About
Scope & Aims
Editorial office
Editorial board
Reviewers
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Guide for authors
Templates
Publication charge
For Reviewers
Guide for reviewers
Our reviewers
ORIGINAL PAPER
An evaluation of the usefulness of Comprehensive Geriatric Assessment
in patients after a fracture within the proximal femoral epiphysis while
staying at a nursing home – a pilot study
1
Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, Poland
Submission date: 2021-10-25
Acceptance date: 2022-01-04
Publication date: 2023-06-01
Physiother Quart. 2023;31(2):85-91
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The aim of this study was to evaluate the usefulness of Comprehensive Geriatric Assessment (CGA) in patients after a fracture within the proximal femoral epiphysis, staying at a nursing home (NH).
Methods:
The study was conducted at a NH centre on 15 people after a fracture within the proximal femoral epiphysis (mean aged 76.9 ± 10.8). The CGA assessment was performed twice: before and after a 12 week stay at the centre. Physiotherapy was carried out five times a week for one hour (Monday to Friday).
Results:
The analysis showed a significant improvement in the Activities of Daily Living scale (ADL). In the case of the physical condition of the patients, the physiotherapy led to significant improvements, predominantly in the gait and balance of the patients. Significant correlations, at the start and end of the study, were found between the ADL and Tinetti scale.
Conclusions:
There was a significant relationship found between the functional status and physical health of the patients undergoing physiotherapy staying at the NH. The systematic 3-month physiotherapy significantly improved the functional and physical condition of elderly patients. CGA can be a tool for evaluating the efficacy of the rehabilitation process of elderly patients staying at a NH. The results are a pilot study, but confirm that CGA can and should be routinely used in geriatric centres in Poland.
The aim of this study was to evaluate the usefulness of Comprehensive Geriatric Assessment (CGA) in patients after a fracture within the proximal femoral epiphysis, staying at a nursing home (NH).
Methods:
The study was conducted at a NH centre on 15 people after a fracture within the proximal femoral epiphysis (mean aged 76.9 ± 10.8). The CGA assessment was performed twice: before and after a 12 week stay at the centre. Physiotherapy was carried out five times a week for one hour (Monday to Friday).
Results:
The analysis showed a significant improvement in the Activities of Daily Living scale (ADL). In the case of the physical condition of the patients, the physiotherapy led to significant improvements, predominantly in the gait and balance of the patients. Significant correlations, at the start and end of the study, were found between the ADL and Tinetti scale.
Conclusions:
There was a significant relationship found between the functional status and physical health of the patients undergoing physiotherapy staying at the NH. The systematic 3-month physiotherapy significantly improved the functional and physical condition of elderly patients. CGA can be a tool for evaluating the efficacy of the rehabilitation process of elderly patients staying at a NH. The results are a pilot study, but confirm that CGA can and should be routinely used in geriatric centres in Poland.
REFERENCES (40)
1.
Dziuban A. Social image of old age and perception of one’s own body in the process of aging. Literature review [in Polish]. Gerontol Pol. 2010;18(3):140–147.
2.
The Lancet Editorial. Global elderly care in crisis. Lancet. 2014;383(9921):927; doi: 10.1016/S0140-6736(14)60463-3.
3.
Gladman JRF. The international classification of functioning, disability and health and its value to rehabilitation and geriatric medicine. J Chin Med Assoc. 2008;71(6):275–278; doi: 10.1016/S1726-4901(08)70122-9.
4.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia. European consensus on definition and diagnosis. Age Ageing. 2010;39(4):412–423; doi: 10.1093/ageing/afq034.
5.
van Kan AG. Epidemiology and consequences of sarcopenia. J Nutr Health Aging. 2009;13(8):708–712; doi: 10.1007/s12603-009-0201-z.
6.
Granacher U, Lacroix A, Muehlbauer T, Roettger K, Gollhofer A. Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults. Gerontology. 2013;59(2):105–113; doi: 10.1159/000343152.
7.
McGough EL, Logsdon RG, Kelly VE, Teri L. Functional mobility limitations and falls in assisted living residents with dementia: physical performance assessment and quantitative gait analysis. J Geriatr Phys Ther. 2013;36(2):78–86; doi: 10.1519/JPT.0b013e318268de7f.
8.
Katch VL, McArdle WD, Katch FI. Essentials of Exercise Physiology. 4th ed. Lippincott Williams and Wilkins, Wolters Kluwer business; 2011:595–630.
9.
Ghisla MK, Cossi S, Timpini A, Baroni F, Facchi E, Marengoni A. Predictors of successful rehabilitation in geriatric patients: subgroup analysis of patients with cognitive impairment. Aging Clin Exp Res. 2007;19(5):417–423; doi: 10.1007/BF03324724.
10.
Szczepańska-Gieracha J, Kowalska J, Malicka I, Rymaszewska J. Cognitive impairment, depressive symptoms and the efficacy of physiotherapy in elderly people undergoing rehabilitation in a Nursing Home Facility. Adv Clin Exp Med. 2010;19(6):755–764.
11.
Kowalska J, Szczepańska-Gieracha J, Piątek J. Cognitive and emotional disturbances and length of stay of elderly people in a nursing home facility [in Polish]. Psychogeriatr Pol. 2010;7(2):61–70.
12.
Wilkinson I., Harper A. Comprehensive geriatric assessment, rehabilitation and discharge planning. Medicine. 2021;49(1):10–16; doi: 10.1016/j.mpmed.2020.10.013.
13.
Ellis G, Gardner M, Tsiachristas A, Langhorne P, Burke O, Harwood RH, et al. Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev. 2017;12;9(9):CD006211; doi: 10.1002/14651858.CD006211.pub3.
