Effects of water-based exercise on activities of daily living in Parkinson's disease patients

Physical exercise plays an important role in reducing the physical and psychological symptoms of those who suffer from Parkinson’s Disease (PD). One form of exercise, water exercise, is a relatively untested means in the treatment of patients suffering from PD. Very few studies have tested the effects of such a program for PD patients. In this pilot study, four patients with PD aged 71-89 years of age followed a six week exercise program in water, three days weekly for a duration from 20 minutes up to one hour in an attempt to improve physical and psychological functions. Testing was done prior to and after the program. The study showed that patients improved on their physical strength, endurance and balance, however tests of perceived self confidence showed no difference between the beginning and end of the study. The results suggest that water exercise is a beneficial medium for PD patients to exercise in and is useful in maintaining and/or improving on strength, endurance and balance. Further research with a randomized controlled trial and a larger sample size is needed to verify the beneficial effects of water exercises for sufferers of PD

Evidence Based Review of Fitness-to-Drive and Return-to-Driving Following Traumatic Brain Injury

The purpose of this study was to conduct an evidence-based review to determine predictors of fitness to drive and return to driving in persons with traumatic brain injury (TBI). Relevant databases (MEDLINE/PubMed, CINAHL, Cochrane Library, and SCOPUS) were searched for primary articles published before June 2016 using MeSH search terms. Using the American Academy of Neurology’s classification criteria, 24 articles were included after reviewing 1998 articles. Studies were rated by class (I–IV), with I being the highest level of evidence. Articles were classified according to TBI severity, as well as types of assessments (on-road, simulator and surveys). There were no Class I studies. Based on Class II studies, only Post-traumatic amnesia (PTA) duration was found to be probably predictive of on-road driving performance. There is limited evidence concerning predictors of return to driving. The findings suggest further evidence is needed to identify predictors of on-road driving performance in persons with TBI. Class I studies reporting Level A recommendations for definitive predictors of driving performance in drivers with TBI are needed by policy makers and clinicians to develop evidence-based guidelines

Impact of health and transportation on accessing healthcare in older adults living in rural regions

Introduction: Living in rural areas pose challenges to accessing healthcare, often requiring individuals to travel to major cities. This study examined the impact of health and transportation among older adults using no healthcare services, family doctor services, and medical specialist services, and compared to those living in rural and small population centers. Methods: Between 2020 and 2021, a survey was disseminated to 244 older adults (Mean age = 72.2 years ± 5.3 years, 50.2% male) living in rural (n = 139) and small communities (n = 105) of Saskatchewan, Canada. Results: In total, 135 participants did not use healthcare services (i.e., family doctor or medical specialist); 55 used family doctor services, and 54 used medical specialist services; 10.6% reported cancelling medical appointments due to the lack or cost of transportation. Living in a rural community was a significant predictor of using family doctors. Additionally, living in a rural environment, not perceiving health as excellent or good, receiving rides from others, and traveling to larger centers for medical care were significant predictors of using medical specialists. Living in a senior’s complex and having diabetes were significantly associated with poorer health. Receiving rides from friends, family, or volunteer driving programs was the most available transportation option in rural vs small population centers. Conclusions: Accessing healthcare is influenced by both health and transportation for older adults living in rural versus small communities. The lack of available and affordable transportation, coupled with the distance and occurrence of medical appointments, impacts healthcare access or cancelling medical appointments

A public health approach to mobilizing community partners for injury prevention: A scoping review.

ObjectivesReducing injuries in adults requires work with diverse stakeholders across many sectors and at multiple levels. At the local level, public health professionals need to effectively bring together, facilitate, and support community partners to initiate evidence-based efforts. However, there has been no formal review of the literature to inform how these professionals can best create action among community partners to address injuries in adults. Thus, this scoping review aims to identify theories, models or frameworks that are applicable to a community-based approach to injury prevention.MethodsSearches of scientific and less formal literature identified 13,756 relevant items published in the English language between 2000 and 2016 in North America, Europe and Australia. After screening and review, 10 publications were included that (1) identified a theory, framework or model related to mobilizing partners; and (2) referred to community-based adult injury prevention.ResultsFindings show that use of theories, frameworks and models in community-based injury prevention programs is rare and often undocumented. One theory and various conceptual models and frameworks exist for mobilizing partners to jointly prevent injuries; however, there are few evaluations of the processes to create community action.ConclusionsSuccessful community-based injury prevention must build on what is already understood about creating partnership action. Evaluating local public health professional injury prevention practice based on available theories, models and frameworks will identify successes and challenges to inform process improvements. We propose a logic model to more specifically guide and evaluate how public health can work locally with community partners