Despite a large prevalence of rotator cuff impingements or tears in the elderly population, little research has focused on understanding how this population adapts to perform tasks of daily living. Past research has focused on the analysis of upper limb kinematics of young healthy individuals while performing these essential tasks (Magermans, 2004, Murray and Johnson., 2004). The purpose of this thesis was to identify kinematic and shoulder loading differences between elderly mobile individuals and elderly individuals with rotator cuff impingements during specific activities of daily living. Motion capture techniques were used in combination with the Shoulder Loading Analysis Modules (Dickerson, 2005, Dickerson et al., 2007) to estimate thoracohumeral kinematics and calculate external joint moments. Two-tailed t-tests with injury status as the factor determined that differences in active range of motion in flexion/extension and humeral rotations existed between the two populations. Results of the ADL analysis showed that the impinged population tended to have decreased plane of elevation and humeral rotations during ADLs. Task was also a main factor for most variables examined. Perineal care, hair-combing and reaching tasks were the most demanding in terms of range of motion necessary to complete the task. The reaching tasks resulted in the highest shoulder moment. K-means clustering techniques proved to be unsuccessful in identifying different motion strategies between the two study groups. This investigation showed that developing adaptations for perineal care, hair-combing and reaching tasks should be considered a priority when working with patients with rotator cuff impingements, as these tasks demanded the largest ranges of motion as well as high shoulder moments.

Despite a large prevalence of rotator cuff impingements or tears in the elderly population, little research has focused on understanding how this population adapts to perform tasks of daily living. Past research has focused on the analysis of upper limb kinematics of young healthy individuals while performing these essential tasks (Magermans, 2004, Murray and Johnson., 2004). The purpose of this thesis was to identify kinematic and shoulder loading differences between elderly mobile individuals and elderly individuals with rotator cuff impingements during specific activities of daily living. Motion capture techniques were used in combination with the Shoulder Loading Analysis Modules (Dickerson, 2005, Dickerson et al., 2007) to estimate thoracohumeral kinematics and calculate external joint moments. Two-tailed t-tests with injury status as the factor determined that differences in active range of motion in flexion/extension and humeral rotations existed between the two populations. Results of the ADL analysis showed that the impinged population tended to have decreased plane of elevation and humeral rotations during ADLs. Task was also a main factor for most variables examined. Perineal care, hair-combing and reaching tasks were the most demanding in terms of range of motion necessary to complete the task. The reaching tasks resulted in the highest shoulder moment. K-means clustering techniques proved to be unsuccessful in identifying different motion strategies between the two study groups. This investigation showed that developing adaptations for perineal care, hair-combing and reaching tasks should be considered a priority when working with patients with rotator cuff impingements, as these tasks demanded the largest ranges of motion as well as high shoulder moments.

Purpose: From an activity-perspective examine the meaning of housing accessibility and older persons´ perception of participation. Method: Systematic literature review of articles searched in the databases, Medline, Pubmed, Ahmed, Cinahl, Scopus and Google Scholar. Search on individual keywords, and in various combinations of the words home environment, home modification, occupational therapy, aging, accessibility and participation. Nine scientific articles were examined. Results: The articles were published between 2005 and 2009. Housing accessibility is important for a better well-being and independence in daily activities of elderly persons. Older persons´ participation and perceived satisfaction with participation, become lower with reduced ability to perform daily activities. Conclusion: Interventions designed to increase accessibility in the home environment may be important for older persons´ well-being. Interventions should be preceded by careful assessment of what is important for the individual as older persons´ perception of participation are individual and change over time.Further knowledge on this subject is needed, particularly studies with participants in very old age and poor health.

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 98-111).

The prevalence of Alzheimer’s disease (AD) in Canada is on the rise, creating the need for evidence-based care practices designed to support individuals with AD and their care providers. Declines in memory, language, visual-spatial, executive abilities, and functional capacity associated with AD create the need for caregiver assistance during the completion of activities of daily living (ADLs). Unfortunately, assisting individuals with more advanced stages of AD is further complicated by communication breakdowns that occur in the dyad (i.e., caregiver and the individual with AD) established to meet a common goal: to complete ADLs. Clinically recommended communication strategies are the current solution used to support caregivers interacting with individuals with AD. However, there are limitations to these recommendations, including that the majority are based on caregiver experience, few are supported by empirical research, and little is known about which strategies are effective when assisting individuals with moderate to severe AD specifically during the context of completing ADLs. This dissertation presents novel research studies that systematically examined formal caregivers’ use of communication strategies while successfully assisting residents with moderate and severe AD during the completion of a representative ADL. Two observational studies and one focus group interview study were conducted to address our hypotheses and research objectives. Key findings from the studies comprising this dissertation were: (1) caregivers used a variety of verbal and nonverbal task-focused communication strategies when successfully assisting residents with AD during the completion of a representative ADL; (2) the task-focused communication strategies caregivers most frequently used were supported by empirical literature and included the use of one direction or idea (i.e., proposition) at a time, closed-ended questions, and paraphrased repetition; (3) when assisting residents with severe AD, caregivers used the resident’s name, one proposition, and paraphrased repetition significantly more than when assisting residents with moderate AD; and (4) the communication strategies that caregivers perceived to use in their care practice indicate that person-centered dementia care is a central aspect to facilitating the completion of ADLs. This research is an important step towards the development of evidence-based communication strategies for caregivers assisting individuals with AD during ADLs.

The prevalence of Alzheimer’s disease (AD) in Canada is on the rise, creating the need for evidence-based care practices designed to support individuals with AD and their care providers. Declines in memory, language, visual-spatial, executive abilities, and functional capacity associated with AD create the need for caregiver assistance during the completion of activities of daily living (ADLs). Unfortunately, assisting individuals with more advanced stages of AD is further complicated by communication breakdowns that occur in the dyad (i.e., caregiver and the individual with AD) established to meet a common goal: to complete ADLs. Clinically recommended communication strategies are the current solution used to support caregivers interacting with individuals with AD. However, there are limitations to these recommendations, including that the majority are based on caregiver experience, few are supported by empirical research, and little is known about which strategies are effective when assisting individuals with moderate to severe AD specifically during the context of completing ADLs. This dissertation presents novel research studies that systematically examined formal caregivers’ use of communication strategies while successfully assisting residents with moderate and severe AD during the completion of a representative ADL. Two observational studies and one focus group interview study were conducted to address our hypotheses and research objectives. Key findings from the studies comprising this dissertation were: (1) caregivers used a variety of verbal and nonverbal task-focused communication strategies when successfully assisting residents with AD during the completion of a representative ADL; (2) the task-focused communication strategies caregivers most frequently used were supported by empirical literature and included the use of one direction or idea (i.e., proposition) at a time, closed-ended questions, and paraphrased repetition; (3) when assisting residents with severe AD, caregivers used the resident’s name, one proposition, and paraphrased repetition significantly more than when assisting residents with moderate AD; and (4) the communication strategies that caregivers perceived to use in their care practice indicate that person-centered dementia care is a central aspect to facilitating the completion of ADLs. This research is an important step towards the development of evidence-based communication strategies for caregivers assisting individuals with AD during ADLs.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Uppsala : Univ., 2001. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Virginia, 1997. / Spine title: Waiting threats to independence. Includes bibliographical references (186-196). Also available online through Digital Dissertations.

Thesis (Ph. D.)--University of Washington, 1998. / Vita. Includes bibliographical references (leaves [46]-51).