Validación de un modelo intercultural de envejecimiento exitoso en población española / Validation of an intercultural successful aging model in Spanish population

Aportar evidencia empírica del ajuste del modelo de envejecimiento exitoso de Iwamasa e Iwasaki en una muestra española. El modelo contempla como indicadores de buen envejecer satisfacción con la vida y bienestar. Los resultados de la validación del modelo basados en una muestra de 593 adultos mayores cursando estudios a lo largo del ciclo vital (tasa de respuesta 77%) señalan como factores más importantes para el envejecimiento con éxito la salud física para la satisfacción con la vida (38%) y el apoyo social o red social (27% para ambos indicadores). Se destaca la importancia de la espiritualidad como elemento cohesionador, con fuertes relaciones con las variables predictoras de envejecimiento exitoso recogidas por el modelo teórico

To provide empirical evidence of the Iwamasa and Iwasaki’s successful aging model in a Spanish sample. The model includes as indicators of good aging life satisfaction and well-being. The results of model validation based on a sample of 593 older adults studying Lifespan Learning (response rate 77%) indicates as the most important factors for successful aging physical health for life satisfaction (38%), and social support or social network (27% for both indicators). The importance of spirituality stands out as a cohesive element with strong relations with the predictors of successful aging collected by the theoretical model

Exploring relations among mindfulness facets and various meditation practices: Do they work in different ways?

Several meditation practices are associated with mindfulness-based interventions but little is known about their specific effects on the development of different mindfulness facets. This study aimed to assess the relations among different practice variables, types of meditation, and mindfulness facets. The final sample was composed of 185 participants who completed an on-line survey, including information on the frequency and duration of each meditation practice, lifetime practice, and the Five Facet Mindfulness Questionnaire. A Multiple Indicators Multiple Causes structural model was specified, estimated, and tested. Results showed that the Model's overall fit was adequate: χ2 (1045)=1542.800 (p<0.001), CFI=0.902, RMSEA=0.042. Results revealed that mindfulness facets were uniquely related to the different variables and types of meditation. Our findings showed the importance of specific practices in promoting mindfulness, compared to compassion and informal practices, and they pointed out which one fits each mindfulness facet better.

Envejecimiento y espiritualidad: estructura factorial y fiabilidad de dos escalas / Aging and spirituality: factorial structure and reliability of 2 scales

Introducción. En el área de la gerontología, el estudio de la mejora de la salud y calidad de vida —cómo envejecer «con éxito»—, la espiritualidad juega un papel clave y constituye uno de los tópicos de la investigación actual. Sin embargo, su incorporación en la literatura científica está resultando ardua y lenta, hecho en parte debido a la ausencia de medidas desarrolladas y validadas especialmente para su uso en el ámbito hispanohablante. Este trabajo tiene como objetivo ofrecer evidencia de las propiedades psicométricas de dos instrumentos de medida de la espiritualidad: la Functional Assessment of Chronic Illness Therapy Spiritual Well-Being (FACIT-Sp) y el Cuestionario Grupo de Espiritualidad de la Sociedad Española de Cuidados Paliativos (GES). Material y métodos. Para ello, se contó con una muestra de 224 personas mayores de Valencia (España), sobre la que se estimaron dos análisis factoriales confirmatorios, con las estructuras propuestas a priori para cada uno de los instrumentos, así como diversos coeficientes de fiabilidad. Resultados. Ambos modelos presentaron un ajuste adecuado a los datos: χ251=104,97 (p<0,01); CFI=0,973; RMSEA=0,076 para el FACIT-Sp y χ217=31,76 (p>0,05); CFI=0,996; RMSEA=0,050 para el Cuestionario GES. También se encontraron índices de fiabilidad que apoyaban el uso de estas medidas en población mayor, con alfas de las escalas de 0,85 y 0,86, respectivamente. Conclusiones. Estos resultados pueden servir como punto de inicio para la inclusión de la espiritualidad en los trabajos que tengan por objetivo desengranar los mecanismos que producen un envejecimiento con éxito en este ámbito (AU)

