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JFSF 2020

Review Article JFSF, Vol 5, No 1, March 2020, p.1-5
Dietary protein intake and bone health
Amalia Tsagari
Keywords: Bone biomarkers, Bone health, Bone mineral density, Dietary protein
Considerable attention has recently focused on dietary protein’s role in the mature skeleton. The aim was to conduct a systematic review evaluating the effects of dietary protein intake alone on bone health measures in adults (Bone Mineral Density (BMD) and bone biomarkers. Searches across 3 databases were conducted through February 2019 including randomized controlled trials (RCT’s) and prospective cohort studies examining the effects of "high versus low" protein intake. Studies in various populations are currently limited, varying doses and dietary compositions were used or prescribed, respectively, and there was medium risk of bias among the RCTs and the cohort studies examined. Moderate evidence suggested that higher protein intake may have protective effect on lumbar spine (LS) bone mineral density (BMD) compared with lower protein intake but no effect on total hip (TH), femoral neck (FN), or total body BMD or bone biomarkers. Current evidence shows no adv erse effects of higher protein intakes. Although there were positive trends on BMD at most bone cites, only the LS showed moderate evidence to support benefits of higher protein intake. Studies were heterogeneous. High-quality, long-term studies are needed to clarify dietary protein’s role in bone health.
Original Article JFSF, Vol 5, No 1, March 2020, p.6-9
Mission (im)possible: Engaging care homes, staff and residents in research studies
Maria Giné-Garriga, Marlene Sandlund, Javier Jerez-Roig, Jo Booth, Dawn A. Skelton
Keywords: Care home setting, Older adults, Research engagement, Staff perceptions
Objectives: With increasing age the risk of institutionalization increases. To address the problem of underrepresentation of care homes and their residents in future research studies, we aimed to explore care home staff members’ thoughts on barriers, challenges, facilitators and key aspects of engaging in research studies. Methods: Five staff members from four care homes in Glasgow and Barcelona were interviewed. Transcription of the interviews was completed verbatim and an inductive thematic analysis was conducted to understand the difficulties and challenges they perceive for engaging in research studies. Results: Three themes emerged that encapsulated the staff members’ perspectives. ‘Too much to deal with’ included two subthemes; ‘interested but with support’ encapsulated four subthemes; and ‘on the residents’ terms’ highlighted three subthemes. Staff members showed interest in engaging in research studies if a clear management support accompanied by a whole team approach was evident. The involvement of the resident’s relatives was seen as essential if residents were to be supported to be engaged. Conclusions: Despite the small sample size, the perspectives of staff members, irrespective of country, provided valuable insights for informing researchers on best approaches to maximize care home and resident engagement in research.
Research Protocol JFSF, Vol 5, No 1, March 2020, p.10-16
Enhancing existing formal home care to improve and maintain functional status in older adults: Protocol for a feasibility study on the implementation of the Care to Move (CTM) programme in an Irish healthcare setting
N. Frances Horgan, Vanda Cummins, Frank Doyle, Maria O’Sullivan, Rose Galvin, Elissa Burton, Jan Sorensen, Dawn A. Skelton, Bex Townley, Debbie Rooney, Gill Jackson, Lauren Swan, Austin Warters
Keywords: Community-dwelling, Feasibility, Home care, Older person, Physical activity-based
An increasing ageing population leads to greater demand for care services to help maintain people in their own homes. Physical activity programmes have been shown to improve older adults’ functional capacity, enabling the older adult to live independently and maintain functional status. There has been a lack of quality research conducted around physical activity within the landscape of home care services. We describe a feasibility study of implementing the Care to Move (CTM) programme in older adults receiving low-level home care. A Phase 1 mixed-methods feasibility study design will explore the recruitment, attrition, retention, costs to deliver and data loss. It will also explore the acceptability and impact of the CTM programme on older adults and thematic analysis of data collected from older people, home care workers and relevant stakeholders through use of semi-structured interviews and focus groups. We will measure functional status and fall outcomes in older adults receiving low levels of home care, facilitating this population to continue living independently at home and providing data currently not known around this group.
Original Article JFSF, Vol 5, No 1, March 2020, p.17-23
Content of exercise programmes targeting older people with sarcopenia or frailty – findings from a UK survey
Miles D. Witham, Melody Chawner, Sarah De Biase, Natalie Offord, Oliver Todd, Andrew Clegg, Avan A. Sayer
Keywords: Exercise, Frailty, Resistance training, Sarcopenia, Survey
Objectives: To establish whether existing exercise programmes offered to people with sarcopenia or frailty adhere to the current evidence base. Methods: We conducted a national survey of practitioners delivering exercise programmes to older people with sarcopenia or frailty in the UK. The link to the online survey was distributed through email lists of professional societies, practice networks and social media. Questions covered target population and programme aims, type, duration and frequency of exercise, progress assessment and outcome measures. Results: One hundred and thirty-six responses were received. 94% of respondents reported prescribing or delivering exercise programmes to people with sarcopenia or frailty. Most programmes (81/135 [60%]) were primarily designed to prevent or reduce falls. Resistance training was the main focus in only 11/123 (9%), balance training in 61/123 (50%) and functional exercise in 28/123 (23%). Exercise was offered once a week or less by 81/124 (65%) of respondents. Outcome measures suitable for assessing the effect of resistance training programmes were reported by fewer than half of respondents (hand grip: 13/119 [11%]; chair stands: 55/119 [46%]). Conclusions: Current UK exercise programmes offered to older people with sarcopenia or frailty lack the specificity, frequency or duration of exercise likely to improve outcomes for this patient group.