14.
Rose D, Jones C, Lucchese N. Predicting the ability of falls in community-residing older adults using the 8- foot up & go: a new measure of functional mobility. J Aging Phys Act. 2002;10(1):466–475; doi: 10.1123/japa.10.4.466.
15.
McGivney SA, Mulvihill M, Taylor B. Validating the GDS depression screen in the nursing home. J Am Geriatr Soc. 1994;42(5):490–492; doi: 10.1111/j.1532-5415.1994.tb04969.x.
16.
Snowdon J, Lane F. Use of the Geriatric Depression Scale by nurses. Aging Ment Health. 1999;3(3):227–234; doi.org/10.1080/13607869956181; doi.org/10.1080/13607869956181.
17.
Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198; doi: 10.1016/0022-3956(75)90026-6.
18.
Sosnowski M, Chmara-Pawlińska R. An assessment of functions of ADL Index and MMSE in patients with various demention syndroms of different origin [in Polish]. Med Rodz. 2002;5:176–178.
19.
Lawton MP, Brody EM. Assessment of older people: self- maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–186.
20.
Guigoz Y. The Mini-Nutritional Assessment (MNA®) review of the literature – what does it tell us? J Nutr Health Aging. 2006;10(6):466–487.
21.
Rogowski Ł, Kusztal M, Gołębiowski T, Bulińska K, Zembroń-Łacny A, et al. Nutritional assessment of patients with end-stage renal disease using the MNA scale. Adv Clin Exp Med. 2018;27(8):1117–1123; doi: 10.17219/acem/75604.
23.
Szewczyk TM, Cwajda J, Cierzniakowska K, Stodolska A, Ślusarz R. Pressure ulcers risk assessment tools [in Polish]. Przew Lek. 2005;8(1):92–97.
24.
Van Marum RJ, Germs P, Ribbe MW. Norton’s decubitus risk score in a nursing home. Tijdschr Gerontol Geriatr. 1992;23(2):48–53.
25.
Evans M, Mottram P. Diagnosis of depression in elderly patients. Adv Psychiatr Treat. 2000;6(1):49–56; doi: 10.1192/apt.6.1.49.
26.
Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of geriatric depression screening scale. J Psychiatr Res. 1982–1983;17(1):37–49; doi: 10.1016/0022-3956(82)90033-4.
27.
Köpke S, Meyer G. The Tinetti Test: Babylon in geriatric assessment. Z Gerontol Geriatr. 2006;39(4):288–291; doi: 10.1007/s00391-006-0398-y.
28.
Tinetti M.E. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34:119–126; doi: 10.1111/j.1532-5415.1986.tb05480.x.
29.
Ferguson GA, Takane Y. Statistical Analysis in Psychology and Education [in Polish]. Warszawa: PWN; 2009.
30.
Heller T, Sorensen A. Promoting healthy aging in adults with developmental disabilities. Dev Disabil Res Rev. 2013;18(1):22–30; doi: 10.1002/ddrr.1125.
31.
Rams P, Szejna A, Braczkowski R, Wantuła T. Comprehensive geriatric assessment as a multidirectional diagnostic process in the elderly [in Polish]. Rehabil Prakt. 2011;2(5):14–17.
32.
The British Geriatrics Society. The Comprehensive Geriatric Assessment Toolkit for Primary Care Practitioners. 2019, 20.
33.
Nourhashémi F, Andrieu S, Gillette-Guyonnet S, Vellas B, Albarède JL, Grandjean H. Instrumental activities of daily living as a potential marker of frailty: a study of 7364 community-dwelling elderly women. J Gerontol A Biol Sci Med Sci. 2001;56(7):448–453; doi: 10.1093/gerona/56.7.m448.
34.
Nykanen I, Lönnroos E, Kautiainen H, Sulkava R, Hartikainen S. Nutritional screening in a population-based cohort of community-dwelling older people. Eur J Public Health. 2013;23(3):405–409; doi: 10.1093/eurpub/cks026.
35.
Cierzniakowska K, Szewczyk T, Łabuńska A, Michalak S, Popow A, Jawień A. The Doreen Norton scale for assessing risk of pressure ulcers [in Polish]. Leczenie Ran. 2011;8(1):7–13.
36.
Borowicz A, Wieczorkowska-Tobis K. Assessment of the risk of falling in the elderly in a rehabilitation ward [in Polish]. Geriatria. 2011;5:13–18.
37.
Welsh TJ, Gordon AL, Gladman JR. Comprehensive geriatric assessment – a guide for the non-specialist. Int J Clin Pract. 2014;68(3):290–293; doi: 10.1111/ijcp.12313.
38.
Nord M, Lyth J, Alwin J, Marcusson J. Costs and effects of comprehensive geriatric assessment in primary care for older adults with high risk for hospitalisation. BMC Geriatr. 2021;21:263; doi: 10.1186/s12877-021-02166-1.
39.
Garrard JW, Cox NJ, Dodds RM, Roberts HC, Sayer AA. Comprehensive geriatric assessment in primary care: a systematic review. Aging Clin Exp Res. 2020;32(2):197–205; doi: 10.1007/s40520-019-01183-w.
40.
Pilotto A, Cella A, Pilotto A, Daragjati J, Veronese N, Musacchio C, et al. Three decades of comprehensive geriatric assessment: evidence coming from different healthcare settings and specific clinical conditions. J Am Med Dir Assoc. 2017;18(2):192.e1–192.e11; doi: 10.1016/j.jamda.2016.11.004.
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
