number: SI-PL-1099 Sunday 3 May 2015 09:03 Room 334–335 THE CONTRIBUTION OF CONCEPTUAL FRAMEWORKS TO KNOWLEDGE TRANSLATION INTERVENTIONS IN PHYSICAL THERAPY A. Hudon 1,2 , M.-J. Gervais 3 , M. Hunt 2,4 1 Université
de Montréal, School of Rehabilitation, Montréal, Canada; 2 Centre for Interdisciplinary Research in Rehabilitation of Greater, Montréal, Canada; 3 Université du Québec à Montréal, Montréal, Canada; 4 McGill University, School of Physical and Occupational Therapy, Montréal, Canada Background: There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated in clinical practice. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used
eS607
in physical therapy knowledge translation interventions and studies to date. Purpose: Knowledge translation in physical therapy implicates multiple stakeholders working in different settings, and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. In this presentation, we demonstrate why these frameworks should be considered important resources to promote the uptake of new evidence in physical therapy practice settings. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Methods: We conducted a literature review in January 2014, using CINAHL, MEDLINE, and EMBASE databases and key words pertaining to knowledge translation and physical therapy, in order to gauge the use of conceptual frameworks for knowledge translation interventions in physical therapy. This review allowed us to identify four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions and to consider limits related to their use. Through this review, we also identified diverse knowledge translation conceptual frameworks, which are used in physical therapy and healthcare. We evaluated five prominent conceptual frameworks and whether they address common barriers to knowledge translation in physical therapy. Results: The four advantages of using conceptual frameworks are that they (1) help map knowledge translation interventions to ensure that essential knowledge translation components are addressed; (2) support efforts to evaluate impacts of the intervention and to promote sustainability; (3) promote the establishment of common ground and enhance communication among stakeholders and (4) encourage transparency and clarity about knowledge translation methods. We also identified two important limitations. Concerns remain regarding the difficulty in demonstrating the benefits of conceptual frameworks in knowledge translation interventions. Also, conceptual frameworks can be misapplied or used in a simplistic or mechanistic fashion. Conclusion(s): In sum, knowledge translation conceptual frameworks have the potential to promote systematic and well-planned knowledge translation interventions in physical therapy. It has been argued that guidance is currently lacking to help healthcare researchers, practitioners, or managers make decisions about which implementation strategies to use, in which contexts, and with what groups of stakeholders. Indeed, planning how to integrate research into practice has been described as a “black box”. Conceptual frameworks for physical therapy knowledge translation can help signpost the process of knowledge translation design and implementation,