Childhood cancer has a profound and negative impact on siblings, yet there are limited studies exploring lived experiences from their perspective. This qualitative study examined the perceptions and ...experiences of siblings of children with cancer who attended a peer support camp. Semi-structured interviews were conducted three to six weeks after the weeklong peer support camp with a stratified random sample of 10 siblings (six non-bereaved and four bereaved) ages 8 to 16 years. The qualitative data were analyzed using conventional content analysis and an inductive data-driven approach. Four themes emerged: social connection (subthemes: support/feeling of belonging, mentorship, and expressing feelings), personal growth, identity, and freedom to have fun and relax. These findings add to the scant body of research by providing enhanced understanding of the siblings’ experiences and new insights into their perceptions of meaning and outcomes associated with participation in a peer support camp. These findings have implications for peer support camp programs and the well-being of siblings of children with cancer.
Abstract Schmid AA, Van Puymbroeck M, Koceja DM. Effect of a 12-week yoga intervention on fear of falling and balance in older adults: a pilot study. Objective To determine whether fear of falling ...(FoF) and balance improved after a 12-week yoga intervention among older adults. Design A 12-week yoga intervention single-armed pilot study. Setting A retirement community in a medium-sized university town in the Midwest. Participants A convenience sample of adults (N=14) over the age of 65 years who all endorsed an FoF. Intervention Each participant took part in a biweekly 12-week yoga intervention. The yoga sessions included both physical postures and breathing exercises. Postures were completed in sitting and standing positions. Main Outcome Measures We measured FoF with the Illinois FoF Measure and balance with the Berg Balance Scale. Upper- and lower-body flexibility were measured with the back scratch test and chair sit and reach test, respectively. Results FoF decreased by 6%, static balance increased by 4% ( P =.045), and lower-body flexibility increased by 34%. Conclusions The results indicate that yoga may be a promising intervention to manage FoF and improve balance, thereby reducing fall risk for older adults. Rehabilitation therapists may wish to explore yoga as a modality for balance and falls programming; however, future research is needed to confirm the use of yoga in such programming.
Context: Caregivers often provide unpaid care for family members and friends with physical disabilities, often to the detriment of their health and well-being. Caregivers often experience pain, and ...individuals with physical disabilities also are likely to experience pain. Merging yoga and self-management to Develop Skills Study (MY-Skills) is an intervention that merges self-management education with yoga for dyads experiencing chronic pain. Aim: This article presents the yoga protocol for the MY-Skills intervention. Methods: The yoga protocol was revised based on feedback from six caregiving dyads. The protocol focuses on reducing pain interference and supporting the caregiving dyad. Results: The final yoga protocol incorporated the following elements: Centering and mantra, prana vidya and pranayama, asanas, mudra, and guided savasana/dhyana. Conclusion: The MY-Skills yoga protocol was modified by a yoga therapist with feedback from study participants. Revisions focused on the caregiving dyad, with specific attention to reducing pain interference.
Because yoga is increasingly recognized as a complementary approach to cancer symptom management, patients/survivors and providers need to understand its potential benefits and limitations both ...during and after treatment. The authors reviewed randomized controlled trials (RCTs) of yoga conducted at these points in the cancer continuum (N = 29; n = 13 during treatment, n = 12 post‐treatment, and n = 4 with mixed samples). Findings both during and after treatment demonstrated the efficacy of yoga to improve overall quality of life (QOL), with improvement in subdomains of QOL varying across studies. Fatigue was the most commonly measured outcome, and most RCTs conducted during or after cancer treatment reported improvements in fatigue. Results also suggested that yoga can improve stress/distress during treatment and post‐treatment disturbances in sleep and cognition. Several RCTs provided evidence that yoga may improve biomarkers of stress, inflammation, and immune function. Outcomes with limited or mixed findings (eg, anxiety, depression, pain, cancer‐specific symptoms, such as lymphedema) and positive psychological outcomes (such as benefit‐finding and life satisfaction) warrant further study. Important future directions for yoga research in oncology include: enrolling participants with cancer types other than breast, standardizing self‐report assessments, increasing the use of active control groups and objective measures, and addressing the heterogeneity of yoga interventions, which vary in type, key components (movement, meditation, breathing), dose, and delivery mode.
