ObjectivesOur primary aim of this pilot study was to test feasibility of the planned design, the interventions (education plus telephone coaching), and the outcome measures, and to facilitate a power calculation for a future randomized controlled trial to improve adherence to recovery goals following hip fracture.DesignThis is a parallel 1:1 randomized controlled feasibility study.SettingThe study was conducted in a teaching hospital in Vancouver, BC, Canada.ParticipantsParticipants were community-dwelling adults over 60 years of age with a recent hip fracture. They were recruited and assessed in hospital, and then randomized after hospital discharge to the intervention or control group by a web-based randomization service. Treatment allocation was concealed to the investigators, measurement team, and data entry assistants and analysts. Participants and the research physiotherapist were aware of treatment allocation.InterventionIntervention included usual care for hip fracture plus a 1-hour in-hospital educational session using a patient-centered educational manual and four videos, and up to five postdischarge telephone calls from a physiotherapist to provide recovery coaching. The control group received usual care plus a 1-hour in-hospital educational session using the educational manual and videos.MeasurementOur primary outcome was feasibility, specifically recruitment and retention of participants. We also collected selected health outcomes, including health-related quality of life (EQ5D-5L), gait speed, and psychosocial factors (ICEpop CAPability measure for Older people and the Hospital Anxiety and Depression Scale).ResultsOur pilot study results indicate that it is feasible to recruit, retain, and provide follow-up telephone coaching to older adults after hip fracture. We enrolled 30 older adults (mean age 81.5 years; range 61–97 years), representing a 42% recruitment rate. Participants excluded were those who were not community dwelling on admission, were discharged to a residential care facility, had physician-diagnosed dementia, and/or had medical contraindications to participation. There were 27 participants who completed the study: eleven in the intervention group, 15 in the control group, and one participant completed a qualitative interview only. There were no differences between groups for health measures.ConclusionWe highlight the feasibility of telephone coaching for older adults after hip fracture to improve adherence to mobility recovery goals.
Objectives: To determine gait characteristics of community-dwelling older adults at different speeds and during a crosswalk simulation. Methods: Twenty-two older adults completed walking trials at self-selected slow, usual, and fast paces, and at a crosswalk simulation, using the GAITRite walkway. These objective measures were complemented by self-report health and mobility questionnaires. Results: Gait speeds at self-selected slow, usual, and fast paces were 98.7 (18.1) cm/s, 140.9 (20.4) cm/s, and 174.0 (20.6) cm/s, respectively, and at simulated crosswalk conditions was 144.2 (22.3) cm/s. For usual pace, right step length variability was 2.0 (1.4) cm and step time variability was 13.6 (7.2) ms, compared with 2.4 (1.3) cm and 17.3 (9.7) ms, respectively, for crosswalk conditions. Discussion: Our sample of healthy older adults walked at a speed exceeding standards for crossing urban streets; however, in response to a crosswalk signal, participants adopted a significantly faster and more variable gait.
Background: Children with cancer can experience pain throughout their clinical course. Accurate assessment of pain can lead to more effective pain management. Purpose: To identify outcome measures used to assess pain in children and to appraise each tool based on psychometric properties, clinical utility, and application to pediatric oncology. Methods: The authors searched 3 electronic databases (MEDLINE, CINAHL, and SCOPUS), using specific search terms to identify measures used to evaluate pain in children with cancer. Of the 956 articles found, 270 were reviewed and 17 measures were identified for further assessment. Each outcome measure was reviewed by 2 independent reviewers, who then ranked each measure using the 4-point Cancer EDGE Task Force Outcome Measure Rating Scale. Discrepancies were discussed to reach consensus. Results: The Wong-Baker FACES Pain Rating Scale is highly recommended (4). The Oucher Pain Scale, Adolescent Pediatric Pain Tool, and Pieces of Hurt Assessment Tool/Poker Chip Tool are recommended (3). Six additional tools are deemed reasonable to use (2) and 7 tools are not recommended (1). Conclusions: Based on clinical utility, psychometric properties, and application to children with oncologic diseases, 4 outcome measures are recommended for the assessment of pain in children with a diagnosis of cancer.
Date Presented 03/27/20 This case series examined differences in participation in OT sessions involving AAT versus no AAT. Nine children with neurological conditions completed three similar activities, once with and once without AAT. Repetitions and length of engagement were recorded for each activity. No consistent differences between the conditions were recorded, perhaps because the integration of a dog added a dynamic component, affecting how activities were completed. Primary Author and Speaker: Ellen Herlache-Pretzer Additional Authors and Speakers: Melissa Winkle Contributing Authors: Kristin Brown, Brianna Bommarito, Jodi Andres, Sarah Hoffmann, Amanda Ewer
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