Age-Related Differences in Arm and Trunk Responses to First and Repeated Exposure to Laterally Induced Imbalances

The objective of this study was to examine age-related differences in arm and trunk responses during first and repeated step induced balance perturbations. Young and older adults received 10 trials of unpredictable lateral platform translations. Outcomes included maximum arm and trunk displacement within 1 s of perturbation and at first foot lift off (FFLO), arm and neck muscle activity as recorded using electromyography (EMG), initial step type, balance confidence, and percentage of harness-assisted trials. Compared to young adults, older adults demonstrated greater arm and trunk angular displacements during the first trial, which were present at FFLO and negatively associated with balance confidence. Unlike young adults, recovery steps in older adults were directed towards the fall with a narrowed base of support. Over repeated trials, rapid habituation of first-trial responses of bilateral arm and trunk displacement and EMG amplitude was demonstrated in young adults, but was absent or limited in older adults. Older adults also relied more on harness assistance during balance recovery. Exaggerated arm and trunk responses to sudden lateral balance perturbations in older adults appear to influence step type and balance recovery. Associations of these persistently amplified movements with an increased reliance on harness assistance suggest that training to reduce these deficits could have positive effects in older adults with and without neurological disorders

In-patients' satisfaction with healthcare in a Nigerian tertiary health institution

Background: Patients' satisfaction is an increasingly common and important component of a comprehensive assessment of quality of care.Objective: This study was designed to determine inpatients' satisfaction with healthcare in a Nigerian tertiary health institution.Methods: Patients were majorly selected from the wards while a few were selected from the out-patients clinic during their follow-up period through a purposive sampling technique into this cross-sectional survey of a tertiary health institution in Nigeria. The instrument used was a selfdeveloped, patient-administered questionnaire on inpatients' satisfaction with healthcare. Data wereanalyzed using descriptive statistics of frequency, means, percentages, pie charts.Results: The participants (61 males and 59 females) had a mean total satisfaction score of 58.2% ± 12.1% and sixtysix (55.0%) participants reported good level of satisfaction. Participants within the age range 18-27 reported the highest mean satisfaction score of 47.8%±13.0%. Participants' mean satisfaction scores on healthcare provided by the health workers were 69.4% ±21.9% for health records staff, 78.5%±14.5% for hospital ward staff, 70.6%±13.6% for doctors, 68.5%±12.4% for nurses and 70.5%±15.1% for physiotherapists. The specific aspect ofservice where participants had the highest mean satisfaction score was electricity (72.9% ±21.2%) while the least mean satisfaction score was on ease of payment (42.5%±28.6%).Conclusion: Level of in-patients' satisfaction with healthcare at this Nigerian tertiary health institution appears good.Keywords: Patient-centred outcome, satisfaction, health institutio