bluuebunny/crossref_metadata_2025_split huggingface dataset:
Existing and Emerging Measures of Muscle Strength and Mass in the Assessment of Sarcopenia
Authors: Duggan Eoin , Xue Feng , Knight Silvin P , Romero-Ortuno Roman 
Published: September 2024

Abstract

Background
Sarcopenia, an accelerated loss of muscle strength and mass is a major driver of adverse health outcomes in older people. The European Working Group on Sarcopenia recommends muscle strength assessment with handgrip strength (HGS) or five chair stands test (5CST) and muscle mass assessment with dual energy X-ray absorptiometry or bioelectrical impedance analysis (BIA). However, these methods can be contraindicated, unavailable or patients can be unable to perform them. We sought to compare the existing measures HGS, 5CST and BIA to emerging measures: quadriceps muscle strength (QMS) and muscle ultrasound.

Methods
Thirty-one participants from a local healthy ageing group (mean age 71±5 years, 80% female) were recruited to the FRAILMatics Physiological Cohort. Max HGS was assessed using the Jamar Plus+ dynamometer and 5CST timed from a standard height chair. Max QMS was measured with the Actiforce hand-held dynamometer. BIA was performed with the TANITA DC-430 MAP and the Sergi equation used to estimate appendicular skeletal muscle mass (ASMM). Rectus femoris muscle thickness (RFMT), vastus lateralis muscle thickness (VLMT) and anterior thigh muscle thickness (ATMT) measurements were taken using the linear array transducer on the GE Vscan Air point of care ultrasound system. Pearson correlation was used to examine the relationship between measures.

Results
Strong correlation was seen between max QMS and max HGS (r = 0.73, P &lt;0.001); moderate correlation between RFMT, VLMT, ATMT and ASMM (r = 0.51, P &lt;0.01; r = 0.56, P&lt;0.01; r = 0.40, P &lt;0.05). 5CST was not correlated with any of the measures (P &gt;0.05).

Conclusion
In the assessment of sarcopenia, QMS and muscle ultrasound could be alternatives to HGS and BIA respectively, especially in cases where the latter are not available or contraindicated. 5CST appears less useful in the assessment of sarcopenia and may be more appropriate as a test of physical performance.
Enhancing Education and Training for Professionals and Formal Carers: Implementing Microlearning
Authors: Zrnic Darko 
Published: September 2024

Abstract

Background
Current technological, economic and social changes trigger the need for new concepts and strategies to support lifelong learning. Education, including work-based learning, is in need of transformation, requiring renewal and innovative ways of relating appropriately to the way we live, work and learn today (Downes, 2005; Kuhlmann & Sauter 2008; Chisholm 2005). Staff shortages and heavier workloads has reduced the availability of health care staff to attend in-depth training courses. This, coupled with the recent moves away from traditional face-to-face learning to e-learning, we had to re-consider teaching theories and teaching methods.

Methods
In this poster I will present how we utilised microlearning to improve staff knowledge about dementia and nutrition. Microlearning is a method of delivering small, bite-sized pieces of information that can be easily consumed and retained by learners. It offers customised learning experiences that cater to the unique needs and preferences of each learner and provides an engaging and interactive learning experience through the use of multimedia, quizzes, and games.

Results
Microlearning facilitates self-directed lifelong learning, as short activities can be easily integrated into everyday activities. Small learning steps with small pieces of information can be used for learning in between and on-demand. In this way microlearning enables individuals to stay up to date in today’s knowledge society and offers a viable supplement to more time-consuming and formalized modes of learning, such as classroom courses or web-based trainings. Additionally, this poster will describe how we have applied microlearning as an emerging pedagogy that enables learners and clinicians to engage in short, focused, asynchronous and just-in-time learning.