Introduction. In the field of gerontology, the study of the improvement of health and quality of life, and «successfully aging», spirituality plays a key role and, is one of the current research approaches. However, its incorporation into scientific literature is arduous and slow, a fact that is in part due to the absence of developed and validated measurement tools, particularly, in the Spanish speaking area. This work aims to present evidence of the psychometric properties of two tools for the measurement of spirituality: the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being (FACIT-Sp) and the GES Questionnaire. Materials and methods. A sample of 224 elderly persons from Valencia (Spain) was recruited, on which two confirmatory factor analyses were estimated, with the proposed a priori structures for each tool, together with several reliability coefficients. Results. Both models presented an good fit to the data: χ251=104.97 (P<.01); CFI=.973; RMSEA=.076 for the FACIT-Sp, and χ217=31.76 (P>.05); CFI=.996; RMSEA=.050 for the GES Questionnaire. Reliability indices also supported the use of the scales in elderly population, with alphas of .85 and .86, respectively. Conclusions. These results may be useful as a starting point to include spirituality in works that aim to discover the mechanisms involved in successful aging (AU)

[Aging and spirituality: Factorial structure and reliability of 2 scales]. / Envejecimiento y espiritualidad: estructura factorial y fiabilidad de dos escalas.

INTRODUCTION: In the field of gerontology, the study of the improvement of health and quality of life, and «successfully aging¼, spirituality plays a key role and, is one of the current research approaches. However, its incorporation into scientific literature is arduous and slow, a fact that is in part due to the absence of developed and validated measurement tools, particularly, in the Spanish speaking area. This work aims to present evidence of the psychometric properties of two tools for the measurement of spirituality: the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being (FACIT-Sp) and the GES Questionnaire. MATERIALS AND METHODS: A sample of 224 elderly persons from Valencia (Spain) was recruited, on which two confirmatory factor analyses were estimated, with the proposed a priori structures for each tool, together with several reliability coefficients. RESULTS: Both models presented an good fit to the data: χ(2)51=104.97 (P<.01); CFI=.973; RMSEA=.076 for the FACIT-Sp, and χ(2)17=31.76 (P>.05); CFI=.996; RMSEA=.050 for the GES Questionnaire. Reliability indices also supported the use of the scales in elderly population, with alphas of .85 and .86, respectively. CONCLUSIONS: These results may be useful as a starting point to include spirituality in works that aim to discover the mechanisms involved in successful aging.

Descripción de los resultados y costes de una intervención preventiva a nivel respiratorio en el anciano institucionalizado: ensayo controlado aleatorizado / Cost-consequence analysis of respiratory preventive intervention among institutionalized older people: Randomized controlled trial

Introducción. En el anciano institucionalizado con limitación funcional se evidencia una mayor reducción de la funcionalidad de la musculatura respiratoria (MR). Los objetivos de este estudio son evaluar los resultados y costes de una intervención de entrenamiento de la MR mediante Pranayama en población anciana institucionalizada con limitación funcional. Material y métodos. Estudio controlado aleatorizado desarrollado en ancianos institucionalizados con limitación para la deambulación (n = 54). La intervención consistió en el entrenamiento de la MR mediante Pranayama, durante 6 semanas (5 sesiones/semana). Los resultados se midieron en relación con la función de la MR mediante las presiones inspiratoria y espiratoria máximas y la ventilación máxima voluntaria, en 4 tiempos. También se valoró la satisfacción percibida por el grupo experimental (GE) a través de un cuestionario ad hoc. Se estimaron los costes directos e indirectos de la intervención desde la perspectiva social. Resultados. El GE reveló una mejora significativa de la fuerza (presiones inspiratoria y espiratoria máximas) y de la resistencia (ventilación máxima voluntaria) de la MR. Además, un 92% del GE refirió una satisfacción alta. Los costes sociales totales, directos e indirectos, ascendieron a 21.678 Euros. Conclusiones. Esta evaluación revela que los resultados en términos de la función de la MR son significativos, que la intervención es bien tolerada y valorada por el residente, y los costes de la intervención son moderados (AU)

