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Translating the Group Lifestyle Balance ProgramTM for Use Among Obese and Overweight Adults with Arthritis: Effects on Measures of Balance

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Obesity and arthritis are risk factors for falls. Little is known about the effects of weight loss on balance in people with arthritis. The Group Lifestyle Balance (GLB) ProgramTM is

Obesity and arthritis are risk factors for falls. Little is known about the effects of weight loss on balance in people with arthritis. The Group Lifestyle Balance (GLB) ProgramTM is an evidence-based, lifestyle change program for weight loss in individuals with prediabetes but it hasn’t been evaluated in people with arthritis. The purpose of this pilot study was to evaluate the effectiveness of an adapted version of the GLB on balance outcomes among overweight (Body Mass Index (BMI) >27) individuals with arthritis. A single-group, quasi- experimental design was used to examine the effects of the adapted GLB program on measures of balance and function. All participants (N=17) received the GLB program and completed the following assessments at baseline, 12 weeks and six months: the Timed-Up-and-Go (TUG), 10 Meter gait speed, Fullerton Advanced Balance Scale (FAB) and the Activity Based Confidence survey (ABC). Repeated measures analysis of variance (ANOVAs) were used to examine changes over time in SPSS Version 24. Participants (mean age = 71.7 years) were primarily female (82%), white (94%), and college educated (94%). There was a linear (F1=14.82, p=.002) and quadratic (F1=7.20, p=.017) effect of time for the TUG. There was a linear effect of time on the FAB (F1=7.10, p=.017), and on both the customary (F1=5.44, p=.033) and fast walking pace (F1=7.59, p=.014) 10-meter gait speed assessments. There were no significant changes on the ABC. The Group Lifestyle Balance program may be an effective way to improve balance and function among overweight and obese individuals with arthritis.

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Date Created
  • 2019

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Posture, mobility, and 30-day hospital readmission in older adults with heart failure

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Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older

Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the role of posture and mobility in contributing to, or improving, physical function in older hospitalized adults. No study to date that we are aware of has addressed this in the older heart failure population.

Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.

Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.

Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).

Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.

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Date Created
  • 2015