Conclusion
Microlearning as an educational strategy has demonstrated a positive effect on the knowledge and confidence of health professions learners in performing procedures, retaining knowledge, studying, and engaging in collaborative learning.
The Effect of Fludrocortisone on Ambulatory Blood Pressure Markers of Falls Risk Amongst Older People with Falls
Authors: Doyle Kate , Kenny Roseanne , Briggs Robert , Lavan Amanda 
Published: September 2024

Abstract

Background
Fludrocortisone is frequently used to raise blood pressure in older patients with falls due to hypotension, yet evidence to support its use is limited. The aim of this study was to assess changes in Ambulatory Blood Pressure Monitors (ABPM) markers of future falls risk seen after commencing/increasing Fludrocortisone in older people with falls due to orthostatic hypotension (OH) or vasovagal syncope.

Methods
A cohort of older patients (≥65 years) attending a tertiary-referral falls & syncope unit and prescribed Fludrocortisone were included. ABPM at index visit and follow-up (after commencing/increasing Fludrocortisone) were analysed, with specific focus on markers of future falls risk: overall Systolic Blood Pressure (sBP), minimum sBP, sBP variability & ‘dips’ in systolic sBP &lt;100 mm Hg. These variables were compared pre and post Fludrocortisone using paired t-tests.

Results
Twenty-three patients (median age 74 years (SD 6.05), 3/4 with OH) were followed for median 4.5 (SD 6.53) months. Two-thirds were commenced on Fludrocortisone, with the dose increased in the rest. Patients commencing Fludrocortisone had a significant increase in overall sBP from 110.13mmHg (95% CI 104.26 – 116.00) to 127.93mmHg (95% CI 120.00 – 135.87) (p&lt;0.001) at follow-up, and a significant increase in minimum sBP from 82.2mmHg (95% CI 76.25 – 88.15) to 99.87mmHg (95% CI 91.47 – 108.26) (p=0.001). There was also a significant reduction in the number of SBP ‘dips’ after commencing Fludrocortisone (9.6 pre to 2.67 post, (95% CI 0.08 – 5.25), p=0.004)), and after commencing/increasing Fludrocortisone dose (8.09 pre to 2.74 post (95% CI 0.62 – 4.85) (p=0.012)).

Conclusion
This study provides clinical data on the effectiveness of Fludrocortisone in older patients with falls due to hypotension, demonstrating significantly improved markers of future falls risk. Overall sBP increased significantly by 16% and minimum sBP increased by over 20% after starting Fludrocortisone. The number of SBP ‘dips’ also significantly reduced, by over 70% in those who commenced Fludrocortisone.
Antipsychotic Prescribing and Falls Risk in Nursing Home Residents with Dementia
Authors: D'Alton Maeve , Eustace Andrew 
Published: September 2024

Abstract

Background
Falls are a common syndrome in older adults leading to adverse outcomes including functional decline, activity restriction, injury and death. They can still occur in residential care. We examined prescribing of medications included in STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk) (1) in nursing home residents with dementia.

Methods
A point prevalence audit was conducted in a dementia-specific nursing home. Data were collected from the electronic healthcare record on demographics, dementia severity, and number of falls in the preceding 12 months. The number and class of regular medications were recorded. Non-cognitive symptoms of dementia were quantified using the Cohen Mansfield Agitation Inventory (CMAI).

Results
Seventy-four residents were included with mean age 82 years, 59(70%) female. The average Mini Mental State Examination (MMSE) was 5/30 and 80% had severe dementia. The average CMAI score was 50. The mean number of falls was 3 (range 0-14). Regular prescribing of specific STOPPFall medications was as follows: antipsychotics 42/74 (57%), benzodiazepines 8/74 (11%), opioids 13/74 (18%), antidepressants 44/74 (59%), antiepileptics 11.74 (15%), diuretics 12/74 (16%). Prescription of a regular antipsychotic was associated with one or more falls (OR 3.19, p = 0.029). There was no significant difference in falls with the other medications studied. The number of falls increased with higher agitation scores.

Conclusion
Antipsychotics increased the risk of falls in a nursing home setting. Fallers had higher rates of agitation, perhaps explaining the increased usage of antipsychotics. Medications should be reviewed on a regular basis and deprescribing considered where appropriate.

