The Charted Care Collection (11/02/2021)
[ photo by Oleg Magni ]
The Chartered Care Collection (11/02/2021)
The Chartered Care Collection provides a review of the latest, pertinent publications from the medical literature on aging. I have selected interesting articles that describe some of the most current research that may be relevant to the loved one in your care. Each article will be referenced if you desire to read more of the study, but I will give a brief synopsis of each study so you are aware of the latest research. Let’s get to The Collection!
The Chartered Care Collection
As we move into November, it is time to discuss some of the latest research to be printed in the many medical journals.
The first study I wanted to include published in the New England Journal of Medicine. This study looked at physical rehabilitation for patients hospitalized with heart failure. I have had numerous patients with heart failure in my rehabilitation facilities, so this one was quite interesting to me, especially for the times I have wondered to myself if pushing my patients was worth the work on their part.
This study looked at patients over the age of 60 who were hospitalized for acute decompensated heart failure and assessed the effect of early, transitional, progressive rehabilitation on physical frailty. Half of the participants were placed in the usual care group while the other half was placed in the intervention group. The intervention group worked on strength, balance, mobility and endurance. The intervention was started during the hospitalization and continued with outpatient sessions three times per week for 12 weeks. The outpatient sessions also provided for a home exercise program that included low-intensity walking and resistance exercise.
At the three month mark, the intervention group was then given individualized exercise prescriptions and received follow up every four weeks. A baseline physical and cognitive assessment was performed on all participants at the start of the study and then again at follow-up. The findings of the study showed that physical function did improve in the treatment group, including fewer falls.
(Related blog post: Falls At Home)
The next study, published in the journal Frontiers in Neurorobotics, looked at differences in functional recovery of the upper extremity affected by stroke. The participants were between 6 and 36 months post-stroke. Half of the group received constraint-induced movement therapy (CIMT) and the other half received robotic-assisted therapy (RT). The study was looking to see if one of the two was superior to the other.
The participants were randomly assigned to one of the two groups. The RT group used two robotic devices (one for the shoulder and one for the wrist). The group underwent three weekly 60 minute sessions for 12 weeks. The participants in the CIMT group had 10 consecutive days, with the exclusion of the weekends off, of six hours of therapy each day and wore a restraint mitt on the unaffected upper extremity for 90% of their active day.
At the start of the study, both groups were similar in their baseline. At the end of the study, both groups showed significant gains in upper extremity function without a significant difference between the two interventions. Although the study might not have shown what it had initially set out to do, it did support the need for ongoing therapy beyond a typical time period after a stroke. The study’s participants showed improvement in function up to 36 months post-stroke, which is something to celebrate.
(Related blog posts: Recovery After Stroke, Hand Pain After Stroke)
Another study I read, from The Journal of Bone and Joint Sugery, looked at the changes in physical activity and walking biomechanics after a hip replacement. The total number of participants was 51. All underwent elective total hip replacements.
Their pre-hip replacement baseline was determined, looking at gait speed, step length, and number of daily sedentary hours. The participants were all given a wristwatch activity monitor to wear which monitored activity levels. In addition, patients were followed up with at one and two years post-operatively.
Interestingly, the study found there was not an increase in activity level, however, the patients did have significant self-reported improvements in pain function and quality of life. My encouragement to those of you who are considering or recently underwent a joint replacement to show this study to be wrong. Be active. Keep moving. That is a way to longevity.
(Related blog posts: Should I Get A Knee Replacement?, What To Expect After A Knee Replacement)
The final paper is from JAMA Internal Medicine. This article investigate the relationship between coffee consumption and cardiac arrhythmia. There were just over 500,000 participants between the ages of 40-69 who filled out questionnaires. Information gathered included amount of total daily coffee consumption. Participants underwent physical examinations and provided biological samples.
The average amount of coffee consumed by all participants was two cups per day. The participants were followed for 4.5 years. In short, the study found that each additional cup of coffee per day (past the average two cups) was associated with a three percent lower risk of arrhythmia. Per those results, thanks for reading, and go have yourself another cup of coffee!
References:
Kitzman, D., et al. Physical Rehabilitation for Older Patients Hospitalized for Heart Failure. New England Journal of Medicine. 2021, July 15; 385(3): 203-216.
Terranova, T., et al. Robot-Assisted Therapy and Constraint-Induced Movement Therapy for Motor Recovery in Stroke: Results from a Randomized Clinical Trial. Front Neurorobot. 2021, July. doi.org/10.3389/fnbot.2021.684019.
Bahl, J., et al. Changes in 24-Hour Physical Activity Patterns and Walking Gait Biomechanics after Primary Total Hip Arthroplasty. J Bone Joint Surg. 2021, July 7; 103 (13): 1166;1174.
Kim, E., et al., Coffee Consumption and Incident Tachyarrhythmias. Reported Behavior, Mendelian Randomization and their Interactions. JAMA Intern Med. 2021, July 19: doi:10.1001/jamainternmed.2021.3616. Online ahead of print
That sums it up for the Chartered Care Collection for this month. Feel free to read each of these articles in full, and feel free to leave your comments or questions below!
© 2021 Jessica Kluetz, DO