Integrating Technology Into Clinical Practice for the Assessment of Balance and Mobility: Perspectives of Exercise Professionals Practicing in Retirement and Long-term Care.

OBJECTIVE: To explore exercise professionals' perspectives on technology integration for balance and mobility assessment practices in retirement and long-term care. SETTING: A private residential care organization in Ontario, Canada, with 18 sites providing accommodation and services for older adults. DESIGN: A qualitative descriptive approach was used including semistructured focus group interviews. Open-ended questions explored perceptions of technology integration along with factors influencing its adoption. Analysis involved preliminary coding based on research questions, review and discussion of emerging themes, and final, resultant coding for each category. PARTICIPANTS: Exercise professionals (kinesiologists and exercise therapists) (N=18). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: All participants felt that technology could enhance their practice by supporting programming, communication, and/or information management. Potential barriers to technology integration related primarily to the need to accommodate the broad range of complex health conditions present among clients, which would impact (1) their ability to engage with the technology and (2) relevance of technology-derived outcomes. Specific concerns related to individuals with significant cognitive and/or functional impairment. Solutions to these barriers emphasized the need for flexible technology and appropriate normative data to maximize the potential for uptake. CONCLUSIONS: The participating exercise professionals working in a retirement and long-term care setting saw technology as a potentially effective addition to current clinical practice. To increase the likelihood for clinical uptake, technology must be maximize flexibility in order to accommodate a wide range of physical and cognitive abilities and meet specific needs related to setting and job responsibilities. The findings emphasize the need for continuous dialogue between technology producers and end users for successful development and implementation.

A Scoping Review of Physical Rehabilitation in Long-Term Care: Interventions, Outcomes, Tools.

Residents in long-term care (LTC) often require physical rehabilitation (PR) to maintain/improve physical function. This scoping review described the breadth of literature regarding PR in LTC to date, synthesizing PR interventions that have been evaluated, outcomes used, and tools for determining service eligibility. A structured search, conducted in six licensed databases and grey literature, identified 381 articles for inclusion. Most interventions were delivered and evaluated at the resident level and typically were multicomponent exercise programs. Performance-based measures, activities of daily living, and mood were the most frequently reported outcomes. A key knowledge gap was PR in relation to goals, such as quality of life. Future studies should reflect medically complex residents who live in LTC, and length of residents' stay should be differentiated. Intervention studies should also explore realistic delivery methods; moreover, tool development for determining service eligibility is necessary to ensure equality in rehabilitative care across the LTC sector.