Introduction. The institutionalized elderly with functional impairment show a greater decline in respiratory muscle (RM) function. The aims of the study are to evaluate outcomes and costs of RM training using Pranayama in institutionalized elderly people with functional impairment. Material and methods. A randomized controlled trial was conducted on institutionalized elderly people with walking limitation (n = 54). The intervention consisted of 6 weeks of Pranayama RM training (5 times/week). The outcomes were measured at 4 time points, and were related to RM function: the maximum respiratory pressures and the maximum voluntary ventilation. Perceived satisfaction in the experimental group (EG) was assessed by means of an ad hoc questionnaire. Direct and indirect costs were estimated from the social perspective. Results. The GE showed a significant improvement related with strength (maximum respiratory pressures) and endurance (maximum voluntary ventilation) of RM. Moreover, 92% of the EG reported a high satisfaction. The total social costs, direct and indirect, amounted to Euros 21,678. Conclusions. This evaluation reveals that RM function improvement is significant, that intervention is well tolerated and appreciated by patients, and the intervention costs are moderate (AU)

[Cost-consequence analysis of respiratory preventive intervention among institutionalized older people: randomized controlled trial]. / Descripción de los resultados y costes de una intervención preventiva a nivel respiratorio en el anciano institucionalizado: ensayo controlado aleatorizado.

INTRODUCTION: The institutionalized elderly with functional impairment show a greater decline in respiratory muscle (RM) function. The aims of the study are to evaluate outcomes and costs of RM training using Pranayama in institutionalized elderly people with functional impairment. MATERIAL AND METHODS: A randomized controlled trial was conducted on institutionalized elderly people with walking limitation (n=54). The intervention consisted of 6 weeks of Pranayama RM training (5 times/week). The outcomes were measured at 4 time points, and were related to RM function: the maximum respiratory pressures and the maximum voluntary ventilation. Perceived satisfaction in the experimental group (EG) was assessed by means of an ad hoc questionnaire. Direct and indirect costs were estimated from the social perspective. RESULTS: The GE showed a significant improvement related with strength (maximum respiratory pressures) and endurance (maximum voluntary ventilation) of RM. Moreover, 92% of the EG reported a high satisfaction. The total social costs, direct and indirect, amounted to Euro 21,678. CONCLUSIONS: This evaluation reveals that RM function improvement is significant, that intervention is well tolerated and appreciated by patients, and the intervention costs are moderate.

Effects of inspiratory muscle training and yoga breathing exercises on respiratory muscle function in institutionalized frail older adults: a randomized controlled trial.

BACKGROUND: In older adults, respiratory function may be seriously compromised when a marked decrease of respiratory muscle (RM) strength coexists with comorbidity and activity limitation. Respiratory muscle training has been widely studied and recommended as a treatment option for people who are unable to participate in whole-body exercise training (WBET); however, the effects of inspiratory muscle training and yoga breathing exercises on RM function remain unknown, specifically in impaired older adults. PURPOSE: To evaluate the effects of inspiratory threshold training (ITT) and yoga respiratory training (YRT) on RM function in institutionalized frail older adults. METHODS: Eighty-one residents (90% women; mean age, 85 years), who were unable to perform WBET (inability to independently walk more than 10 m), were randomly assigned to a control group or one of the 2 experimental groups (ITT or YRT). Experimental groups performed a supervised interval-based training protocol, either through threshold inspiratory muscle training device or yoga breathing exercises, which lasted 6 weeks (5 days per week). Outcome measures were collected at 4 time points (pretraining, intermediate, posttraining, and follow-up) and included the maximum respiratory pressures (maximum inspiratory pressure [MIP] and maximum expiratory pressure [MEP]) and the maximum voluntary ventilation (MVV). RESULTS: Seventy-one residents completed the study: control (n = 24); ITT (n = 23); YRT (n = 24). The treatment on had a significant effect on MIP YRT (F(6,204) = 6.755, P < .001, η2 = 0.166), MEP (F(6,204) = 4.257, P < .001, η2 = 0.111), and MVV (F(6,204) = 5.322, P < .001, η2 = 0.135). Analyses showed that the YRT group had a greater increase of RM strength (MIP and MEP) and endurance (MVV) than control and/or ITT groups. CONCLUSION: Yoga respiratory training appears to be an effective and well-tolerated exercise regimen in frail older adults and may therefore be a useful alternative to ITT or no training, to improve RM function in older population, when WBET is not possible.

