Qualitative research concerning physiotherapy approaches to encourage physical activity in older adults with dementia.

BACKGROUND: Physical exercise is known to improve the level of activities of daily living and physical function in people with dementia; however, symptoms of dementia often pose challenges when implementing physical therapy. This study aimed to elucidate how physiotherapists (PTs) engage with older adults with dementia to encourage exercise and participation in physical activity. METHODS: In this qualitative study, four PTs working with older adults with dementia in long-term care facilities in Japan were recruited and interviewed. We used a modified grounded theory approach to assess how PTs engaged with older adults with dementia during physiotherapy sessions. RESULTS: Based on PT responses, five categories of engagement were identified: "make structured preparations for clients to begin physical activity," "link exercise therapy to a client's daily life," "discover changes in daily life," "ascertain cognitive function," and "accommodate client differences." Concepts were derived under each category. The category "make structured preparations for clients to begin physical activity" served as a preceding stage for PTs to engage with older adults with dementia. PTs linked exercise therapy to each client's daily life activities to encourage voluntary participation in daily physical activity. PTs ensured the performance of routine patterns of movement and modified these movement patterns per clients' differing paces. CONCLUSION: PTs provided exercise and movement training based on various degrees of client involvement and made structured preparations for clients to begin physical activity that were linked to exercise therapy. Our findings may prompt PTs to encourage older people with dementia to participate in physical therapy and benefit from exercise.

Physical therapy processes-interactions between a physical therapist and an older client with dementia.

BACKGROUND: In Japan, the population aging rate highlights the need to examine various care provisions for older adults with dementia, including physical therapy. However, despite its positive effects, there are also many challenges associated with providing physical therapy for older adults with dementia. OBJECTIVE: This qualitative case study examined the interactions between a physical therapist and a patient with dementia and the process by which physical therapy was provided to her. METHODS: This study utilized a modified grounded theory approach to analyze the interview of one physical therapist, a woman with four years of clinical experience who specializes in physical therapy for older adults who provided a 20-minute physical therapy session to her client, a woman in her 80s with dementia who sought to maintain her ability to perform activities of daily living and preserve her independence. Data were collected in January 2017. RESULTS: Fifteen concepts that represent aspects of the services that the therapist provided to her client were identified. Five distinct categories were derived: 1) foundations of the relationship; 2) understanding individual factors; 3) supporting execution of functional activities; 4) assessing cognitive function; and 5) support to ensure safety in daily living. CONCLUSION: Physical therapists help older adults with dementia execute functional activities, which helps ensure their safety and independence, and fosters strong therapist-client relationships. Future studies should interview multiple physical therapists to generate additional concepts. Further, quantifying these concepts and developing tools to assess clients will improve care provision and inform physical therapists with limited experience in treating patients with dementia.

A unique kinesin-like protein, Klp8, is involved in mitosis and cell morphology through microtubule stabilization.

Kinesins are microtubule (MT)-based motors involved in various cellular functions including intracellular transport of vesicles and organelles, and dynamics of chromosomes during cell division. The fission yeast Schizosaccharomyces pombe expresses nine kinesin-like proteins (klps). Klp8 is one of them and has not been characterized yet though it has been reported to localize at the division site. Here, we studied function and localization of Klp8 in S. pombe cells. The gene klp8+ was not essential for both viability and cytoskeletal organization. Klp8-YFP was concentrated as medial cortical dots during interphase, and organized into a ring at the division site during mitosis. The Klp8 ring seemed to be localized in the space between the actomyosin contractile ring and the plasma membrane. The Klp8 ring shrank as cytokinesis proceeded. In klp8-deleted (Δ) cells, the speed of spindle elongation during anaphase B was slowed down. Overproduction of Klp8 caused bent or elongated cells, in which MTs were abnormally elongated and less dynamic than those in normal cells. Deletion of klp8+ gene suppressed the delay in mitotic entry in blt1Δ cells. These results suggest that Klp8 is involved in mitosis and cell morphology through MT stabilization.

[Relation between self-evaluation of skills and learning strategy in the acquisition of the hygienic nursing skills].

The purpose of this study is to investigate which learning strategies nursing students use to acquire the nursing skills of cleanliness. The investigation of 71 first-year nursing students consists of self-evaluation of shampooing and bed-bath/foot-bath/changing the night-clothes (19 questions each) and learning strategies (15 questions). To compare the difference between 2 groups in the acquisition of learning strategies, we used the Mann-Whitney U test to calculate the average evaluation of each skill, the self-evaluation, and the total scores of each of cognitive domain, psychomotor domain and affective domain, categorizing the students into higher evaluation and lower evaluation. The recovery rate of questionnaires was 81.7%. The psychomotor domain in the self-evaluation was high, but the cognitive domain and affective domain were low. As for the learning strategies used, the higher evaluation group in total self-evaluation used lectures and prior learning and nursing practice (P < 0.05, P < 0.01). Moreover, the higher evaluation group of the cognitive domain used explanations by the teacher in lectures and practice, and the higher evaluation group of the psychomotor domain used explanations of basic activity in lectures and training and guidance in the practice room (P < 0.05, P < 0.01). Also, the higher evaluation group of the affective domain didn't use learning strategies to acquire skills of the affective domain. In the future, it is necessary to consider learning strategies in acquiring the affective skills.