Reference
1. Seppala LJ, Petrovic M, Ryg J, Bahat G, Topinkova E, Szczerbińska K, et al. STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drgs. Age and Ageing. 2020;50(4):1189-99.
The Spectrum Of Symptoms In Older Patients With Severe Orthostatic Hypotension
Authors: Byrne Lisa , Poulose Bindu , Joseph Lincy , Hade Dymphna , Rice Ciara , Deirdre Kelly , Briggs Robert 
Published: September 2024

Abstract

Background
Orthostatic Hypotension (OH) is an important cause of falls in older people, with patients typically presenting with postural dizziness/light-headedness. However, while we recognise clinically that in older patients with OH, symptoms are often absent or atypical, little work to date has captured this spectrum of OH symptoms. The aim of this study therefore was to examine symptom profiles in a large cohort of older people with severe OH and ascertain the prevalence of ‘asymptomatic’ OH.

Methods
We included a consecutive cohort of older patients (aged ≥60 years) with severe OH attending a tertiary referral falls unit. OH, was identified during an active stand using a Finometer® measuring beat-to-beat phasic blood pressure. Patients were asked to report any symptoms during the test and each symptom was recorded. Severe OH was defined as failure of recovery of BP to within 20 mmHg systolic/10mmHg diastolic of baseline value within 3 minutes of standing.

Results
71% of patients (n=393) reported symptoms during the active stand, with two thirds of these reporting ≥2 symptoms. The most frequent reported symptoms were dizziness (52%) and poor balance (52%), followed by weakness (38%), visual disturbance (28%), light-headedness (21%), fatigue (6%), nausea (4%), feeling warm (4%) and palpitations (1%). Nurses reported pallor in 13% of patients, while 3% needed to lie down due to hypotension/presyncope. Average time to symptom reporting was 16 seconds (compared to 11 seconds in patients who did not have severe OH).

Conclusion
Almost one third with severe OH reported no symptoms during an active stand, while only half reported ‘typical’ OH symptoms of dizziness/light-headedness. Atypical symptoms such as fatigue, and generalised weakness are relatively common. Atypical symptomatology is therefore frequent in older patients with severe OH. These findings have important implications for the clinical assessment of older people with falls.
Identification and Management of Post-Stroke Spasticity
Authors: Harte Gillian , Lawson Susan , Walsh Rachel , Ryan Dan 
Published: September 2024

Abstract

Background
Spasticity is thought to affect up to 40% of people with severe weakness after stroke, with 15% of those experiencing severe and disabling spasticity. Untreated, it can lead to pain, increased dependence, contracture and other motor impairments (National clinical guideline for stroke for the UK and Ireland, 2023). Guidelines recommend that people with motor weakness should be assessed for spasticity, and spasticity guidelines recommend that all people with problematic spasticity should be managed within a specialist service, using physical and pharmacological management as appropriate (Royal College of Physicians, 2018). The objective of this study was to determine the prevalence of spasticity reported by patients attending a post stroke review clinic, and the subsequent management of these patients.

Methods
Participants: All patients attending a post-stroke review clinic between March 2023 and April 2024. Data: All patients were asked if they experience stiffness, cramping or spasms. Responses and subsequent onward referrals were recorded. Where patients were referred onward for further assessment and management, the interventions employed were recorded. Analysis was performed using descriptive statistics.

Results
During the data collection period, 270 patients visited the clinic. Stiffness, cramps or spasms were reported by 32 (11.9%), with the majority of these (n=27, 84%) referred to a specialist physiotherapist with expertise in spasticity management for comprehensive assessment. Of the referred patients, 5 (18.5%) did not attend their appointments, 5 (18.5%) are still awaiting appointments, 6 (22.2%) were diagnosed with non-neural stiffness, and 9 (33.3%) received botulinum toxin injections at a specialist physiotherapist-led spasticity clinic.

