Motor, cognitive and mobility deficits in 1000 geriatric patients: protocol of a quantitative observational study before and after routine clinical geriatric treatment - the ComOn-study.

BACKGROUND: Motor and cognitive deficits and consequently mobility problems are common in geriatric patients. The currently available methods for diagnosis and for the evaluation of treatment in this vulnerable cohort are limited. The aims of the ComOn (COgnitive and Motor interactions in the Older populatioN) study are (i) to define quantitative markers with clinical relevance for motor and cognitive deficits, (ii) to investigate the interaction between both motor and cognitive deficits and (iii) to assess health status as well as treatment outcome of 1000 geriatric inpatients in hospitals of Kiel (Germany), Brescia (Italy), Porto (Portugal), Curitiba (Brazil) and Bochum (Germany). METHODS: This is a prospective, explorative observational multi-center study. In addition to the comprehensive geriatric assessment, quantitative measures of reduced mobility and motor and cognitive deficits are performed before and after a two week's inpatient stay. Components of the assessment are mobile technology-based assessments of gait, balance and transfer performance, neuropsychological tests, frailty, sarcopenia, autonomic dysfunction and sensation, and questionnaires to assess behavioral deficits, activities of daily living, quality of life, fear of falling and dysphagia. Structural MRI and an unsupervised 24/7 home assessment of mobility are performed in a subgroup of participants. The study will also investigate the minimal clinically relevant change of the investigated parameters. DISCUSSION: This study will help form a better understanding of symptoms and their complex interactions and treatment effects in a large geriatric cohort.

Methods for the selection of assistive technology in neurological rehabilitation practice.

OBJECTIVES: To identify theoretical frameworks and instruments used by rehabilitation professionals to perform the selection process of assistive technology (AT) in neurological rehabilitation centres in six Western European countries. DESIGN: Descriptive, exploratory study by using survey design. METHODS: Sixty neurological rehabilitation centres were selected from the total number (n = 259) of centres, identified through a search of official databases from national bodies and associations, with 10 in each country. Each centre was approached to identify a professional to be contacted. Custom-designed questionnaires with multiple-choice and open-ended questions were sent out by e-mail and regular mail to each of these professionals. RESULTS: Thirty questionnaires were returned, of which 29 could be analysed. Ten participants reported using a theoretical framework to select AT. Four models, three frames of reference, and one international classification were mentioned. Fifteen professionals replied to the question on which instruments they use by mentioning one or more methods; 14 participants stated that they used no specific instruments or left the question open. The instruments mentioned show a broad variety, the majority of the published ones not being AT-specific. Professionals often use self-made tools to fill this gap. CONCLUSION: There is a lack of evidence-based AT-specific methods for the selection process. The development of comprehensive, easy to use tools for the selection of AT is recommended.