Feasibility, Usability, and Acceptability of Online Mind-Body Exercise Programs for Older Adults: A Scoping Review.

Objectives: Engaging in mind-body exercises (MBEs: e.g., Tai Chi and yoga) can have physical and mental health benefits particularly for older adults. Many MBEs require precise timing and coordination of complex body postures posing challenges for online instruction. Such challenges include difficulty viewing instructors as they demonstrate different movements and lack of feedback to participants. With the shift of exercise programs to online platforms during the COVID-19 pandemic, we conducted a scoping review to examine the feasibility, usability, and acceptability of online MBE classes for older adults. Materials and Methods: We followed the scoping review methodology and adhered to the PRISMA reporting checklist. We searched five databases: Medline, Embase, CINHAL, Web of Science, and ACM digital library. Screening of articles and data extraction was conducted independently by two reviewers. Settings/Location: Online/virtual. Subjects: Older adults ≥55 years of age. Outcome Measures: Feasibility measures. Results: Of 6711 studies retrieved, 18 studies were included (715 participants, mean age 66.9 years). Studies reported moderate to high retention and adherence rates (mean >75%). Older adults reported online MBE classes were easy to use and reported high satisfaction with the online format. We also identified barriers (e.g., lack of space and privacy and unstable internet connection) and facilitators (e.g., convenience and technical support) to the online format. Opinions related to social connectedness were mixed. Conclusion: Online MBE programs for older adults appear to be a feasible and acceptable alternative to in-person programs. It is important to consider the type of exercise (e.g., MBE), diverse teaching styles, and learner needs when designing online exercise classes.

Assessment tools for measurement of dementia-friendliness of a community: A scoping review.

BACKGROUND: A quantitative assessment of the dementia-friendliness of a community can support planning and evaluation of dementia-friendly community (DFC) initiatives, internal review, and national/international comparisons, encouraging a more systematic and strategic approach to the advancement of DFCs. However, assessment of the dementia-friendliness of a community is not always conducted and continuous improvement and evaluation of the impact of dementia-friendly initiatives are not always undertaken. A dearth of applicable evaluation tools is one reason why there is a lack of quantitative assessments of the dementia-friendliness of communities working on DFC initiatives. PURPOSE: A scoping review was conducted to identify and examine assessment tools that can be used to conduct quantitative assessments of the dementia-friendliness of a community. DESIGN AND METHODS: Peer-reviewed studies related to DFCs were identified through a search of seven electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, EMCare, HealthSTAR, and AgeLine). Grey literature on DFCs was identified through a search of the World Wide Web and personal communication with community leads in Australia, Canada, New Zealand, the United Kingdom, and the United States. Characteristics of identified assessment tools were tabulated, and a narrative summary of findings was developed along with a discussion of strengths and weaknesses of identified tools. RESULTS: Forty tools that assess DFC features (built environment, dementia awareness and attitudes, and community needs) were identified. None of the identified tools were deemed comprehensive enough for the assessment of community needs of people with dementia.

Impact of COVID-19 on mobility and participation of older adults living in Hamilton, Ontario, Canada: a multimethod cohort design protocol.

INTRODUCTION: The novel COVID-19 required many countries to impose public health measures that likely impacted the participation and mobility of community-dwelling older adults. This protocol details a multimethod cohort design undertaken to describe short-term and medium-term changes to the mobility and participation of older Canadians living in the community rather than retirement facilities during the COVID-19 pandemic. METHODS AND ANALYSIS: A longitudinal telephone (or online)-administered survey is being conducted with a random sample of older adults living within 20 km of McMaster University, Hamilton, Ontario, Canada, identified from census dissemination areas. Baseline data collection of community-dwelling older adults aged 65 years and over began in May 2020 with follow-ups at 3, 6, 9 and 12 months. The Late-Life Function and Disability Instrument and global rating of change anchors are the primary outcomes of interest. A subsample of respondents will participate in open-ended, semistructured interviews conducted over the telephone or through video-conference, to explore participants' lived experiences with respect to their mobility and participation during the pandemic. Descriptive statistics and quantitative approaches will be used to determine changes in mobility and social and personal participation, and associated personal and environmental factors. For the interviews, qualitative data will be analysed using descriptive phenomenology. ETHICS AND DISSEMINATION: Approval was obtained from the Hamilton Integrated Research Ethics Board of McMaster University (2020-10814-GRA). This study may inform the design of programmes that can support community-dwelling older adults during and after the COVID-19 pandemic. Findings will be disseminated through peer-reviewed publications and conferences focused on ageing.