Conclusion
Data from this exploratory study indicates the importance of assessing spasticity in patients post stroke and highlights the importance of access to a physiotherapist with specialist knowledge and skills in spasticity management.
A Review of the Concurrent Incidence and Evidence for Dysphagia and Constipation in Acute Stroke Patients
Authors: Almahal Hammam , McCarthy Kate , Robinson Shelia , Hartigan Irene 
Published: September 2024

Abstract

Background
Dysphagia post-acute stroke is a commonly reported complication. It can effect up to 80% of the post stroke population (Banda et al., 2022). Constipation is a well-recognised complication in all hospital admissions. The cause of which is thought of as multifactorial, change in diet and fluid intake, reduced mobility, change in routine etc. A scoping review has found that despite both conditions being prevalent in a stroke population, their concurrent incidence has not been studied or reported.

Methods
A scoping literature review was carried out to investigate the incidence of these conditions concurrently in stroke. Databases used were CINAHL, EMBASE and MEDLINE. Inclusion criteria for the review included 1) Stroke population over 18 years 2) published in English 3) any measure taken of constipation. Opinion pieces and non-peer reviewed papers were excluded. An audit of our current inpatient cohort on the stroke unit was also carried out to identify if these concurrent conditions are being documented and acted upon.

Results
The literature review resulted in an empty review. There was no clearly defined literature that reported on the concurrent incidence of dysphagia and constipation in an acute stroke population. The supportive audit on the ward included 29 patients on the inpatient acute stroke unit. 2 of 29 had documented constipation, while 21 of 29 (72%) patients were prescribed laxatives. 15 of 29 (51.7%) had been commenced on a modified diet by speech and language therapy secondary to dysphagia.

Conclusion
Dysphagia and constipation have been identified as common post stroke complications. 72% of the inpatient cohort have been commenced on laxatives, this indicates the recognition and pre-emptive management off this prevalent complication. Dysphagia was documented in over 50% of patients. Continued research needs to be carried out on the concurrent incidence and management of these post stroke complications.
Muscle Makers: Evaluating a 10-Week Strength and Nutrition Programme's Impact on Sarcopenia
Authors: Forde Grainne , Harte Gillian , Quinn Siobhan , McCarron Cathal , Conaty Sarah , O'Neill Desmond 
Published: September 2024

Abstract

Background
Sarcopenia is a progressive skeletal muscle disorder characterized by loss of muscle mass and strength, leading to adverse outcomes like physical disability, poor quality of life, and death. The European Working Group on Sarcopenia in Older People (EWGSOP) identifies sarcopenia using criteria including low muscle strength, quantity, quality, and performance. This highlights the importance of early detection and intervention strategies, such as the physiotherapy-led Muscle Makers programme —a 10-week outpatient Progressive Resistance Training (PRT) program with fortnightly Clinical Nutrition input. This data collection aimed to evaluate the programme's effectiveness over a 6-month period.

Methods
Data was collected on all participants who attended Muscle Makers (one 1-hour session/week) between September 2023 and February 2024. Analysis included participants with both pre- and post-10-week programme outcome measures completed. Data was collected and analysed using MS Excel. Outcome Measures (OCMsused: Timed Up and Go (TUG) and 5-time sit to stand (5TST).Inclusion: Participants with both pre- and post-OCMscompletedExclusion: Participants without pre/post OCMsNon-normally distributed data was log-transformed prior to statistical testing.Results: Number of participants fitting inclusion criteria: 44 (Male: 20, Female: 24)Average age: 80.6 yearsAverage sarcopenia score (SARC F): 4.04 (probable sarcopenia)Average number of falls in the past 12 months: 1.56Average number of classes attended: 8.12

Data Results

Conclusion
The participants in the Muscle Makers programme achieved significant improvements in both the 5TST and TUG tests, demonstrating enhanced lower body strength, balance, and overall functional mobility. These improvements suggest that the 10-week strength and nutrition intervention effectively mitigates the effects of sarcopenia, highlighting the potential of targeted exercise and nutritional strategies in managing and potentially reversing the progression of this condition.
Determining Inclusion Criteria For Post-Acute Care Rehabilitation – Home Alone Is Not A Barrier To Success
Authors: OConnell Karen , Cashen Aoife , Coen Michelle , Loughnane Hannah , Waldron Eithne , O’Connor Anne , Tynan Michelle , Reddin Catriona , Flattery Valerie , Robinson Stephanie 
Published: September 2024