Intervención fisioterápica preventiva del deterioro de la musculatura respiratoria en ancianas institucionalizadas con limitación funcional / Physiotherapy Intervention for Preventing the Respiratory Muscle Deterioration in Institutionalized Older Women with Functional Impairment

Introducción: En el anciano de edad avanzada (> 80 años) la función respiratoria puede verse afectada cuando a la presencia de comorbilidad y la pérdida de movilidad se suma el descenso de la fuerza de la musculatura respiratoria (MR). La literatura médica ha mostrado que el entrenamiento de la MR puede ser una intervención efectiva para mejorar la funcionalidad y prevenir el deterioro clínico, especialmente en la población con debilidad de la MR. El objetivo del estudio fue evaluar la efectividad del entrenamiento de la MR en la fuerza y resistencia de esta musculatura, en ancianas institucionalizadas con limitación funcional. Método: Se asignaron aleatoriamente 54 residentes con limitación para deambular (media 85 años, DE 6,7) a un grupo control (n = 27) y entrenado (n = 27). Se desarrolló un programa de entrenamiento supervisado, mediante Threshold ®IMT, 5 días por semana durante 6 semanas. Las variables principales fueron: la presión inspiratoria máxima (PImáx), la presión espiratoria máxima (PEmáx) y la ventilación voluntaria máxima (MVV), medidas en las semanas 0, 4, 7 y 10.ResultadosLos análisis estadísticos no revelaron cambio en la PImáx (F3,114 = 1,04, p = 0,368, R2 = 0,027), PEmáx (F3,114 = 1,86, p = 0,14, R2 = 0,047) y MVV (F3,114 = 1,74, p = 0,162, R2 = 0,044) entre ambos grupos tras la intervención. No obstante, la carga de trabajo mejoró significativamente con el entrenamiento (F5,100 = 72,031, p < 0,001, R2 = 0,791). Conclusión: El dispositivo de entrenamiento umbral en un programa interválico de 6 semanas no produce una mejora significativa de los parámetros relacionados con la fuerza y la resistencia de la MR, en la población estudiada(AU)

Introduction: In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness. The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. Method: Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold®IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10.ResultsStatistical analysis revealed no significant differences in PImax (F3,114=1.04, p=0.368, R2=0.027), PEmax (F3,114=1.86, p=0.14, R2=0.047) and MVV (F3,114=1.74, p=0.162, R2=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F5,100=72.031, p<0.001, R2=0.791). Conclusion: In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population(AU)

Physiotherapy intervention for preventing the respiratory muscle deterioration in institutionalized older women with functional impairment.

INTRODUCTION: In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness. The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. METHOD: Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold(®)IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PI(max)), maximum expiratory pressure (PE(max)) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10. RESULTS: Statistical analysis revealed no significant differences in PI(max) (F(3,114)=1.04, p=0.368, R(2)=0.027), PE(max) (F(3,114)=1.86, p=0.14, R(2)=0.047) and MVV (F(3,114)=1.74, p=0.162, R(2)=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F(5,100)=72.031, p<0.001, R(2)=0.791). CONCLUSION: In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population.