Randomized controlled trials conducted both during and after cancer treatment provide evidence for the efficacy of yoga to improve quality of life and fatigue. Yoga has the potential to improve additional cancer‐related symptoms (eg, sleep, depression, anxiety, distress, cognition) and biomarkers of stress and inflammation/immunity, but further research is needed.
Abstract Schmid AA, Van Puymbroeck M, Altenburger PA, Dierks TA, Miller KK, Damush TM, Williams LS. Balance and balance self-efficacy are associated with activity and participation after stroke: a ...cross-sectional study in people with chronic stroke. Objectives To (1) examine the relationships between multiple poststroke mobility variables (gait speed, walking capacity, balance, balance self-efficacy, and falls self-efficacy) and activity and participation; and (2) determine which poststroke mobility variables are independently associated with activity and participation. Design This is the primary analysis of a prospective cross-sectional study completed to understand the impact of mobility on activity and participation in people with chronic stroke. Setting University-based research laboratory, hospitals, and stroke support groups. Participants People (N=77) with stroke greater than 6 months ago were included in the study if they were referred to occupational or physical therapy for physical deficits as a result of the stroke, completed all stroke related inpatient rehabilitation, had residual functional disability, scored a ≥4 out of 6 on the short, 6-item Mini-Mental State Examination, and were between the ages of 50 and 85. Interventions Not applicable, this is a cross-sectional data collection of 1 timepoint. Main Outcome Measures We measured activity and participation with the validated International Classification of Functioning, Disability and Health Measure of Participation and Activities. Other variables included gait speed (10-meter walk), walking capacity (6-minute walk), balance (Berg Balance Scale), balance self-efficacy (Activities Specific Balance Confidence Scale), and falls self-efficacy (Modified Falls Efficacy Scale). Results Only balance self-efficacy was found to be independently associated with poststroke activity (β=−.430, P <.022, 95% confidence interval CI, −.247 to −.021) and participation (β=−.439, P <.032, 95% CI, −.210 to −.010). Conclusions Among people with chronic stroke, balance self-efficacy, not physical aspects of gait, was independently associated with activity and participation. While gait training continues to be important, this study indicates a need to further evaluate and address the psychological factors of balance and falls self-efficacy to obtain the best stroke recovery.
Lifelong learning programs for older adults are suggested as a promising strategy to promote successful and active aging. This observational study utilized cross-sectional data from a nationwide ...survey administered to adults aged 65 and older who were recruited through nine Osher Lifelong Learning Institutes (OLLI). Data collected included general demographics, and measures of physical and mental health, cognitive ability, meaning and purpose, cognitive reserve, and successful aging. Descriptive characteristics of the population revealed a predominantly White, female population, the majority of whom were married, retired, and reported high levels of educational attainment. Participants reported high levels of physical and mental health, and meaning and purpose as measured by PROMIS® measures. High levels of cognitive reserve, self-reported cognitive ability, and successful aging were also found in this sample. Using references to the general aging adult population comparative analyses found OLLI participants reported significantly higher physical health and mental health, and cognitive reserve scores. This study provides additional context for understanding characteristics of older adults who are cognitively aging well.
Older adults' wellbeing during the transition into an assisted living facility (ALF) is not well understood and may influence their wellbeing. The Mueller Assessment of Transition (MAT) was created ...to measure the impact of transition on older adults' wellbeing. Early developmental testing of the MAT revealed a hypothesized model with two constructs (adjustment strategies and constraints to wellbeing). Therefore, the purpose of this study was to confirm the factor structure of the MAT with a representative sample of older adults transitioning into ALFs.