Original Article JFSF, Vol 5, No 2, June 2020, p.24-30
Neither Timed Up and Go test nor Short Physical Performance Battery predict future falls among independent adults aged ≥75 years living in the community
Beatrice Pettersson, Ellinor Nordin, Anna Ramnemark, Lillemor Lundin-Olsson
Keywords: Accidental falls, Aged, Functional ability, Geriatric assessment/methods, Postural balance
Objectives: Previous research has shown that balance and gait difficulties are predictors of falls. The aim of this study was to evaluate the predictive validity of two tools reporting on balance and gait among older community living adults independent in personal activities of daily living (p-ADL). Methods: Prospective study design. Baseline assessment included the Timed Up and Go test (TUG) and the Short Physical Performance Battery (SPPB). Following baseline, falls were recorded monthly for one year by 202 participants (70.1% women) who were independent in p-ADL, and at least 75 years old (79.2±3.5). ROC-curves were made and AUC were calculated. Results: Fortyseven percent of the participants reported falls. AUCs calculated for TUG were 0.5 (95% CI: 0.5-0.6) for those with at least one fall, and 0.5 (95% CI: 0.5-0.6) for recurrent fallers. Corresponding figures for SPPB were 0.5 (95% CI: 0.5-0.6) and 0.5 (95% CI: 0.5-0.6). Conclusion: This study does not support a recommendation to use the Timed Up and Go test or the Short Physical Performance Battery as tools for the identification of fall-prone persons among older adults living in the community. These results reinforce the need for further research into appropriate tools for identifying independent but fall-prone older adults.
Review Article JFSF, Vol 5, No 2, June 2020, p.31-37
Dual-task exercises in older adults: A structured review of current literature
Luz A. Varela-Vásquez, Eduard Minobes-Molina, Javier Jerez-Roig
Keywords: Ageing, Balance, Dual task, Risk of falling, Walking speed
Considerable attention has recently focused on the role of dual-task exercises (DT) in the older adult. The aim was to conduct a review to describe the dual-task exercises that have been shown to be effective in improving balance and other physical characteristics such as decreased falling and walking speed in older adults. Review of intervention studies, in the Pubmed, PEDro, CINAHL and Web of Science databases. The search produced 498 references, 11 of which were identified with the description of the dual-task exercises, finding a wide variety of exercises, as well as great variability of outcome measures, discovering that the dual task is predominantly used for balance and walking speed training. All studies presented at least one group performing a double cognitive-motor task, some studies used the fixed priority modality in one group and variable in another, finding greater improvements in variable prioritisation. It can be said that dual-task training in older adults can improve balance and walking speed, which in turn reduces the risk of falling only if the planned dual-task training meets certain characteristics, such as training in specific concepts crucial in motor learning and dual-task training modalities.
Opinion Article JFSF, Vol 5, No 2, June 2020, p.38-41
Sarcopenia in Hemiplegia
Maria C. Papadatou
Keywords: Disability, Muscle strength, Muscle wasting, Sarcopenia, Stroke
Sarcopenia is a disease characterized by quantitative and qualitative degeneration of the skeletal muscles and it primarily presents with a decline in the muscle strength. It frequently occurs in patients after a cerebrovascular accident due to a combination of various factors, such as the brain injury, structural adaptations, limited physical activity as long as malnutrition. Most of the articles and reviews concerning stroke-related sarcopenia are limited and usually are discussing about the factors and causes that may lead to the muscle wasting and the particular characteristics that distinguish it from age-related sarcopenia. As a result, even though sarcopenia is described as a medical entity, it appears to lack the attention that requires, limiting the maximum therapeutic effect a patient can obtain. Suggestions have been made concerning general treatment and management of sarcopenia, associated with exercise, diet and the use of medical preparations, lacking though disease-specific guidelines for management, treatment and possibly prevention of stroke-related sarcopenia. Nowadays, it is considered of major importance that the medical community should be properly informed and to raise awareness on this particular issue aiming to a better and holistic management of the patients after a cerebrovascular accident, in order to reduce morbidity and disability that both are sequelae that reduce quality of life.
Short Communication JFSF, Vol 5, No 2, June 2020, p.42-46
The MOVE.TE Falls Prevention and Management Program: lessons learnt in the Portuguese context
Pedro Maciel Barbosa, Anabela C. Martins, Paula C. Santos, Ricardo Dias, Paulo Pereira, Bernardo Pinto, Rubina Moniz, Ana C. Casaca, Rita Silva, Cristina Melo, Ana L. Silva, Maria J. Bigode, Hugo Mendes, Madalena Gomes da Silva
Keywords: Falls prevention, Physiotherapy, Older Adults, Knowledge Translation
MOVE.TE is a non-profit participatory physiotherapy platform that aims at translating knowledge in the field of physiotherapy and developing freely available evidence-based physiotherapy programmes targeting the primary care services of the Portuguese National Health service. A group of volunteer academics and clinicians collaborated at different stages and time points to create the first ever falls prevention and management programme and guidance for Physiotherapy in primary care, in Portugal. This report describes this seven-step process. In spite of many challenges, this project constitutes an example of advocacy in physiotherapy for the promotion of better healthcare for older adults.