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Relationships between Cognitive Functioning and Powered Mobility Device Use: A Scoping Review.

ABSTRACT: Powered mobility devices (PMD) promote independence, social participation, and quality of life for individuals with mobility limitations. However, some individuals would benefit from PMD, but may be precluded access. This is particularly true for those with cognitive impairments who may be perceived as unsafe and unable to use a PMD. This study explored the relationships between cognitive functioning and PMD use. The objectives were to identify cognitive functions necessary to use a PMD and describe available PMD training approaches. A scoping review was undertaken. Seventeen studies were included. Four examined the predictive or correlational relationships between cognitive functioning and PMD use outcomes with intellectual functions, visual and visuospatial perception, attention, abstraction, judgement, organization and planning, problem solving, and memory identified as having a relation with PMD use outcome in at least one study. Thirteen others studied the influence of PMD provision or training on users' PMD capacity and cognitive outcomes and reported significative improvements of PMD capacities after PMD training. Six studies found improved cognitive scores after PMD training. Cognitive functioning is required to use a PMD. Individuals with heterogeneous cognitive impairment can improve their PMD capacities. Results contribute to advancing knowledge for PMD provision.

SUBMITTER: Pellichero A

PROVIDER: S-EPMC8657167 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Relationships between Cognitive Functioning and Powered Mobility Device Use: A Scoping Review.

Pellichero Alice A Kenyon Lisa K LK Best Krista L KL Lamontagne Marie-Eve ME Lavoie Marie Denise MD Sorita Éric É Routhier François F

International journal of environmental research and public health 20211126 23

<h4>Background</h4>Powered mobility devices (PMD) promote independence, social participation, and quality of life for individuals with mobility limitations. However, some individuals would benefit from PMD, but may be precluded access. This is particularly true for those with cognitive impairments who may be perceived as unsafe and unable to use a PMD. This study explored the relationships between cognitive functioning and PMD use. The objectives were to identify cognitive functions necessary to ...[more]

PMID: 34886194

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Project description:BackgroundPower mobility devices (PMD) are critical to achieving independent mobility and social participation for many individuals who have trouble walking. Provision of PMDs is complex, with cognitive functioning expressed by clinicians as a major concern. Even if PMD use can be predicted by the level of cognitive functioning, outcome tools used to assess readiness do not consider how cognitive functioning may affect PMD use.ObjectiveThe specific aims of this review are to identify existing assessments used to assess cognitive functioning and PMD use, classify cognitive functions that are identified within existing assessments related to PMD use, and explore the relationships between cognitive functioning (ie, executive functions and attention) and PMD use.MethodsA systematic review will be conducted using the electronic databases MEDLINE (Ovid), CINAHL, Embase, PsycINFO (Ovid), and Web of Science based on the concepts of PMD performance and capacity, and cognitive functioning. To be included, studies must have: a sample of PMD users (inclusive of age and diagnoses), an assessment of cognitive functioning, and an assessment of PMD capacity or performance. The International Classification of Functioning, Disability and Health will be used to classify cognitive functions. Study quality will be assessed using the Mixed Methods Appraisal Tool. Qualitative and quantitative studies will be analyzed in a complementary manner depending on their designs; a result-based convergent synthesis design will be applied.ResultsThis proposed systematic review protocol has been registered in PROSPERO (CRD42019118957). It was funded by the Quebec Rehabilitation Research Network and approved on February 2019.ConclusionsResults will inform the development of a PMD driving program that aims to enhance cognition. The results of this study will enhance understanding of the influence of cognitive functioning on PMD use and will support the clinical practice in choosing appropriate evaluative tools.Trial registrationPROSPERO CRD42019118957; https://www.crd.york.ac.uk/PROSPERO/display_record.php? RecordID=118957.International registered report identifier (irrid)DERR1-10.2196/16534.