Abstract

Background
Older adults discharged after acute hospitalisation are at risk for functional decline and adverse health outcomes. With population ageing, traditional approaches to rehabilitation with extended acute care stay are not sustainable. Successful outcomes in home-based rehabilitation relies on appropriate patient selection criteria. Some evidence suggests that older adults living alone are at highest risk for poor health-related outcomes including prolonged hospital admission and high readmission rates due to lack of cohabitants to support their needs.

Methods
Retrospective case analysis of consecutive participants in an older persons home based rehabilitation programme were included. Demographics including age, gender, frailty status, living arrangements, length of inpatient stay savings (days) and functional improvement (FIM) were measured. Logistical regression was used to estimate the relationship between living alone and functional gains.

Results
Eighty-three consecutive cases were reviewed, 10 cases excluded as readmitted (n=8), or clinically deteriorated and unable to complete the programme (n=2). Readmission rate (30 day) was 9.6%. Of 73 cases, 42.5%(n=31) lived alone, and 57.5%(n=42) co-habited during the programme. Mean (SD) clinical frailty score for those living alone was 5.26(1.03) and 4.98(1.07) for those not living alone. Improvements in FIM were similar in both groups, mean (SD) 11.4(7.2) versus 9.0(6.0). There was no statistically significant difference in change in FIM score between groups (-2.40(-5.56 to 0.77), p=0.136). Of 18 items in FIM, greatest benefit was seen in locomotion, bed/chair/toilet transfers, grooming, dressing and bathing skills. Mean bed-day savings was 6.45(2.07) acute inpatient bed-days per participant.

Conclusion
Our findings demonstrate that older adults who live alone benefit equally well from home based rehabilitation programme. Therefore, living alone should not limit enrolment on such programmes. Rehabilitation gains in the home environment were greatest in parameters that are challenging to target in acute care settings.
Exploring the Impact of Animal Assisted Interventions on the Occupational Participation of People Living with Dementia
Authors: Timmons Danielle 
Published: September 2024

Abstract

Background
Animal Assisted Intervention (AAI) is defined as a goal-directed intervention designed to promote improvement in social, emotional, physical and cognitive functioning (AAII 2020). AAIs are a growing area in dementia research and practice (Lai et al. 2019). There is a significant gap in implementing and researching AAI in a UK context (Fine 2019). Caring for pets and service animals is considered an instrumental activity of daily living (AOTA 2008) and AAI has been shown to enhance the occupational participation of other client populations (Winkle et al. 2012; Herlache-Pretzer et al. 2017; Andreasen et al. 2017). It is unclear what impact AAI has on the occupational participation of people living with dementia (PLWD).

Methods
Interpretative Phenomenological Analysis was proposed to facilitate deep level interpretations of the experience of occupational participation for PLWD who have an assistance dog. Over a two-month period, the researcher proposed to complete four thirty-minute video observations capturing PLWD participating in a chosen occupation in their home environment. The researcher further proposed to maintain a reflexive journal and document notable observations throughout the research process to enhance the development of themes.

Results
PLWD have the right to access personally meaningful occupations (WFOT 2006). Assistance dogs may have the potential to facilitate positive occupational experiences such as occupational identity, occupational competence and occupational adaptation.

Conclusion
Occupational therapists who claim to be guided by the principals of client-centred practice (RCOT 2015a) must strive to look beyond traditional interventions to effectively meet the individual needs and preferences of PLWD (Brodrick and Barry 2016). Education and further research (Fine 2019) are required to raise the profile of AAI in a UK context. Future research would benefit from exploring the experience of occupational participation in social environmental contexts for PLWD (who have an assistance dog), to gain whole experiential accounts of this phenomenon.