In a nationwide sample, 108 older adult participants completed the MAT to measure wellbeing when relocating into ALFs. Confirmatory factor analysis (CFA) assessed the structural validity of the MAT. Internal consistency was evaluated, and chi-square tests of association for regional differences in MAT scores were also conducted.
The CFA produced strong fit indices to confirm the hypothesized 2-factor (constraints to wellbeing and adjustment strategies) model of the MAT. Cronbach's alpha for the internal consistency was 0.784 and chi-square test indicated no significant regional differences.
The MAT was established as a valid and reliable standardized assessment. Implications for using the MAT as a tool to measure older adults' wellbeing and future research are discussed.
Highlights • Prior work in yoga and occupational therapy are reviewed. • The Merging Yoga and Occupational Therapy (MY-OT) intervention is proposed as an intervention to manage fall risk factors ...after stroke. • Balance, balance confidence, and fall risk factor management improved after the MY-OT intervention.
Purpose: The purposes of this mixed-methods study were to (1) investigate whether walking faster or walking farther was more important for getting "out and about" to persons with chronic stroke and ...(2) explore explanations for walking preferences. Method: A convenience sample of 77 adults with chronic stroke completed questionnaires and walking outcomes in one visit. Participants were asked whether walking faster or farther was more important to them for getting "out and about", and differences between response groups (faster vs. farther) were evaluated. Participants also described their preference for walking faster or farther. Qualitative responses were analyzed using content analysis. Results: The majority of participants (76%; n = 58) reported walking farther was more important, while 18% (n = 14) reported walking faster was more important. Statistically significant differences were not found between response groups for any variable. Primary themes identified from participant preferences for walking faster included: (1) faster speed equals better walking ability and (2) getting places faster/quicker. Primary themes from preferences for walking farther included: (1) engaging in activity and participation within home and community; (2) walking farther at a slower pace; and (3) fatigue with walking. Conclusions: Individual preferences for walking faster versus walking farther by persons with chronic stroke should be considered by clinicians when making decisions for rehabilitation.
Implications for Rehabilitation
Individual preferences for walking faster versus walking farther by patients with chronic stroke should be considered by rehabilitation clinicians when making decisions about examination and intervention.
The majority of participants with chronic stroke in this study indicated the importance of walking farther in order to better engage in activities both at home and away from home.
Interventions that focus on improving endurance and energy conservation may need to be used for persons with chronic stroke who want to walk father in order to maximize their potential for walking longer distances.
The Stopping Elderly Accidents, Deaths and Injuries (STEADI) screening algorithm aligns with current fall prevention guidelines and is easy to administer within clinical practice. However, the ...stratification into low, moderate and high risk categories limits the meaningful interpretation of the fall-related risk factors.
Baseline measures from a modified STEADI were used to predict self-reported falls over 4 years in 3170 respondents who participated in the 2011-2015 National Health and Aging Trends Study. A point method was then applied to find coefficient-based integers and 4-year fall risk estimates from the predictive model. Sensitivity and specificity estimates from the point method and the combined moderate and high fall risk STEADI categories were compared.
There were 886 (27.95%) and 387 (12.21%) respondents who were classified as moderate and high risk, respectively, when applying the stratification method. Falls in the past year (OR: 2.16; 95% CI: 1.61 to 2.89), multiple falls (OR: 2.94; 95% CI: 1.89 to 4.55) and a fear of falling (OR: 1.77; 95% CI: 1.45 to 2.16) were among the significant predictors of 4-year falls in older adults. The point method revealed integers that ranged from 0 (risk: 27.21%) to 44 (risk: 99.71%) and a score of 10 points had comparable discriminatory capacity to the combined moderate and high STEADI categories.
Coefficient-based integers and their risk estimates can provide an alternative interpretation of a predictive model that may be useful in determining fall risk within a clinical setting, tracking changes longitudinally and defining the effectiveness of an intervention.
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