Kelly Carr

Universal Design: A Step toward Successful Aging

The concept of aging successfully has become increasingly important as demographics shift towards an aging population. Successful aging has been defined to include (1) a low probability of disease and disease-related disability; (2) a high level of physical and cognitive functioning; and (3) an active engagement in life. The built environment can create opportunities or constraints for seniors to participate in social and productive activities. Universally designed spaces are more easily accessed and used by a spectrum of people without specialized adaptations. Thus, a universally designed environment creates opportunities for older adults to participate in these activities without the stigmatization associated with adapted or accessible designs. Providing older adults with specific universal design options (e.g., lever handle faucets) has the potential to increase the ease of completing activities of daily living, which promotes a continual engagement in life. Literature regarding universal design is promising; however, its theory requires further attention from professionals designing the built environment, evidence of the significance of its application from academics, and the embracement of its core principles from society. Overall, universal design has the potential to provide a stepping stone toward successful aging.

Barriers Are Not the Limiting Factor to Participation in Physical Activity in Canadian Seniors

The identification of barriers to physical activity and exercise has been used for many decades to explain exercise behavior in older adults. Typically health concerns are the number one barrier to participation. Data from CCHS-HA dataset (N = 20, 875) were used to generate a sample of Canadians, 60+ years, who did not identify a health condition limitation, illness, or injury as a barrier to participation in physical activity (n = 4,900) making this dataset unique in terms of the study of barriers to participation. While the vast majority of older adults participated in physical activity, 9.4% did not. The relationships between nonparticipation, barriers, self-reported health status, and chronic health conditions were determined using binary logistic regression. The main findings suggest that traditional barriers and self-reported health status are not responsible for nonparticipation. Nonparticipation was best predicted by chronic health conditions suggesting a disconnect between self-reported health status and underlying health conditions. The data are clear in suggesting that barriers are not the limiting factor and physical activity programming must be focused on meeting the health needs of our aging population.

Effectiveness of commercial video gaming on fine motor control in chronic stroke within community-level rehabilitation

Abstract Purpose: The purpose of this study was to investigate the effectiveness of commercial gaming as an intervention for fine motor recovery in chronic stroke. Methods: Ten chronic phase post-stroke participants (mean time since CVA = 39 mos; mean age = 72 yrs) completed a 16-session program using the Nintendo Wii for 15 min two times per week with their more affected hand (10 right handed). Functional recovery (Jebsen Hand Function Test (JHFT), Box and Block Test (BBT), Nine Hole Peg Test (NHPT)), and quality of life (QOL; Stroke Impact Scale (SIS)) were measured at baseline (pre-testing), after 8 sessions (mid-testing) and after 16 sessions (post-testing). Results: Significant improvements were found with the JHFT, BBT and NHPT from pre-testing to post-testing (p = 0.03, p = 0.03, p = 0.01, respectively). As well, there was an increase in perceived QOL from pre-testing to post-testing, as determined by the SIS (p = 0.009). Conclusion: Commercial gaming may be a viable resource for those with chronic stroke. Future research should examine the feasibility of this as a rehabilitation tool for this population. Implications for Rehabilitation Stroke survivors often live with lasting effects from their injury, however, those with chronic stroke generally receive little to no rehabilitation due to a perceived motor recovery plateau. Virtual reality in the form of commercial gaming is a novel and motivating way for clients to complete rehabilitation. The Nintendo Wii may be a feasible device to improve both functional ability and perceived quality of life in chronic stroke survivors.

Non-immersive Virtual Reality for Fine Motor Rehabilitation of Functional Activities in Individuals with Chronic Stroke: A Review

