BACKGROUND: Regaining walking ability is a key target in geriatric rehabilitation. This study evaluated the prevalence of walking ability at (pre-)admission and related clinical characteristics in a cohort of geriatric rehabilitation inpatients; in inpatients without walking ability, feasibility and effectiveness of progressive resistance exercise training (PRT) were assessed.METHODS: Inpatients within RESORT, an observational, longitudinal cohort of geriatric rehabilitation inpatients, were stratified in those with and without ability to walk independently (defined by Functional Ambulation Classification (FAC) score ≤ 2) at admission; further subdivision was performed by pre-admission walking ability. Clinical characteristics at admission, length of stay, and changes in physical and functional performance throughout admission were compared depending on (pre-)admission walking ability. Feasibility (relative number of PRT sessions given and dropout rate) and effectiveness [change in Short Physical Performance Battery, FAC, independence in (instrumental) activities of daily living (ADL/IADL)] of PRT (n = 11) in a subset of inpatients without ability to walk independently at admission (able to walk pre-admission) were investigated compared with usual care (n = 11) (LIFT-UP study).RESULTS: Out of 710 inpatients (median age 83.5 years; 58.0% female), 52.2% were not able to walk independently at admission, and 7.6% were not able to walk pre-admission. Inpatients who were not able to walk independently at admission, had a longer length of stay, higher prevalence of cognitive impairment and frailty and malnutrition risk scores, and a lower improvement in independence in (I)ADL compared with inpatients who were able to walk at both admission and pre-admission. In LIFT-UP, the relative median number of PRT sessions given compared with the protocol (twice per weekday) was 11 out of 44. There were no dropouts. PRT improved FAC (P = 0.028) and ADL (P = 0.034) compared with usual care.CONCLUSIONS: High prevalence of inpatients who are not able to walk independently and its negative impact on independence in (I)ADL during geriatric rehabilitation highlights the importance of tailored interventions such as PRT, which resulted in improvement in FAC and ADL.
Feelings of disconnectedness and social isolation among older adults are increasingly recognised as important challenges of our times. Interestingly, nature interaction can stimulate social connectedness and enhance perceived social support, indicating that nature can contribute to social wellbeing. However, nature may not always be around or accessible for older adults. In such cases, digital nature could provide an alternative means for enjoying nature's benefits. To identify limitations and restrictions that older adults experience with respect to nature interaction, and to explore preferences with respect to digital nature and their potential for influencing social wellbeing, two studies are reported: a qualitative study comprising focus groups with Dutch care centre residents (N = 26) and a subsequent quantitative study (N = 200) testing effects of digital landscapes on social wellbeing measures. Findings from the focus groups indicate that opportunities for nature interaction and preferences for digital nature vary with mobility restrictions, whereas findings from the quantitative study testify to the potential of digital nature for enhancing social wellbeing and related emotions. These findings extend research on how (digital) nature interventions can contribute to the social wellbeing of older adults and pinpoint essential nature characteristics important for doing so.
Re-structuring of a Dutch mono-industrial region; example of TwenteTable of contents of the chapter Introduction Geography and location of Twente Industrialization of Twente and development of the Textile Industry Decline of the Textile Industry Restructuring Twente: arguments for a regional innovation strategy Moving towards a more diversified economy Stronger co-operation between governments, universities, and industries The role of universities and the example of ‘Kennispark Twente’ Further regional and international co-operation Twente today
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