"Think of It Like a Game": Older Adults' and Health Professionals' Perspectives on Interactive Exercise Technology Design.

Purpose: Interactive exercise technology (IET) is an effective and practical way to support physiotherapy for older adults. The purpose of this study was to use design thinking to collect feedback on the first iteration of an IET prototype from older adults and health professionals and to use that feedback to gain an understanding of their needs and values, with the goal of developing recommendations to inform the second iteration of the IET prototype. Method: This study was conducted using three steps of design thinking: (1) test, in which four focus groups were conducted, asking older adults and health professionals about their perspectives on an IET prototype; (2) empathize, in which the focus group discussions were recorded and transcribed and thematic content analysis was conducted; and (3) define, in which the needs and values of the participants were identified. Results: The participants were 19 health professionals and four older adults. Four themes, which represented the values that these groups held regarding IET design, were revealed: instruction, safety, accessibility, and motivation. Conclusions: Older adults and health professionals have specific needs for the design of IET, which should be considered in the development of future IET.

Objectif : la technologie des exercices interactifs (TEI) est un moyen efficace et pratique de soutenir la physiothérapie chez les aînés. La présente étude a fait appel à la réflexion conceptuelle pour colliger les commentaires d'aînés et de professionnels de la santé sur la première itération d'un prototype de TEI, s'inspirer de leurs commentaires pour comprendre leurs besoins et leurs valeurs et formuler des recommandations pour éclairer la deuxième itération du prototype de TEI. Méthodologie : la présente étude a été réalisée au moyen des trois étapes de la réflexion conceptuelle : 1) le test, dans le cadre duquel quatre groupes de travail ont été formés pour demander aux aînés et aux professionnels de la santé leurs points de vue sur un prototype de TEI; 2) l'empathie, visant l'enregistrement et la transcription les discussions des groupes de travail, suivis d'une analyse de contenu thématique et 3) la définition, afin de déterminer les besoins et les valeurs des participants. Résultats : les participants étaient 19 professionnels de la santé et quatre aînés. Quatre thèmes sont ressortis, représentatifs des valeurs de ces groupes à l'égard de la TEI : directives, sécurité, accessibilité et motivation. Conclusion : les aînés et leurs professionnels de la santé ont des besoins particuliers à l'égard de la conception de la TEI, dont il faudrait tenir compte dans l'élaboration de futures TEI.

Music Lessons: Exploring the Role and Meaning of Music for Older Adults with Dementia.

An aging population and increasing rates of dementia point to the need for alternative strategies that allow individuals to age in place. This multiple case study explored, from an insider's perspective, the role and meaning of music for individuals with dementia who are aging in place. Methods were semi-structured interviews, observations, and videos. The study's central theme is connection, with three types of "connectors" - self, partner, and music - as subthemes. Connection to self involves present moment awareness, accessing memories, and self-expression. Connection to partner builds on self-connection and spending time together with music. Lastly, the connection to music builds on the previous two subthemes as well as the desire to keep things "normal". This study provides insight into the growing body of interdisciplinary literature dedicated to dementia, music, aging in place, and contemplative practices, as well as implications for aging and caring for someone with dementia.

A theory-based multi-component intervention to increase reactive balance measurement by physiotherapists in three rehabilitation hospitals: an uncontrolled single group study.

BACKGROUND: Most implementation interventions in rehabilitation, including physiotherapy, have used passive, non-theoretical approaches without demonstrated effectiveness. The goal of this study was to improve an important domain of physiotherapy practice - reactive balance measurement - with a targeted theory-based multi-component intervention developed using the Theoretical Domains Framework. The primary objective was to determine documented reactive balance measure use in a 12-month baseline, during, and for three months post- intervention. METHODS: An uncontrolled before-and-after study was completed with physiotherapists at three urban adult rehabilitation hospitals in Ontario, Canada. The 12-month intervention included group meetings, local champions, and health record modifications for a validated reactive balance measure. The primary outcome was the proportion of records with a documented reactive balance measure when balance was assessed pre-, during- and post-intervention. Secondary outcomes were changes in use, knowledge, and confidence post-intervention, differences across sites, and intervention satisfaction. RESULTS: Reactive balance was not measured in any of 211 eligible pre-intervention records. Thirty-three physiotherapists enrolled and 28 completed the study. Reactive balance was measured in 31% of 300 eligible records during-intervention, and in 19% of 90 eligible records post-intervention (p < 0.04). Knowledge and confidence significantly increased post-intervention (all p < 0.05). There were significant site differences in use during- and post-intervention (all p < 0.05). Most participants reported satisfaction with intervention content (71%) and delivery (68%). CONCLUSIONS: Reactive balance measurement was greater among participants during-intervention relative to the baseline, and use was partially sustained post-intervention. Continued study of intervention influences on clinical reasoning and exploration of site differences is warranted.