More than two thirds of the individuals who have strokes are over the age of 65. Therefore, as the global population continues to age, the risk of stroke is expected to increase substantially. Virtual reality (VR) is an emerging therapy that holds promise for the rehabilitation of patients with chronic stroke conditions. VR is an interactive, computer-based simulation of real life tasks, occurring in real time. The aim of this review was to explore whether non-immersive VR could be used to effectively improve fine motor function of the affected upper extremity in patients with chronic stroke. Ten studies examining non-immersive VR for the purpose of chronic stroke rehabilitation were included for review. Studies utilized a variety of VR-based interventions, reporting trends toward improvement on nearly all outcome measures. Results were examined at the levels of “body structure and function” and “activity” according to the International Classification of Functioning. Across the studies, significant improvements were reported for the Jebsen Test of Hand Function, the Box and Block Test, participants’ finger fractionation, finger tracking measures, and time from peak hand velocity to movement of an object. However, considerable variability in participants’ recovery rates of fine motor function across the studies suggests that the results should be interpreted with caution. More research using randomized controlled trial designs will clarify evidence surrounding the amount of improvement that can be experienced with non-immersive VR-based interventions. This review provides justification for continued investigation within the field of motor skill recovery in patients with chronic stroke.

Sport, Physical Activity, and Aging: Are We on the Right Track?

This chapter provides a critical overview of the applicability and effectiveness of ‘Sport for Life’ and ‘Sport for All’ approaches in achieving ‘success’ during older adulthood. Older adulthood, as suggested by the World Health Organization (WHO), commonly coincides with the eligibility to collect pension payments, and thus begins between 60 and 65 years of age (WHO, 2002a). As many parts of the world face a demographic shift toward this older population base, a critical examination of strategies to maintain health, function, and well-being into later life is warranted. Positioned within a framework of successful aging, this chapter discusses the implications of holding the individual accountable for personal health and functioning, while aligning this notion with the expectation of all individuals to maintain physically active lives through sport participation. As an example of older adults participating in sport we highlight the World Masters Games and debate the use of competitive Masters athletes to exemplify the aging ideal as well as serve as role models for the senior population. We consider barriers to sport and physical activity participation and provide a snapshot of engagement profiles throughout older adulthood. Conclusions are drawn regarding ‘Sport for Life’ and ‘Sport for All’ approaches when encouraging older adults to age successfully, and contrasts are made to the broader framework of ‘active aging’.

A qualitative description of successful aging through different decades of older adulthood

ABSTRACT Objective: To qualitatively examine factors that contribute to successful aging during different decades of older adulthood. Methods: Fundamental qualitative description was adopted as the methodological framework. Through purposeful sampling, 42 community dwelling older adults (mean age = 79.6 years, age range = 65–97 years; 19 males) were recruited. Focus groups (6) segmented by decade of life were conducted with participants 65–74 (n = 17) and 75–84 (n = 17) years of age. Semi-structured interviews (16) were conducted with four participants from each decade, as well as participants 85 years of age and older (n = 8). Data analyses were conducted independently for each decade of life and included inductive analysis of textual data through continuous comparisons of meaning units. Results: Three primary themes related to successful aging were identified across all decades of older adulthood: (1) staying healthy (secondary themes: genetics and lifestyle choices), (2) maintaining an active engagement in life (secondary themes: social engagement and cognitive engagement), and (3) keeping a positive outlook on life. Participants in specific decades of older adulthood identified three additional secondary themes related to maintaining an active engagement in life: finances (65–74 and 85+ years), social support (75+ years), and successful marriage (75+ years). Similarly, only adults 65–84 years of age identified a secondary theme for keeping a positive outlook on life: acceptance and adaptation. Conclusion: Primary themes related to successful aging were agreed upon by participants in all decades of older adulthood, while age-based differences existed among secondary themes. Thus, what it means to age successfully may be age-dependent.

Emerging Adults with Chronic Illness Pursuing and Enhancing Leisure

The purpose of this study is to develop an understanding of the adjustment process undertaken by emerging adults living with a chronic illness in their pursuit and enjoyment of leisure. A theoretical focus is placed on the processes of selection, optimization, and compensation. Semi-structured interviews were conducted with 27 participants who have a chronic illness. Participants’ experiences were rooted much more in triumph rather than loss. Selection was influenced by a consideration of uncertainty, a desire to avoid potential embarrassment, and an acceptance or rejection of constraints. Three types of approaches that helped them optimize their leisure experience involved participants shaping their perspectives about leisure and life, enhancing resources to make leisure possible, and by living through pain and discomfort. Responding to challenges that might otherwise limit their participation or enjoyment in leisure, participants prepared for possible incidents, received support from others, and confronted negative situations.