Electroestimulación en el tratamiento de la mano hemipléjica espástica después de un ictus: estudio aleatorizado / Electrical stimulation in the treatment of the spastic hemiplegic hand after stroke: a randomized study

Fundamento y objetivo: Se ha señalado que la estimulación eléctrica neuromuscular (EENM) puede favorecer la recuperación motora de la mano tras un ictus. El objetivo de este estudio se basó en examinar el efecto de un protocolo de electroestimulación sobre el rango articular y la fuerza de la mano de un grupo de pacientes mayores con hemiplejia espástica tras ictus. Pacientes y método: Veinte pacientes mayores de 60 años con afectación de la mano tras ictus fueron asignados aleatoriamente a un grupo experimental (rehabilitación convencional y EENM) o un grupo control (rehabilitación convencional). La EENM se aplicó en los extensores de muñeca y dedos 30 minutos 3 días/semana durante 8 semanas. Las medidas de resultado incluyeron pruebas goniométricas y dinamométricas. Se evaluaron al inicio, y después de 4 y 8 semanas de tratamiento. Resultados: Tras el tratamiento, el grupo experimental mostró mejoras significativas (p<0,05) en el rango de movimiento (ángulo de reposo, extensión activa y extensión pasiva de la articulación de la muñeca, y ángulo de reposo de las articulaciones metacarpofalángicas de los dedos), así como en la fuerza de la mano (fuerza de prensión y pinza). Conclusiones: Los cambios observados parecen estar asociados con la presencia de intervención y sugieren que el protocolo de EENM aplicado podría ser un útil complemento en el tratamiento rehabilitador para mejorar el déficit motor de la mano en pacientes cuidadosamente seleccionados después de un ictus (AU)

Background and objective: It has been claimed that neuromuscular electrical stimulation (NMES) may enhance hand motor recovery after a stroke. The aim of this study was to examine the effect of an electrostimulation protocol on range of motion and strength of the hand in a group of elderly patients with spastic hemiplegia after a stroke. Patients and method: 20 elderly patients 60 years old and over with hand impairment due to stroke were randomly assigned to either the experimental group (conventional rehabilitation and NMES) or control group (conventional rehabilitation). NMES was applied on wrist and finger extensors 30min 3 days/week for 8 weeks. Outcome measurements included goniometry and dynamometry tests. The patients were evaluated at baseline, after 4 and 8 weeks of treatment. Results:After the treatment, the experimental group showed significant improvements (p<0,05) in range of motion: resting wrist angle, active wrist extension, passive wrist extension and resting metacarpophalangeal angle of fingers; and strength of hand: grip and pinch strength. Conclusion: The observed changes seem to be associated with the presence of intervention and they suggest that the NMES protocol applied could be a useful complementary rehabilitation treatment to improve hand motor impairment in carefully selected patients after a stroke (AU)

[Electrical stimulation in the treatment of the spastic hemiplegic hand after stroke: a randomized study]. / Electroestimulación en el tratamiento de la mano hemipléjica espástica después de un ictus: estudio aleatorizado.

BACKGROUND AND OBJECTIVE: It has been claimed that neuromuscular electrical stimulation (NMES) may enhance hand motor recovery after a stroke. The aim of this study was to examine the effect of an electrostimulation protocol on range of motion and strength of the hand in a group of elderly patients with spastic hemiplegia after a stroke. PATIENTS AND METHOD: 20 elderly patients 60 years old and over with hand impairment due to stroke were randomly assigned to either the experimental group (conventional rehabilitation and NMES) or control group (conventional rehabilitation). NMES was applied on wrist and finger extensors 30 min 3 days/week for 8 weeks. Outcome measurements included goniometry and dynamometry tests. The patients were evaluated at baseline, after 4 and 8 weeks of treatment. RESULTS: After the treatment, the experimental group showed significant improvements (p<0,05) in range of motion: resting wrist angle, active wrist extension, passive wrist extension and resting metacarpophalangeal angle of fingers; and strength of hand: grip and pinch strength. CONCLUSION: The observed changes seem to be associated with the presence of intervention and they suggest that the NMES protocol applied could be a useful complementary rehabilitation treatment to improve hand motor impairment in carefully selected patients after a stroke.