PurposeResearch on effectiveness of low-threshold mobility interventions that are viable for users of residential aged care is scarce. Low-threshold is defined as keeping demands on organizations (staff skills, costs) and participants (health status, discipline) rather low. The study explored the effectiveness of a multi-faceted, low-threshold physical activity program in three residential aged-care facilities in Austria. Main goals were enhancement of mobility by conducting a multi-faceted training program to foster occupational performance and thus improve different aspects of health-related quality of life (QoL).Participants and methodsThe program consisted of a weekly session of 60 minutes over a period of 20 weeks. A standardized assessment of mobility status and health-related QoL was applied before and after the intervention. A total of 222 of 276 participants completed the randomized controlled trial study (intervention group n=104, control group n=118; average age 84 years, 88% female).ResultsSubjective health status (EuroQoL-5 dimensions: P=0.001, d=0.36) improved significantly in the intervention group, and there were also positive trends in occupational performance (Canadian Occupational Performance Measure). No clear effects were found concerning the functional and cognitive measures applied.ConclusionThus, the low-threshold approach turned out to be effective primarily on subjective health-related QoL. This outcome could be a useful asset for organizations offering low-threshold physical activity interventions.

BackgroundMobility is a main issue for health-related quality of life in old age. There is evidence for effects of physical activity (PA) interventions on several dimensions of health for the aged and also, some specific evidence for vulnerable populations, like residents of residential aged care. Research on low-threshold PA interventions for users of residential aged care and documentation of their sustainability are scarce. “Low threshold” implies moderate demands on the qualification of trainers and low frequency of conduct, implying low demands on the health status and discipline of users. Yet the investigation of low-threshold interventions in residential aged care seems important as they might foster participation of users and implementation in everyday routines of provider organizations. An initial study (October 2011 to June 2012) had found intervention effects on health-related quality of life. The objective of this study was to examine sustainability of the effects of a low-threshold PA intervention on health-related quality of life in residential aged care.MethodsData collection took place in three residential aged care homes in Vienna, Austria. At 1-year follow-up (June 2013), participants from the intervention group were interviewed using a standardized questionnaire. Using general mixed linear models and Friedman tests followed by paired t- and Wilcoxon signed-rank tests, we compared outcome measures at follow-up with measures obtained at baseline and at the end of the intervention.ResultsAt the 1-year follow-up assessment, participants’ (mean age 84.7 years; 89.7% female) subjective health status was still significantly increased, equaling a small sustainable intervention effect (Cohen’s d=0.38, P=0.02). In comparison with baseline, a significant decline of reported pain/discomfort (P=0.047) was found. Regarding the subdimensions of health-related quality of life, favorable trends could be observed.ConclusionThe study indicates that effects of a low-threshold PA intervention on health-related quality of life in residential aged care can be sustainable. Addressing hindering factors like poor health status and implementing proactive support and individualization of the program to enable PA for residents might foster sustainability of effects.

The mechanism of injury and clinical presentation of metatarsal fractures in children are age-dependent, with patients five years of age or less and those more than five years of age having different mechanisms of injury and different types of metatarsal fractures.

Long-term care for the aged is an area that has not been in the focus of health promotion so far. The paper describes context, concept and project plan of a 2-year pilot project of comprehensive health-promoting setting development in residential aged care in Austria, and provides an overview over main experiences and results. Austria's most relevant health promotion agencies, a specialized scientific institute and Austria's largest provider of aged care acted as partners. The project aimed at developing elements of a comprehensive approach, but also providing evidence for the effectiveness of health promotion. Therefore, the project combined an organizational development approach with a scientific, randomized controlled study on mobility enhancement for residents. A comprehensive settings approach turned out acceptable for the main stakeholders of aged care (owners and management, staff, residents and residents' relatives). Strategy development, based on a systematic needs assessment, found staff health to be of special interest for the organization (ergonomics, workability over life course), and residents' relatives, got more attention. The mobility study was able to achieve positive results on occupational performance, concerning quality-of-life indicators and reached also formerly inactive groups. After the end of the project, health promotion is still on the agenda of the organization; further developments will be monitored. Good support from the policy level and well-established networking between the aged care provider, health promotion agencies and a network for health promotion in health care seems to have been an important resource for success.

This study provides S-100B reference ranges for pediatric patients based on the largest group of healthy pediatric patients yet analyzed.