Factors associated with life-space mobility restriction in home-care older adults receiving home-visit rehabilitation: A cross-sectional multi-center study in Japan.

AIM: Life-space mobility (LSM) restriction is a serious issue among older adults using home-visit rehabilitation (HR). This study evaluated physical function, transportation, and other factors not comprehensively tested in previous studies and examined factors associated with the restriction of LSM among older adults using HR. METHODS: This cross-sectional multi-center study recruited 88 HR users (49 men, 39 women, mean age 79.0 [±7.8] years) living in urban and rural areas from August to October 2020. We administered the Life-Space Assessment (LSA), the Self-Efficacy Scale on Going out among community-dwelling Elderly (SEGE), grip strength, a 30-s chair stand test, Bedside Mobility Scale, Functional Independence Measure, Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE) test. Participants were divided into two groups based on the cut-off value of the LSA scores. In the logistic regression analysis, the dependent variable was LSA scores ≤30, and the independent variables were measured based on objective evaluation items and adjusted for confounding factors (age, sex, and frequency of use of day-care services). RESULTS: Restriction of LSM was significantly associated with FAI (odds ratio [OR] = 0.817, 95% confidence interval [CI] = 0.706-0.945), HACE facilitators (OR = 1.558, 95% CI = 1.168-2.079), and living alone (OR = 12.822, 95% CI = 1.202-136.716). CONCLUSION: Restriction of LSM is associated with environmental factors, such as assistive devices and household composition, and ability to engage in instrumental activities of daily living. Our findings indicate a great need for focusing on these factors among home-care older adults receiving HR. Geriatr Gerontol Int 2023; 23: 722-728.

Self-efficacy and Physical Function in Cancer Survivors Receiving Home-visit Rehabilitation.

Objectives: Home-visit rehabilitation is critical for cancer patients because it facilitates recovery. However, few studies have reported relevant information and practices concerning this patient support. This study investigated the factors influencing the self-efficacy of cancer survivors receiving home-visit rehabilitation compared with non-cancer home-visit rehabilitation users by matching propensity scores. Methods: The present study was a cross-sectional study involving participants from two cancer care institutions. Fifteen cancer survivors who received home-visit rehabilitation (9 men, 6 women; age=77.6±11.1 years) were matched for their propensity scores (adjusted for age, sex, and comorbidity) with 15 home-visit rehabilitation users without cancer (8 men, 7 women; age=74.7±11.7 years). Self-efficacy was measured based on the self-efficacy for activities of daily living (SEADL) scale and self-efficacy for going out among community-dwelling elderly people (SEGE) scale. Grip strength (GS), 30-second chair stand test (CS-30), Functional Independence Measure (FIM), and Life-Space Assessment (LSA) were measured based on objective evaluation items. Results: In cancer survivors, the SEADL was significantly correlated with GS, CS-30, FIM, motor-FIM (mFIM), and LSA. The CS-30 of cancer survivors was significantly correlated with SEGE. Among home-visit rehabilitation users without cancer, although the correlation between SEADL and FIM or mFIM was significant, SEGE was not significantly correlated with the other measurements. Conclusions: When compared with home-visit rehabilitation users without cancer, self-efficacy among cancer survivors was influenced not only by activities of daily living but also by physical function and life-space mobility.

[Factors related to regional differences among home-visit rehabilitation users].

AIM: The present study investigated the relationship between the type of residential area and each factor of the International Classification of Functioning, Disability and Health (ICF) framework among elderly subjects receiving home-visit rehabilitation. METHODS: This was a cross-sectional study conducted at two institutions. A total 84 participants (46 men and 38 women, age: 79.1±7.8 years old) who were receiving home-visit rehabilitation in urban and rural areas were examined. The parameters measured included the modified Gait Efficacy Scale (mGES), grip strength, 30-seconds chair stand test (CS-30), Functional Independence Measure (FIM), Life-Space Assessment (LSA), Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE), which is based on the ICF concepts of health status, physical structure, physical and mental functions, activities, participation, personal factors, and environmental factors respectively; these points were evaluated by physical or occupational therapists. The health status was based on the diagnosis obtained from the clinical record. RESULTS: Receiving home-visit rehabilitation in a rural area was significantly associated with the LSA (odds ratio [OR]=1.075, p=0.028), optimistic and positive feelings for life (OR=0.698, p=0.040), and community mobility scores (OR=5.755, p=0.001). CONCLUSIONS: Environmental factors, activities, and personal factors differed depending on the region where the elderly subject received home-visit rehabilitation. Thus, intervention methods concerning home-visit rehabilitation may need to be adjusted according to the region where the patient lives.

Comparison of respiratory function, physical function, and activities of daily living among community-dwelling patients with respiratory and non-respiratory disease.

[Purpose] The purpose of this study was to investigate the differences in respiratory function, physical function, and Activities of Daily Living (ADL) between respiratory and non-respiratory patients using community-based home rehabilitation. [Participations and Methods] Maximum Phonation Time (MPT), upper and lower limb muscle strength, and ADL were compared in two groups: a respiratory disease group including respiratory patients and those with respiratory comorbidities, and a non-respiratory disease group. Cutoff values were determined for items that showed significant differences between groups. [Results] There were no significant differences between the two groups in assessments other than MPT. MPT was significantly lower in the respiratory disease group, with an MPT cutoff value of 10.1 sec and an area under the curve of 0.74. [Conclusion] Use of the MPT cutoff value may help to determine whether respiratory function is impaired in patients with respiratory disease.