The role of music in the lives of older adults with dementia ageing in place: A scoping review.

The number of people around the world living with dementia is predicted to rise from 44 million to 135 million by 2050. Traditional treatments for dementia have been largely unsuccessful and prompted the emergence of alternative strategies. Music is emerging as an effective therapeutic strategy for older adults with dementia however, most of the work to date has focused on institutions. The purpose of this scoping review was to summarize what is known about the role and impact that music plays in the lives of community-dwelling older adults with dementia. Using a five-stage framework for conducting a scoping review, analysis revealed three ways in which music influences the lives of community-dwelling older adults with dementia: (a) reduced agitation, (b) improved cognition, and (c) enhanced social well-being. The concept of personhood provided a lens with which to conceptualize the findings and highlights the need for continued research.

MAPx (Mobility Aid Personalization): examining why older adults "pimp their ride" and the impact of doing so.

We all do this. We personalize things. We buy leopard-printed seat covers and fuzzy dice for our cars, and display action figures and photographs in our offices. Studying older adults who have extended this process of personalization to their mobility devices, the purpose of the mobility aid personalization (MAPx) project is to examine MAPx and its impact on the health and mobility of older adults. Using a qualitative research design, field observations and interviews were conducted with 72 older adults to gain an in-depth understanding of device customization from an emic (insider's) perspective. Findings illustrate that older adults personalize their devices for reasons of fun, function and fashion. MAPx - the process of purposefully selecting or modifying a mobility device to suit individual needs and preferences - was also found to promote health and mobility by encouraging device acceptance, increasing social participation, enhancing joy and preserving identity. MAPx makes an important contribution to our understanding of the complex relationship between older adults and assistive devices and provides a new approach to some old problems including falls, inactivity and social isolation. Encouraging MAPx is a promising rehabilitation strategy for promoting health and community mobility among the older adult population. Implications for Rehabilitation Personalizing an assistive device facilitates device acceptance, promotes health and well-beingand should be supported and encouraged in rehabilitative care. Choice, variety and access are critical aspects of assistive devices; vendors, manufacturers andpractitioners should work together to provide clients with a greater range of affordable optionsfor new devices. Function is more than mechanical or physical; social factors including social identity, stigma andsocial roles must be adequately considered and explicit in rehabilitative practice.

Seniors, risk and rehabilitation: broadening our thinking.

PURPOSE: Conceptualizations of risk in seniors' rehabilitation emphasize potential physical injury, functional independence and cost containment, shifting rehabilitation from other considerations essential to promoting a satisfying life. In a two-day multidisciplinary planning meeting we critically examined and discussed alternatives to dominant conceptualizations. METHOD: Invitees reflected on conceptualizations of risk in stroke rehabilitation and low vision rehabilitation, identified and explored positive and negative implications and generated alternative perspectives to support rehabilitation approaches related to living a good life. RESULTS: Current risk conceptualizations help focus rehabilitation teamwork and make this work publically recognizable and valued. However, they also lead to practice that is depersonalized, decontextualized and restrictive. Further research and practice development initiatives should include the voices of clinicians and seniors to more adequately support meaningfully living, and foster safe spaces for seniors and clinicians to speak candidly, comprehensively and respectfully about risk. To ensure that seniors' rehabilitation targets a satisfying life as defined by seniors, increased focus on the environment and more explicit examination of how cost containment concerns are driving services is also necessary. CONCLUSION: This work reinforced current concerns about conceptualizations of risk in seniors' rehabilitation and generated ways forward that re-focus rehabilitation more on promoting a satisfying life. Implications for rehabilitation In seniors' rehabilitation, considerations of risk focus on physical injury, functional dependence and cost containment. Focus on provider-defined risk of physical injury limits examination of patient goals and patients' histories of judging and dealing with risk. Focus on functional dependence and cost containment may lead to practice that is depersonalized and decontextualized. Abandonment of ableist and ageist thinking and an explicit focus on person-centered definitions of risk and a satisfying life are recommended.

