THE SUSTAINABILITY OF CHAIR YOGA PRACTICE IN OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS

Abstract

utilisation. No studies reporting evidence about the influence of social care quality or equity were identified. Evidence indicates that lower availability and supply of social care is associated with increased use of hospital care, particularly in UK studies. There is some indication than nursing home and residential care may have more influence than home based social care on healthcare utilisation. Evidence typically reflected secondary health care outcomes, with clear gaps regarding primary care use outcomes. This review offers a clear and timely picture of how access to social care influences healthcare use for older adults. Objectives: To verify the ability of the Balance Evaluation Systems Test (BESTest), Mini-BESTest, Brief-BESTest and Berg Balance Scale (BBS) to identify institutionalized elderly falling. Methods: This is a retrospective cohort study. Institutionalized elderly (n=39; aged 62-90 years; mean=78.26 [7.3] years) were recruited from a philanthropic nursing home of Sao Paulo City (Brazil). All participants were tested with BESTest, Mini-BESTest, Brief-BESTest, and BBS and the history of falls from a year ago was collected by the medical records. For the analysis , a falls status indicator was used and the sample was dichotomized in "Non-Faller" (participants who had no fall in the last year) and "Faller" (participants who had a fall or more in the last year). The sensitivity and specific-ity between the total score of the BESTest, Mini-BESTest, Brief-BESTest, and BBS was calculated based on the fall hazard indicator. The cutoff points were determined using the Receiver Operating Characteristic (ROC) curves. The statistical significance of each analysis was verified by the area under the ROC curve (AUC) and by their respective 95% confidence intervals (95% CI). Results: All balance tests were able to identify falls status (AUC=0.63; 0.70; 0.78 and 0.75, BESTest, Mini-BESTest, Brief-BESTest, and BBS, respectively), the Brief-BESTest (sensitivity=94%, specificity=61%) and the BBS (sensitivity=94%, specific-ity=56%) had the higher ability. Conclusions: All balance tests are valuable to identify fall status in institutionalized elderly. The Brief-BESTest presented slightly higher ability to identify falls status in our sample. Chair yoga is relatively gentle and easy-to-learn form of yoga and is well suited to older adults with oasteoarthri-tis (OA) who cannot participate in standing exercises. The purpose of this study was to determine whether chair yoga practice could be sustained during and three months after an 8-week chair yoga intervention for older adults with lower extremity OA. A two-arm randomized controlled trial was conducted with twice-weekly 45-minute sessions (16 sessions) of chair yoga or Health Educaiton Program (HEP; attentional control group). Pain, pain interference, balance, gait speed, fatigue, and functional ability were measured at baseline, during intervention (4 and 8 weeks) and post-intervention(1 and 3 months). Hierarchical Linear Modeling was conducted to measure changes across time within and between groups and measure sustainability of the effect of chair yoga compared to HEP from Week 9 to Week 21 (1 month and 3 month follow-ups). One hundred twelve participants completed the intervention and data collection; 106 completed at least 12 of 16 sessions (retention rate = 95%). There was no other statistically significant sustained effect of chair yoga at the 3-month post intervention for any other variables except pain interference (p = .012). In terms of compliance with home practice after the intervention, only less than 50% of the yoga participants continued yoga practice at home using the guide book. The findings of this study were that older adults do not enjoy doing these types of activities at home alone and prefer to do programs in groups with support from an instructor. Prospective cohort of patients included in the Institutional Registry of elderly patients with Hip fracture between june 2014 and december 2016. We excluded pathologic, peripros-thetic, subtrochanteric or secondary to polytrauma fractures. We classified patients as: old patients (OP) ≥65 and <85 years and very old patients (VOP) ≥85 years. We used Kaplan Meier method to estimated one year survival. We used a Cox model to estimate OP Hazard Ratios with 95% confidence intervals (95%CI). We included 759 patients, 43% were OP and 57% were VOP. Proportion of women was 83% and 85% respectively, p0.45. They had similar frequency of polymedication (46% and 47%, p0.78) and proportion of people having two or more Charlson score (28% and 32%, p0.26). VOP were more dependent by Barthel score (36% and 65%, p<0.01) and more fail Edmonton score (34% and 67%, p<0.01). One year survival was 96% (95%CI 93-98) in OP and 84% (95%CI 79-88) in VOP. Complications were more frequent in VOP, 26% and 34% p0.02. Readmission were 30% and 41%, p<0.01. Age is an independent risk factor for one year mortality with a crude HR 4.59 (IC95% 2.16-9.73, p <0.01), adjusted for frailty, functionality, ASA score, Charlson, polymedication and nutrition HR 3.52 (95%CI 1.63-7.6, p<0.01).