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Biomedical subjects

Ian D Cameron

Publications and source records attributed to Ian D Cameron.

29 records · Page 2Linked to original sources
PubMed2003

A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS).

OBJECTIVES: To determine the effectiveness of vitamin D and home-based quadriceps resistance exercise on reducing falls and improving the physical health of frail older people after hospital discharge. DESIGN: Multicenter, randomized, controlled trial with a factorial design. SETTING: Five hospitals in Auckland, New Zealand, and Sydney, Australia. PARTICIPANTS: Two hundred forty-three frail older people. INTERVENTIONS: Patients were randomized to receive a single dose of vitamin D (calciferol, 300,000 IU) or placebo tablets and 10 weeks of high-intensity home-based quadriceps resistance exercise or frequency-matched visits. MEASUREMENTS: The primary endpoints were physical health according to the short-form health survey at 3 months and falls over 6 months. Physical performance and self-rated function were secondary endpoints. Assessments took place in the participants' homes at 3 and 6 months after randomization and were performed by blinded assessors. RESULTS: There was no effect of either intervention on physical health or falls, but patients in the exercise group were at increased risk of musculoskeletal injury (risk ratio = 3.6, 95% confidence interval = 1.5-8.0). Vitamin D supplementation did not improve physical performance, even in those who were vitamin D deficient (<12 ng/mL) at baseline. CONCLUSION: Neither vitamin D supplementation nor a home-based program of high-intensity quadriceps resistance exercise improved rehabilitation outcomes in frail older people after hospitalization. There was no effect of vitamin D on physical performance, and the exercises increased the risk of musculoskeletal injury. These findings do not support the routine use of these interventions at these dosages in the rehabilitation of frail older people.

Accidental Falls↗
PubMed2003

Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided.

OBJECTIVES: To determine fall risk factors in nursing home and intermediate-care residents who can and cannot stand unaided. DESIGN: Prospective cohort study. SETTING: Residential elderly care facilities in Sydney, Australia. PARTICIPANTS: One thousand people aged 65 to 103 (mean age +/- standard deviation: 85.0 +/- 7.4). MEASUREMENTS: Accidental falls. RESULTS: Fall rates were highest in those with fair standing balance, intermediate in those with the best standing balance, and lowest in those with the worst standing balance. This nonlinear pattern was even more striking when subjects were categorized according to their standing balance and ability to rise from a chair. Using this dual classification, fall rates were highest in those who could rise from a chair but could not stand unaided (81%) and lowest in those who could neither rise from a chair nor stand unaided (48%). In residents who could stand unaided, risk factors included increased age, male sex, higher care classifications, incontinence, psychoactive medication use, previous falls, and slow reaction times. In contrast, quite different risk factors were evident in residents who could not stand unaided, with a number of known fall risk factors (previous stroke, reduced ability to rise from a chair, slow reaction times) being associated with fewer falls. In this group, risk factors were intermediate versus nursing home care, poor health status, psychoactive medication use, Parkinson's disease, previous falls, and being able to get out of a chair. CONCLUSION: The findings indicate that there are different risk factors for falls for people living in residential aged care facilities who can and cannot stand unaided. These findings provide important information for developing fall-prevention strategies and suggest that those who can stand unaided but have multiple falls risk factors constitute the highest priority group for such interventions.

Accidental Falls↗
PubMed2002

1: Rehabilitation and older people.

Older people make up the majority of participants in general rehabilitation programs. Stroke and hip fracture are the major diagnostic groups. Most older people with significant disability of recent onset have the potential to benefit from rehabilitation. Assessing an older person's premorbid functional and cognitive status, which are strong determinants of rehabilitation outcome, is an important component of management. The major goals of rehabilitation for older people are mobility and self-care without the assistance of another person. Evidence suggests that rehabilitation for older people involving a coordinated multidisciplinary team of health professionals (including nurses and doctors) is effective. Contemporary rehabilitation practice is not confined to traditional inpatient rehabilitation units; it also occurs in the community and other non-hospital settings, and involves general practitioners.

Activities of Daily Living↗
PubMed2002

Hip protectors.

Explore the source record for details and available documents.

Aged↗
PubMedDate not supplied

Coordinated multidisciplinary rehabilitation after hip fracture.

PURPOSE: To review the topic of coordinated multidisciplinary rehabilitation after hip fracture from a research perspective and to provide information to guide the provision of rehabilitation services for patients with hip fracture. METHODS: Literature review including searches of Medline, Embase, Cochrane Collaboration and evidence based clinical guidelines, checking of references of publications and consultation with researchers. RESULTS: The research evidence is heterogeneous and remains inclusive. Programs that assist patients with hip fracture to regain function and return home as soon as feasible are likely to be effective as they appear to increase the percentage of patients who return home and remain there after hip fracture. Rehabilitation programs that achieve this are likely to be cost effective. These programs involve health professionals from multiple disciplines (nurses, allied health professionals and medical practitioners) who work collaboratively, may operate in several settings, and routinely provide specific treatments that are supported by strong evidence of effectiveness. CONCLUSIONS: Patients with hip fracture should be offered a coordinated a multidisciplinary rehabilitation program with the specific aim of regaining sufficient function to return to their pre-fracture living arrangements.

Accidental Falls↗
PubMedDate not supplied

Evidence for the optimal management of acute and chronic phantom pain: a systematic review.

OBJECTIVES: The objective was to examine the evidence to determine the optimal management of phantom limb pain in the preoperative and postoperative phase of amputations. METHODS: Trials were identified by a systematic search of MEDLINE, review articles, and references of relevant trials from the period 1966-1999, including only English-language articles. Included trials involved a control group, any intervention, and reported phantom pain as an outcome. RESULTS: Twelve trials were identified, including 375 patients whose follow-ups ranged in duration from 1 week to 2 years. Only three randomized, controlled studies with parallel groups and three randomized crossover trials were identified. Eight trials examined treatment of acute phantom pain, including epidural treatments (three trials), regional nerve blocks (three trials), treatment with calcitonin (one trial), and transcutaneous electrical nerve stimulation (one trial). Three trials demonstrated a positive impact of the intervention on phantom limb pain, but the remainder demonstrated no difference between the intervention and control groups. Four trials examined late postoperative interventions, including transcutaneous electrical nerve stimulation (two trials) and the use of Farabloc (a metal threaded sock) and ketamine (one trial each). With regard to late postoperative interventions, three of the four trials showed modest short-term reduction of phantom limb pain. There was no relation between the quality of the trial and a positive result of the intervention. CONCLUSIONS: Although up to 70% of patients have phantom limb pain after amputation, there is little evidence from randomized trials to guide clinicians with treatment. Evidence on preemptive epidurals, early regional nerve blocks, and mechanical vibratory stimulation provides inconsistent support for these treatments. There is currently a gap between research and practice in the area of phantom limb pain.

Acute Disease↗
PubMedDate not supplied

The perils of pet ownership: a new fall-injury risk factor.

OBJECTIVE: To describe fall-related injuries due to pets in an older population. DESIGN: Case series. PARTICIPANTS AND SETTING: Patients aged 75 years and over presenting to the emergency department of a metropolitan hospital in northern Sydney over 18 months, with a fracture directly related to their pet. MAIN OUTCOME MEASURES: Type of fracture; circumstances of injury. RESULTS: 16 cases (mean patient age, 81 years) are described; 13 (81%) involved women. Animals of five species were involved, with cats and dogs being the most common pet hazard. CONCLUSIONS: Pets are a potential environmental hazard in the occurrence of fall-related injuries in older people, with dogs and cats most likely to be involved. Women appear more likely than men to be injured.

Accidental Falls↗