Low Vision Rehabilitation, Age-Related Vision Loss, and Risk: A Critical Interpretive Synthesis.

PURPOSE: Given the centrality of risk in geriatric rehabilitation, it is critically important to attend to how conceptualizations of risk shape research, policies, and rehabilitation practices. This paper presents a critical interpretive synthesis (CIS) of literature addressing risk and low vision rehabilitation for older adults with age-related vision loss (ARVL) to identify key guiding assumptions regarding risk and discuss implications for what gets attended to, and not attended to, within research and rehabilitation. DESIGN AND METHODS: This CIS combined guidelines proposed by Dixon-Woods and colleagues (2006-Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Medical Research Methodology, 6, 35) and Alvesson and Sandberg (2011-Generating research questions through problematization. Academy of Management Review, 36, 247-271; 2013-Constructing research questions: Doing interesting research. London: Sage). The iterative review process involved 3 steps: literature search and selection, data extraction, and syntheses to identify boundary assumptions. The dataset included 83 research and practice description articles. RESULTS: Older adults with ARVL were constructed as "at risk" for various adverse outcomes, particularly dependency and self-harm, and as posing risks to others. An epidemiological approach to risk based in assumptions aligned with a technico-scientific perspective was dominant, with risk conceptualized as an embodied, individual-level phenomenon that is to be determined and managed through objective screening and expert monitoring. IMPLICATIONS: Key concerns include a lack of: attention to the tensions created when rehabilitation research and practice attempt to promote independence while simultaneously reducing risk, incorporation of aging adults' perspectives on risk, and analysis of environmental factors that shape risks. Research that starts by valuing older adults' experiences and attends to context can inform rehabilitation practices that support health-promoting, risk-taking, and facilitate collaborative approaches to risk management.

Development of a Theory-Based Intervention to Increase Clinical Measurement of Reactive Balance in Adults at Risk of Falls.

BACKGROUND: Effective balance reactions are essential for avoiding falls, but are not regularly measured by physical therapists. Physical therapists report wanting to improve reactive balance assessment, and theory-based approaches are recommended as the foundation for the development of interventions. This article describes how a behavior change theory for health care providers, the theoretical domains framework (TDF), was used to develop an intervention to increase reactive balance measurement among physical therapists who work in rehabilitation settings and treat adults who are at risk of falls. CASE DESCRIPTION: We employed published recommendations for using the TDF-guided intervention development. We identified what health care provider behavior is in need of change, relevant barriers and facilitators, strategies to address them, and how we would measure behavior change. In this case, identifying strategies required selecting both a reactive balance measure and behavior change techniques. Previous research had determined that physical therapists need to increase reactive balance measurement, and identified barriers and facilitators that corresponded to 8 TDF domains. A published review informed the selection of the Balance Evaluation Systems Test (Reactive Postural Responses Section) as addressing the barriers and facilitators, and existing research informed the selection of 9 established behavior change techniques corresponding to each identified TDF domain. OUTCOMES: The TDF framework were incorporated into a 12-month intervention with interactive group sessions, local champions, and health record modifications. Intervention effect can be evaluated using health record abstraction, questionnaires, and qualitative semistructured interviews. SUMMARY: Although future research will evaluate the intervention in a controlled study, the process of theory-based intervention development can be applied to other rehabilitation research contexts, maximizing the impact of this work.Video Abstract is available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A123).

Problematising risk in stroke rehabilitation.

PURPOSE: Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. METHOD: Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. RESULTS: Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. CONCLUSIONS: Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or more severe stroke. Viewing individuals affected by stroke as possessing a range of independence and diverse personally valued activities that exist within a network of relations offers wider possibilities for action in rehabilitation.

Evaluating Intention and Effect: The Impact of Healthcare Facility Design on Patient and Staff Well-Being.

