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1.
Cancers (Basel) ; 15(9)2023 Apr 24.
Article in English | MEDLINE | ID: covidwho-2319550

ABSTRACT

Background: To determine the feasibility, reliability, and safety of the remote five times sit to stand test (5STS) test in patients with gastrointestinal cancer. Methods: Consecutive adult patients undergoing surgical treatment for lower gastrointestinal cancer at a major referral hospital in Sydney between July and November 2022 were included. Participants completed the 5STS test both face-to-face and remotely, with the order randomised. Outcomes included measures of feasibility, reliability, and safety. Results: Of fifty-five patients identified, seventeen (30.9%) were not interested, one (1.8%) had no internet coverage, and thirty-seven (67.3%) consented and completed both 5STS tests. The mean (SD) time taken to complete the face-to-face and remote 5STS tests was 9.1 (2.4) and 9.5 (2.3) seconds, respectively. Remote collection by telehealth was feasible, with only two participants (5.4%) having connectivity issues at the start of the remote assessment, but not interfering with the tests. The remote 5STS test showed excellent reliability (ICC = 0.957), with limits of agreement within acceptable ranges and no significant systematic errors observed. No adverse events were observed within either test environment. Conclusions: Remote 5STS for the assessment of functional lower extremity strength in gastrointestinal cancer patients is feasible, reliable, and safe, and can be used in clinical and research settings.

2.
Trials ; 23(1): 1052, 2022 Dec 27.
Article in English | MEDLINE | ID: covidwho-2196411

ABSTRACT

BACKGROUND: The COVID-19 pandemic and associated social distancing regulations have led to an increased risk of social isolation and physical inactivity, particularly among older adults. The benefits of physical activity for reducing fall risk and improving mood and mental functioning have been well documented. The aim of this trial is to investigate the effect of the MovingTogether programme on psychological distress (primary outcome) and physical activity, social capital, cognition, concern about falling, loneliness, physical functioning, quality of life and physical activity enjoyment (secondary outcomes). METHODS: A randomised controlled trial with a waitlist control will be conducted, recruiting 80 adults aged 60+ years with access to Facebook and a computer or tablet and not currently meeting the aerobic physical activity guidelines. Randomisation will be completed using REDCap. The intervention group (n = 40) will join a private Facebook group where allied health facilitators will provide targeted healthy lifestyle education throughout the 10-week programme with weekly telehealth group calls. Intervention participants will also be provided access to tailored strength and aerobic exercise guidance and an evidence-based eHealth balance exercise programme. Psychological distress and secondary outcomes will be assessed at baseline, 11 weeks (post-intervention) and 16 weeks (1-month follow-up). Linear mixed models will be applied for each outcome measure as per an intention-to-treat approach to determine the between-group differences. Secondary analyses are planned in people with greater adherence and those with higher psychological distress. DISCUSSION: COVID-19 has highlighted the need for scalable, effective and novel methods to improve and protect the health of older adults. The integration of an evidence-based fall prevention programme with a mental health-informed online health promotion programme may help to improve mental and physical health outcomes among older adults. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001322820p. Registered on 29 September 2021.


Subject(s)
COVID-19 , Diet, Healthy , Humans , Aged , Quality of Life , Pandemics/prevention & control , Mental Health , COVID-19/prevention & control , Australia , Exercise/psychology , Health Promotion/methods , Randomized Controlled Trials as Topic
3.
Australas J Ageing ; 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2107889

ABSTRACT

OBJECTIVES: Cognitive screening via telehealth is increasingly employed, particularly during the COVID-19 pandemic. Telephone adaptations of existing cognitive screening tests must be validated across diverse populations. The present study sought to evaluate an existing 26-point telephone adaptation of the Mini-Mental State Examination (tMMSE) in a sample of older Aboriginal Australians. Additionally, we aimed to evaluate a telephone adaptation of the urban version of the Kimberley Indigenous Cognitive Assessment short-form (tKICA screen). METHODS: A sub-sample (n = 20) of participants (aged 55-69 years; 11 women) who had completed an in-person cognitive assessment (MMSE and KICA screen) within the past 6 months as part of the Koori Growing Old Well Study completed telephone-based cognitive testing without an assistant. RESULTS: There was moderate correlation and reasonable agreement between MMSE versions (rs  = 0.33; p = 0.2), although the limits of agreement were unacceptably wide (-4.1 and 4.8 points difference). Poorer performance was seen on the tMMSE for Season (p = 0.02) and Phrase (p = 0.02) items, and better performance for three-word Recall (p = 0.03). KICA-screen versions were poorly correlated (rs  = 0.20; p = 0.4) with telephone scoring a mean of 2.17 points below the face-to-face score, greater bias observed at the lower end of the performance and worse scores for Season (p = 0.02) and Recall (p = 0.001) items. Age and education were not associated with telephone screening performance. Hearing impairment was associated with poorer performance on the tKICA screen (p = 0.04) but not the tMMSE (p = 0.6). CONCLUSIONS: Results indicate that telephone administration of the MMSE and/or KICA screen is not equivalent to in-person testing for older Aboriginal people, and further revision and evaluation are required.

