Walking devices used by the elderly living in rural areas of Thailand.

BACKGROUND: The use of all types of external devices was previously investigated for elderly with and without orthopaedic problems of a developed country. This study describes the proportion, types and the reasons of using a walking device in elderly who live in many rural areas of Thailand. METHODS: Participants (n = 390) were interviewed using a questionnaire to ascertain their demographics, health status and types of walking device required for daily activities. RESULTS: Forty-one participants (11%) used a walking device, particularly when walking long distances due to a fear of falling, musculoskeletal pain, and impaired walking ability. The proportion of walking devices used dramatically increased in participants aged 75 years and over (six times of those aged 60-74 years). Most of the participants used a modified walking stick by their own determination (81%), while only 7% used one according to medical prescription. A significant increase in the need of a walking device was seen in participants aged 75 years and over (OR = 13.9; 95% CI 5.9-32.7; P < 0.001), with a medical problem (OR = 45.9; 95% CI 6.7-73.4; P < 0.001) and who required regular medication (OR = 12.7; 95% CI 5.0-33.6; P = 0.001). CONCLUSION: The findings emphasise the importance of a community health service to promote health status, particularly before 75 years of age.

Effects of cassava wax bath as a new therapeutic approach on patients with plantar fasciitis: a double-blind, randomised clinical trial.

The aim of this study was to investigate the efficacy of a new therapeutic approach (cassava wax bath: CWB) compared with usual care (paraffin wax bath: PWB) in patients with plantar fasciitis (PF). Forty patients with PF were recruited into the study (CWB group, n = 20, PWB group, n = 20). Patients in the CWB group received cassava wax bath and patients in the PWB group received usual care (PWB). The primary outcome was pain intensity (PI). The secondary outcomes were the pressure pain threshold (PPT), pain frequency (PFr), foot and ankle ability measure (FAAM), and ankle dorsiflexion range of motion (ADROM). All outcomes were assessed before and after the five-week intervention, one month, and three months after the intervention period. After the intervention, statistically significant improvement was found in all outcomes after the intervention period and during the one month and three months follow-up study in both groups (P < 0.05). For all outcomes, no between-group differences were seen at any post-assessment time-point, except for PFr (P < 0.05). In conclusion, the findings of this study indicate that CWB was significantly superior to PWB in reducing PFr. For the other outcomes, CWB and PWB were both equally effective in reducing PI and increasing PPT, FAAM, and ADROM in patients with PF. Therefore, CWB might be considered as a novel useful therapeutic option for PF patients.Trial registration: Thai Clinical Trials Registry (TCTR) (Identification number: TCTR20220128002), First posted date: 28/01/2022.

Development of a mobile application for assessing reaction time in walking and TUG duration: Concurrent validity in female older adults.

Introduction: The TUG can be used to distinguish between people who fall and people who don't fall. To evaluate cognitive dual-task performance while walking for fall prediction, TUG-dual was frequently employed. A recent study has created a mobile application that enables simple interaction to provide greater convenience for monitoring the duration of TUG, TUG-subtraction, and reaction time. Objective: The research aim was to ascertain the concurrent validity of the mobile application that was developed for the clinical assessment of TUG, TUG-subtraction, and reaction time. Methods: Twenty-nine older persons participated in this study. The testing protocol involved the TUG, TUG-subtraction, and reaction time assessment. For TUG and TUG-subtraction, the duration to complete the task was recorded by the APDM Mobility Lab system and the mobile application. For the reaction time tests, the reaction times (msec) were recorded by the Multi Choice Reaction timer and the Mobile application. The TUG durations recorded by the APDM Mobility Lab system were correlated with those recorded by the mobile application to verify the concurrent validity using Pearson's product moment correlation coefficient. Also, the reaction time by the Multi Choice Reaction timer was correlated with the mobile application. Bland-Altman plots were used to explore the existence of any systematic differences between the measurements. Results: Our results showed very strong correlations between the TUG and TUG-subtraction duration derived from the APDM Mobility Lab system and the mobile application (r = 0.96 and 0.96, respectively). For the reaction time, the results showed a moderate correlation between the reaction time derived from the mobile application and the Multi Choice Reaction Timer (r = 0.67). Conclusion: The mobile application, which allows measurement in TUG and TUG-subtraction, is a highly valid tool for TUG duration assessment. However, this application is capable for assess the reaction time with moderate validity for reaction time assessment.

The use of functional performance tests by primary health-care providers to determine walking ability with and without awalking device in community-dwelling elderly.

Background: Primary health-care (PHC) providers are important for community involvement in health promotion and prevention efforts, particularly today that the number of elderly is increasing dramatically. The use of a standard practical measure would help in promoting the effectiveness of referral and monitoring processes. Objectives: To investigate the use of functional performance tests in terms of the appropriate cutoff point to determine walking ability with and without a walking device in community-dwelling elderly, and reliability of the tests when used by PHC providers. Methods: Community-dwelling people aged 65 years or older who walked with or without a walking device (n = 309) were interviewed and assessed for information related to the use of a walking device in daily living. Then, they were randomly assessed for their functional ability using the Timed Up and Go Test (TUG), Five Times Sit-to-Stand Test (FTSST), and the 10-Meter Walk Test (10MWT). PHC providers, including a physical therapist, village health volunteer, and a caregiver, assessed 30 participants' functional performances, to address rater reliability of the tests. Results: The findings suggested that outcomes of the tests (TUG < 12 s, FTSST < 15 s, and 10MWT > 0.8 m/s) can indicate the ability of walking without a walking device of the participants. These tests could be used by PHC providers, except for the FTSST by a caregiver. Conclusions: The findings offer a clear cutoff point for promoting the involvement of PHC providers and the standardization of a screening, monitoring, and referral process among many clinical and community settings.