OBJECTIVE: This post occupancy evaluation (POE) assessed the impact of architectural design on psychosocial well-being among patients and staff in the context of a new complex continuing care and rehabilitation facility. BACKGROUND: Departing from typical POEs, the hospital design intentions formed the theoretical basis to assess outcomes. Intentions included creating an environment of wellness; enhancing connection to the community, the city, and nature; enhancing opportunities for social interaction; and inspiring activity. METHODS: A pretest-posttest quasi experiment, including quantitative surveys, assessed the impact of the building design on well-being outcomes across three facilities-the new hospital, the former hospital, and a comparison facility with a similar population. RESULTS: With the exception of connection to neighborhood (for patients) and opportunities to visit with others (for staff) and wayfinding (for patients and staff), impressions of the new hospital mirrored the design intentions relative to the former hospital and the comparison facility among patients and staff. Perceptions of improvement in mental health, self-efficacy in mobility, satisfaction, and interprofessional interactions were enhanced at the new hospital relative to the former hospital, whereas optimism, depressive symptoms, general well-being, burnout, and intention to quit did not vary. Interestingly, patients and staff with favorable impressions of the building design fared better on most well-being-related outcomes relative to those with less favorable impressions. CONCLUSIONS: Beyond the value of assessing the impact of the design intentions on outcomes, the approach used in this study would benefit evaluation strategies across a diversity of health and other public and large-scale buildings.

Wheelchair cleaning and disinfection in Canadian health care facilities: "That's wheelie gross!".

BACKGROUND: Wheelchairs are complex equipment that come in close contact with individuals at increased risk of transmitting and acquiring antibiotic-resistant organisms and health care-associated infection. The purpose of this study was to determine the status of wheelchair cleaning and disinfection in Canadian health care facilities. METHODS: Acute care hospitals (ACHs), chronic care hospitals (CCHs), and long-term care facilities (LTCFs) were contacted and the individual responsible for oversight of wheelchair cleaning and disinfection was identified. A structured interview was conducted that focused on current practices and concerns, barriers to effective wheelchair cleaning and disinfection, and potential solutions. RESULTS: Interviews were completed at 48 of the 54 facilities contacted (89%), including 18 ACHs, 16 CCHs, and 14 LTCFs. Most (n = 24) facilities had 50-200 in-house wheelchairs. Respondents were very concerned about wheelchair cleaning as an infection control issue. Specific concerns included the lack of reliable systems for tracking and identifying dirty and clean wheelchairs (71%, 34/48), failure to clean and disinfect wheelchairs between patients (52%, 25/48), difficulty cleaning cushions (42%, 20/48), lack of guidelines (35%, 27/48), continued use of visibly soiled wheelchairs (29%, 14/48) and lack of resources (25%, 12/48). CONCLUSION: Our results suggest that wheelchair cleaning and disinfection is not optimally performed at many Canadian hospitals and LTCFs. Specific guidance on wheelchair cleaning and disinfection is necessary.

The role of social engagement and identity in community mobility among older adults aging in place.

UNLABELLED: The purpose of this study was to understand how neighbourhoods - as physical and social environments - influence community mobility. Seeking an insider's perspective, the study employed an ethnographic research design. Immersed within the daily lives of 6 older adults over an 8-month period, auditory, textual, and visual data was collected using the "go-along" interview method. During these interviews, the researcher accompanied participants on their natural outings while actively exploring their physical and social practices by asking questions, listening, and observing. Findings highlight a process of community mobility that is complex, dynamic and often difficult as participant's ability and willingness to journey into their neighborhoods were challenged by a myriad of individual and environmental factors that changed from one day to the next. Concerned in particular with the social environment, final analysis reveals how key social factors - social engagement and identity - play a critical role in the community mobility of older adults aging in place. IMPLICATIONS FOR REHABILITATION: Identity and social engagement are important social factors that play a role in community mobility. The need for social engagement and the preservation of identity are such strong motivators for community mobility that they can "trump" poor health, pain, functional ability and hazardous conditions. To effectively promote community mobility, the social lives and needs of individuals must be addressed.

The Posttraumatic Stress Disorder Checklist as a screening measure for posttraumatic stress disorder in rehabilitation after burn injuries.