Project description:ObjectiveTo synthesize available evidence that has examined the relationship between physical therapy (PT) and opioid use. TYPE: Scoping Review LITERATURE SURVEY: Data sources including Google Scholar, Embase, PubMed, Cochrane Library, and CINAHL were searched for English articles up to October 24, 2019 using terms ("physical therapy"[Title/Abstract] OR physiotherapy[Title/Abstract] OR rehabilitation[Title/Abstract]) AND (opiate*[Title/Abstract] OR opioid*[Title/Abstract]).MethodologyIncluded studies evaluated a PT intervention and reported an opioid-use outcome. Data were extracted to describe the PT intervention, patient sample, opioid-use measurement, and results of any time or group comparisons. Study quality was evaluated with Joanna Briggs checklists based on study design.SynthesisThirty studies were included that evaluated PT in at least one of these seven categories: interdisciplinary program (n = 8), modalities (n = 3), treatment (n = 3), utilization (n = 2), content (n = 3), timing (n = 13), and location (n = 2). Mixed results were reported for reduced opioid-use after interdisciplinary care and after PT modalities. Utilizing PT was associated with lower odds (ranging from 0.2-0.8) of using opioid medication for persons with low back pain (LBP) and injured workers; however, guideline-adherent care did not further reduce opioid use for persons with LBP. Early PT utilization after index visit for spine or joint pain and after orthopedic surgery was also associated with lower odds of using opioid medications (ranging from 0.27-0.93). Emergency department PT care was not associated with fewer opioid prescriptions than standard emergency department care. PT in a rehabilitation center after total knee replacement was not associated with lower opioid use than inpatient PT.ConclusionsThe relationship between timing of PT and opioid use was evaluated in 13 of 30 studies for a variety of patient populations. Eight of these 13 studies reported a relationship between early PT and reduced subsequent opioid use, making the largest sample of studies in this scoping review with supporting evidence. There is limited and inconclusive evidence to establish whether the content and/or location of PT interventions improves outcomes because of heterogeneity between studies.

Project description:Background/objectivesTo examine the prevalence of mobility device use in U.S. community-dwelling older adults including older adults with cancer history ("survivors") and to estimate mobility disability noting variation by cancer history, cancer site, and other factors to improve early detection of mobility limitations.DesignCross-sectional analysis from the 2011 National Health and Aging Trends Study.SettingIn-person interviews in the homes of study participants.ParticipantsNationally representative sample of community-dwelling Medicare beneficiaries, aged 65 and older (n = 6,080 including 1,203 survivors).MeasurementsParticipants were asked about cancer history, pain that limited activity, mobility device use (eg, canes, walkers, wheelchairs, and scooters), history of falls, and medical conditions plus they were assessed for approximate mobility disability using a 3-m gait speed test. The results were scored on a scale of 0 to 4 (0 = lowest, 4 = highest) using criteria from the National Institute on Aging.ResultsA total of 19% of older adults and 23% of survivors reported using one or more mobility device, most commonly a single-point cane. Approximately 10% of breast, 6% of prostate, and 3% of colorectal cancer survivors reported using two or more devices in the past month. Survivors had lower mean gait speed scores (2.27) than adults without cancer history (2.39). In regression models, survivors were 18% less likely than adults without cancer history to score high on the gait speed test (odds ratio = .82; P < .05). Prior mobility device use, history of multiple falls, unhealthy weight, Black race, multimorbidity, and pain that limited activity were associated with lower gait speed scores in all participants (all P < .05).ConclusionA greater proportion of older survivors used mobility devices than adults without cancer history. Mobility device use varied by cancer site and was highest in survivors of breast, colorectal, and gynecological cancer. Survivors were also more likely to show signs of mobility disability, based on gait speed, compared with adults without cancer history. These indications, although modest, suggest that older survivors may require special attention to functional changes in survivorship.

Dataset Information

Relationships between Cognitive Functioning and Powered Mobility Device Use: A Scoping Review.

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Relationships between Cognitive Functioning and Powered Mobility Device Use: A Scoping Review.

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