4.
BMJ Open ; 11(7): e048395, 2021 07 26.
Article in English | MEDLINE | ID: covidwho-1327672

ABSTRACT

INTRODUCTION: One in three people aged 65 years and over fall each year. The health, economic and personal impact of falls will grow substantially in the coming years due to population ageing. Developing and implementing cost-effective strategies to prevent falls and mobility problems among older people is therefore an urgent public health challenge. StandingTall is a low-cost, unsupervised, home-based balance exercise programme delivered through a computer or tablet. StandingTall has a simple user-interface that incorporates physical and behavioural elements designed to promote compliance. A large randomised controlled trial in 503 community-dwelling older people has shown that StandingTall is safe, has high adherence rates and is effective in improving balance and reducing falls. The current project targets a major need for older people and will address the final steps needed to scale this innovative technology for widespread use by older people across Australia and internationally. METHODS AND ANALYSIS: This project will endeavour to recruit 300 participants across three sites in Australia and 100 participants in the UK. The aim of the study is to evaluate the implementation of StandingTall into the community and health service settings in Australia and the UK. The nested process evaluation will use both quantitative and qualitative methods to explore uptake and acceptability of the StandingTall programme and associated resources. The primary outcome is participant adherence to the StandingTall programme over 6 months. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the South East Sydney Local Health District Human Research Ethics Committee (HREC reference 18/288) in Australia and the North West- Greater Manchester South Research Ethics Committee (IRAS ID: 268954) in the UK. Dissemination will be via publications, conferences, newsletter articles, social media, talks to clinicians and consumers and meetings with health departments/managers. TRIAL REGISTRATION NUMBER: ACTRN12619001329156.


Subject(s)
Exercise Therapy , Independent Living , Aged , Australia , Cost-Benefit Analysis , Humans , Randomized Controlled Trials as Topic
5.
Exp Gerontol ; 152: 111434, 2021 09.
Article in English | MEDLINE | ID: covidwho-1258367

ABSTRACT

BACKGROUND: Evidence-based interventions to improve mobility in older people include balance, strength and cognitive training. Digital technologies provide the opportunity to deliver tailored and progressive programs at home. However, it is unknown if they are effective in older people, especially in those with cognitive impairment. OBJECTIVE: The aim of this study was to examine the efficacy of a novel tablet-delivered cognitive-motor program on mobility in older people with cognitive impairment. METHODS: This was a 6-month single-blind randomised controlled trial of older people living in the community with subjective and/or objective cognitive impairment. Participants randomised to the intervention were asked to follow a 120 min per week balance, strength and cognitive training program delivered via an app on an iPad. Both the intervention and control group received monthly phone calls and health fact sheets. The primary outcome measure was gait speed. Secondary measures included dual-task gait speed, balance (step test, FISCIT-4), 5 sit to stand test, cognition (executive function, memory, attention), mood and balance confidence. Adherence, safety, usability and feedback were also measured. RESULTS: The planned sample size of 110 was not reached due to COVID-19 restrictions. A total of 93 (mean age 72.8 SD 7.0 years) participants were randomised to the two groups. Of these 77 participants returned to the follow-up clinic. In intention-to-treat analysis for gait speed, there was a non-significant improvement favouring the intervention group (ß 0.04 m/s 95% CI -0.01, 0.08). There were no significant findings for secondary outcomes. Adherence was excellent (84.5%), usability of the app high (76.7% SD 15.3) and no serious adverse events were reported. Feedback on the app was positive and included suggestions for future updates. CONCLUSION: Due to COVID-19 the trial was under powered to detect significant results. Despite this, there was a trend towards improvement in the primary outcome measure. The excellent adherence and positive feedback about the app suggest a fully powered trial is warranted.


Subject(s)
COVID-19 , Cognitive Dysfunction , Accidental Falls , Aged , Cognition , Cognitive Dysfunction/therapy , Exercise , Exercise Therapy , Humans , Postural Balance , SARS-CoV-2 , Single-Blind Method , Tablets
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