OBJECTIVES: To determine the profile of posttraumatic stress disorder (PTSD) among outpatients with burn injuries referred to psychology in a rehabilitation hospital, and the utility of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) as a screening measure for PTSD. DESIGN: Retrospective psychological chart review. SETTING: Outpatient burn clinic of a rehabilitation hospital. PARTICIPANTS: Outpatients (N=132) with burns referred to psychology between December 1999 and January 2010. INTERVENTIONS: Psychological evaluation and self-report questionnaires measuring PTSD and depression. MAIN OUTCOME MEASURES: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to assess clinical diagnosis of disorders, PCL-C to measure PTSD, and the Beck Depression Inventory-II to measure depression. RESULTS: Of 132 outpatients, 127 (96%) had work-related injuries, 116 (88%) were men, and 16 (12%) were women. Mean age ± SD at injury was 39.0±11.1 years. Mean time from injury to assessment was 15.7±42.7 months. Burn etiology included: electrical (46.2%), scald (28.0%), flame (16.7%), chemical (5.3%), and contact (3.8%). Most patients (75%) were diagnosed with PTSD, either clinical (39.4%) or subclinical (35.6%). PTSD (clinical or subclinical) was frequently diagnosed in the following etiology groups: scald (85.7%), flame (77.3%), and electrical (74.6%). There were significant relationships between PTSD and depression (P<.001), and between subclinical PTSD and adjustment disorder (P<.03). PCL-C mean scores ± SD in the clinical and subclinical PTSD groups were 59.7±8.9 and 43.5±15.6, respectively. A PCL-C total score of 50 or higher had a sensitivity of 90% and specificity of 79% for PTSD diagnosis. CONCLUSIONS: There was a high prevalence of PTSD (clinical or subclinical) among outpatients with burns referred to psychology. Prospective screening of psychological symptoms, clinical assessment, and intervention is warranted, especially for patients with work-related burn injuries. Our results suggest that PCL-C is a useful screening measure for PTSD in patients with burns.

Pedometers as measurement tools and motivational devices: new insights for researchers and practitioners.

Pedometers are increasingly used in physical activity research and health promotion initiatives. This pilot study examines the efficacy of pedometers as motivational tools for increasing daily physical activity and exploring the practical issues related to pedometer use in research and intervention studies. A mixed-method design is used to collect data on the level of activity and in-depth information about participants' experiences wearing the pedometers. Participants are 10 midlife women between the ages of 45 and 64 (mean age = 52.9). Analysis indicates pedometers function as important motivational tools for increasing daily physical activity and improving the awareness of activity patterns for participants. Findings provide new insights into participants' experiences using the pedometers and understanding how these devices function as research tools. Several important methodological considerations for future research and intervention designs using pedometers are discussed.

Envelhecimento saudável: uma revisão das pesquisas em língua inglesa / Envejecimeiento saludable: una revisión de las pesquisas en lengua inglesa / Aging Health: a review in the research´s English language

“Envelhecimento saudável”, como uma perspectiva particular para explorar o relacionamento entre saúde e envelhecimento, é um paradigma teórico poderoso na cultura e prática da gerontologia e uma força dominante nas agendas de pesquisa, organizações financiadoras e governos no mundo de língua inglesa. Escrito a partir de uma perspectiva norte-americana, essa resenha proporciona um resumo da extensa documentação em literatura de língua inglesa dedicada ao “envelhecimento saudável”, incluindo a identificação de críticas-chave e desafios da área. A seção final do trabalho considera o quanto um foco no “ir e vir” (“going and doing”) de idosos entre determinados lugares de envelhecimento representa uma direção nova e estimulante para as pesquisas futuras sobre envelhecimento saudável.

“Aging Heal th” , as a par t icular perspective to explore the relationship between health and aging, is a powerful theoretical paradigm in the practical culture and of the gerontology and a dominant force in research agendas, organizations financiers and governments in the world of English language. Wr i t ing f rom a Nor th Amer ican perspective, this summary provides a summary ofthe extensive documentation in literature of dedicated English language to the “aging health”, including the identification of critical-key and challenges of the area. The final section of the workconsiders how much a focus in “going and coming” (“going and doing”) of aged between determinedaging places represents a new direction and stimulant for the future research overageing health.

“Envejecimiento saludable”, con una perspectiva particular para explorar la relación entre salud y envejeciemento, es un paradigma teórico poderoso en la cultura e práctica de la geriatria y una fuerza dominante en las agendas de pesquisa,organizaciones financieras y gobiernos en el mundo de la lengua inglesa. Escrito a partir de una perspectiva norte-americana, esa reseña proporciona un resumen de la extensa documentación enliteratura en la lengua inglesa dedicada ao “envejecimiento saludable”, incluso la identificación de las críticas-clave e desafíos de la área. La sección final del trabajo considera o cuanto un foco en el “ir y venir” (“going and doing”) del ancianos entre determinados lugares de envejecimiento representa una dirección nuova e incitante para las pesquisas futuras sobre envejecimiento saludable.