Does dance-based therapy increase gait speed in older adults with chronic lower extremity pain: a feasibility study.

A decreased gait speed in older adults can lead to dependency when the individuals are no longer able to participate in activities or do things for themselves. Thirty-seven senior apartment residents (31 females; Mean age=80.6 years; SD=8.9) with lower extremity pain/stiffness participated in a feasibility and preliminary efficacy study of 12 weeks (24 sessions). Healthy-Steps dance therapy compared to a wait-list control group. Small improvements in gait speed ([ES]=0.33) were noted for participants completing 19-24 dance sessions. Improvements in gait speed measured by a 10 Meter Walk Test (0.0517 m/s) exceeded 0.05 m/s, a value deemed to be meaningful in community dwelling older adults. These feasibility study findings support the need for additional research using dance-based therapy for older adults with lower extremity pain.

Development of an online orientation course for preceptors in a dedicated education unit program.

The dedicated education unit (DEU) is an emerging model of nursing education. Instead of an instructor-led clinical group, students are partnered with a unit staff nurse for precepted learning. These experiences in learning typically begin with early clinical courses. Precepting nursing students in a DEU is different from precepting newly hired staff nurses and traditional clinical students. This article describes the DEU model implemented at one university, the challenges associated with preparing staff nurses to precept nursing students, the development of a face-to-face DEU preceptor orientation, and progression to an innovative online orientation course.

Dance-based therapy in a program of all-inclusive care for the elderly: an integrative approach to decrease fall risk.

BACKGROUND: Loss of balance and diminished gait are major fall risk factors in older persons. Literature suggests that physical activity based on dance may improve balance and gait. The aim of this pilot study was to determine whether dance-based therapy affects the balance/gait of community-based frail seniors. CONCEPTUAL FRAMEWORK: The Roy Adaptation Model and Environmental Press Theory were used as joint frameworks. PARTICIPANTS: Eleven participants were recruited from a Program of All-inclusive Care for the Elderly (PACE). Inclusion criteria were (1) Mini-Mental State Examination score of 23 or more, (2) attending PACE on Monday, Wednesday, and Friday, and (3) able to stand with or without assistance. METHODS: A Lebed Method dance intervention was conducted using a longitudinal design 3 times a week for 6 weeks. Functional Reach and Timed Get Up and Go were measured at baseline, 6 weeks after the start of the intervention, and 6 weeks postintervention and repeated to estimate the persistence of the effect. CONCLUSIONS: Graphs were compared looking for functional trends; postintervention interviews were conducted with each subject. IMPLICATIONS: Dance therapy results in positive functional trends, suggesting that further study using dance-based therapy will be useful to decrease fall risks in older persons.

Nighttime restfulness during daytime dance therapy: an exploratory study using bed sensors.

Dance-based therapy has the potential to slow the progression of functional limitations in older adults. The purpose of this study was to explore the feasibility of measuring the impact of dance-based therapy on the nighttime restfulness patterns of older adults in an aging-in-place facility using passive bed sensors. A secondary data analysis of the continuous 2-month nighttime bed sensor data was reviewed for measurable change during a dance study. A measurable variation in nighttime restfulness level was detected between the dancers and nondancers, and no high or very high restlessness was detected during this period for the dance-based therapy group. Although these exploratory variations are modest, the findings suggest that bed sensors can be used to measure nighttime restfulness following a therapeutic dance intervention. More research is needed in this emerging area.

A model of risk reduction for older adults vulnerable to nursing home placement.

Because of the cost of nursing home care and desire of older adults to stay in their homes, it is important for health care providers to understand the factors that place older adults at risk for nursing home placement. This integrative review of 12 years of research, as published in 148 articles, explores the risk factors for nursing home placement of older adults. Using the framework of the vulnerable populations conceptual model developed by Flaskerud and Winslow (1998), we explored factors related to resource availability, relative risks, and health status. Important factors include socioeconomic status, having a caregiver, the availability and use of home- and community-based support services, race, acute illness particularly if hospitalization is required, medications, dementia, multiple chronic conditions, functional disability, and falls. Few intervention studies were identified. Development of evidence-based interventions and creation of policies to address modifiable risk factors are important next steps.

Exploring the effects of dance-based therapy on balance and mobility in older adults.

Balance and mobility are a common concern among older adults. This pilot randomized controlled study examines the effect of dance-based therapy to increase balance and mobility in 27 participants with mean age 85 years (±7.5) from a single aging-in-place facility in the Midwest. Multidirectional reach, velocity, step length differential, and a Functional Ambulation Profile were measured before and after 18 sessions of low-impact dance-based therapy. Although a Wilcoxon rank sum test showed no significance, effect size analyses suggest that dance-based therapy was mildly or moderately effective in several components of balance and mobility. Additional research is needed with a full-scale trial.

Best practice in fall prevention: roles of informal caregivers, health care providers and the community.

Falls are an important public health problem for older adults, resulting in significant morbidity and mortality, as well as healthcare costs. Evidence supports the assessment of older adults' fall risks and implementation of interventions to reduce these risks. Older adults are the key stakeholder in preventing falls, but need the support of their informal caregivers, healthcare providers, and community groups. This article addresses the roles of these additional stakeholders in providing and supporting best practices in fall prevention. Together these stakeholders can assist older adults in self-management of fall prevention, based on the preferences of the individual, local resources, and available programmes and healthcare services.

Testing an in-home gait assessment tool for older adults.

In this paper, we present results of an automatic vision-based gait assessment tool, using two cameras. Elderly residents from TigerPlace, a retirement community, were recruited to participate in the validation and test of the system in scripted scenarios representing everyday activities. The residents were first tested on a GAITRite mat, an electronic walkway that captures footfalls, and with inexpensive web cameras recording images. The extracted gait parameters from the camera system were compared with the GAITRite; excellent agreement was achieved. The residents then participated in the scenarios, with only the cameras recording. We found that the residents displayed different gait patterns during the realistic scenarios compared to the GAITRite runs. This finding provides support of the importance and advantage of continuous gait assessment in a daily living environment. Results on 4 elderly participants are included in the paper.