Kathryn Daniel

Wii-Hab for Pre-Frail Older Adults

Purpose: To examine the effectiveness of a novel intervention aimed at decreasing indices related to frailty through systematic, Progressive Functional Rehabilitation (PFR). Methods: Pre‐frail volunteers were recruited to participate in a 15 week exercise intervention or control group. Those who met study criteria and consented were randomized into one of three groups: control, seated exercise, or Wii®‐fit. Test measures were completed before and after the 15 week intervention period on all participants. Measures included: Senior Fitness Test, Body Weight, Balance Efficacy Scale, CHAMPS, Late‐Life Function and Disability Index, MOS SF‐36. Attendance was also recorded. Results: There were improvements on several of the measures included in the Senior Fitness Test including chair stands, arm curls, step 2, six minute walk, sit and reach, and the timed up and go. A few participants did lose weight. All of the differences reflected improved physical functional status in the seated exercise or Wii‐fit groups compared with the control group. Discussion: Increased physical activity was beneficial for all who participated. There were improvements in physical performance scores on several of the measures on the senior fitness test in both the seated exercise and Wii‐fit groups. Participants in the Wii‐fit group also showed improvement in their reported caloric expenditure and balance confidence. Conclusion: This pilot study suggests a rehabilitation effect that was similar to the effect of community based senior fitness classes. A home video game console system with weight vest could be an effective alternative for pre‐frail senior adults to group exercise classes.

Emerging Technologies to Enhance the Safety of Older People in Their Homes

As more and more Baby Boomers are growing into their senior years, technology applications are being developed and marketed to increase their ability to remain independent in their own homes for as long as possible. This article reviews currently available devices and products that are intended to meet home safety needs of the elderly. The purpose of the article to share with nurses who care for elderly patients and their families some of the products and services that are currently available. Data regarding acceptability and efficacy of these products are still needed.

Heart Failure: Exercise-Based Cardiac Rehabilitation: Who, When, and How Intense?

The primary chronic symptom in patients with clinically stable heart failure (HF) is reduced exercise tolerance, measured as decreased peak aerobic power (peak oxygen consumption [Vo2]), and is associated with reduced quality of life and survival. Exercise-based cardiac rehabilitation (EBCR) is a safe and effective intervention to improve peak Vo2, muscle strength, physical functional performance, and quality of life and is associated with a reduction in overall and HF-specific hospitalization in clinically stable patients with HF. Despite these salient benefits, fewer than one-tenth of eligible patients with HF are referred for EBCR after hospitalization. In this review, selection for and timing of EBCR for patients with HF, as well as exercise prescription guidelines with special emphasis on the optimal exercise training intensity to improve peak Vo2, are discussed.

Assistive technologies for use in the home to prolong independence

In this paper, we describe applications of computing assisted technology to home environments of elderly persons.

Meta-analysis of Exercise Training on Vascular Endothelial Function in Cancer Survivors:

Cancer and cardiovascular disease (CVD) are leading causes of morbidity and mortality in the United States. Vascular endothelial dysfunction, an important contributor in the development of CVD, improves with exercise training in patients with CVD. However, the role of regular exercise to improve vascular function in cancer survivors remains equivocal. We performed a meta-analysis to determine the effect of exercise training on vascular endothelial function in cancer survivors. We searched PubMed (1975 to 2016), EMBASE CINAHL (1937 to 2016), OVID MEDLINE (1948 to 2016), and Cochrane Central Registry of Controlled Trials (1991 to 2016) using search terms: vascular function, endothelial function, flow-mediated dilation [FMD], reactive hyperemia, exercise, and cancer. Studies selected were randomized controlled trials of exercise training on vascular endothelial function in cancer survivors. We calculated pooled effect sizes and performed a meta-analysis. We identified 4 randomized controlled trials (breast cancer, n=2; prostate cancer, n=2) measuring vascular endothelial function by FMD (n=3) or reactive hyperemia index (n=1), including 163 cancer survivors (exercise training, n=82; control, n=81). Aerobic exercise training improved vascular function (n=4 studies; standardized mean difference [95% CI]=0.65 [0.33, 0.96], I2=0%; FMD, weighted mean difference [WMD]=1.28 [0.22, 2.34], I2=23.2%) and peak exercise oxygen uptake (3 trials; WMD [95% CI]=2.22 [0.83, 3.61] mL/kg/min; I2=0%). Our findings indicate that exercise training improves vascular endothelial function and exercise capacity in breast and prostate cancer survivors.

PESTO: Data integration for visualization and device control in the SmartCare project

The SmartCare project is to design, develop, and evaluate an intelligent sensor-driven living environment for the elderly. The core objectives are to provide emergency detection, improve quality of life, extend independence for the elderly, and detect patterns of behavior that could suggest early signs of a physical or cognitive issue, all in an unobtrusiveness manner. This paper specifically focuses on the development of the infrastructure integration component: PESTO and two of its sub components: a 3D visualization of the residents smart apartment (VISMA) and a system to provide everyday task assistance through the Z-Wave home automation technology (ZAPS).

SmartCare: An introduction

This paper introduces SmartCare, a project revolving around a smart environment especially built to enable aging in place. The paper describes the vision behind SmartCare as well as its translation into a deployed system. The physical incarnation of SmartCare is the SmartCare apartment, an actual apartment in a retirement community. We provide a description the technologies that are deployed in the SmartCare apartment. This paper does not introduce novel algorithms for smart environments, rather it provides an architectural system description of a real smart environment that was designed to enable aging in place.

Concurrent Infusion of Integrated Behavioral Health Practice Into Social Work Field and Classroom Instruction

ABSTRACT This administrative case study describes a concurrent infusion of integrated behavioral health (IBH) practice into social work field and classroom instruction using the same manualized IBH treatment as the core treatment content. The infusion was applied to youth/young adult and older adult populations in field instruction and classroom instruction. Diffusion of innovation theory provided the framework for the infusion process and analysis. Quantitative data were extracted from Web-based learning platforms and administrative data sets and analyzed using descriptive and univariate statistical methods. Qualitative data were extracted from de-identified transcripts of student session segments and Web-based learning platforms and analyzed using phenomenological methods.