Waterloo Research

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Browsing Waterloo Research by Author "Adachi, Jonathan"

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    Assessing the feasibility of an integrated collection of education modules for fall and fracture prevention (iCARE) for healthcare providers in long term care: A longitudinal study
    (Public Library of Science (PLOS), 2024) Rodrigues, Isabel B.; Ioannidis, George; Kane, Lauren L.; Hillier, Loretta M.; Adachi, Jonathan; Heckman, George; Hirdes, John; Holroyd-Leduc, Jayna; Jaglal, Susan; Kaasalainen, Sharon; Marr, Sharon; McArthur, Caitlin; Straus, Sharon; Tarride, Jean-Eric; Abbas, Momina; Costa, Andrew P.; Lau, Arthur N.; Thabane, Lehana; Papaioannou, Alexandra
    Falls and hip fractures are a major health concern among older adults in long term care (LTC) with almost 50% of residents experiencing a fall annually. Hip fractures are one of the most important and frequent fall-related injuries in LTC. There is moderate to strong certainty evidence that multifactorial interventions may reduce the risk of falls and fractures; however, there is little evidence to support its implementation. The purpose of this study was to determine the feasibility (recruitment rate and adaptations) with a subobjective to understand facilitators to and barriers of implementing the PREVENT (Person-centred Routine Fracture PreEVENTion) model in practice. The model includes a multifactorial intervention on diet, exercise, environmental adaptations, hip protectors, medications (including calcium and vitamin D), and medication reviews to treat residents at high risk of fracture. Our secondary outcomes were to determine if there was a change in knowledge uptake of the guidelines among healthcare providers and in the proportion of fracture prevention prescriptions post-intervention. We conducted a mixed-methods longitudinal cohort study in three LTC homes across southern Ontario. A local champion was selected to help guide the implementation of the model and promote best practices. We reported recruitment rates using descriptive statistics and challenges to implementation using content analysis. We reported changes in knowledge uptake and in the proportion of fracture prevention medications using the McNemar's test. We recruited three LTC homes and identified one local champion for each home. We required two months to identify and train the local champion over three, 1.5-hour train-the-trainer sessions, and the local champion required three months to deliver the intervention to a team of healthcare professionals. We identified several facilitators, barriers, and adaptations to PREVENT. Benefits of the model include easy access to the Fracture Risk Scale (FRS), clear and succinct educational material catered to each healthcare professional, and an accredited Continuing Medical Educational module for physicians and nurses. Challenges included misperceptions between the differences in fall and fracture prevention strategies, fear of perceived side effects associated with fracture prevention medications, and time barriers with completing the audit report. Our study found an increase knowledge uptake of the guidelines and an increase in the proportion of fracture prevention prescriptions post-intervention.
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    The reliability and validity of a non-wearable indoor positioning system to assess mobility in older adults: A cross-sectional study
    (Public Library of Science (PLOS), 2025) Rodrigues, Isabel B.; Hewston, Patricia; Adachi, Jonathan; Borhan, Sayem; Ioannidis, George; Kouroukis, Alexa; Leckie, Carolyn; Lee, Andrea; Rabinovich, Alexander; Siva, Parthipan; Swance, Rachel; Tariq, Suleman; Thabane, Lehana; Papioannou, Alexandra
    Background Detecting early changes in walking speed can allow older adults to seek preventative rehabilitation. Currently, there is a lack of consensus on which assessments to use to assess walking speed and how to continuously monitor walking speed outside of the clinic. Chirp is a privacy-preserving radar sensor developed to continuously monitor older adults' safety and mobility without the need for cameras or wearable devices. Our study purpose was to evaluate the inter-sensor reliability, intrasession test-retest reliability, and concurrent validity of Chirp in a clinical setting. Methods We recruited 35 community-dwelling older adults (mean age 75.5 (standard deviation: 6.6) years, 86% female). All participants lived alone in an urban city in southwestern Ontario and had access to a smart device with wireless internet. Data were collected with a 4-meter ProtoKinetics ZenoTM Walkway (pressure sensors) with the Chirp sensor (radar positioning) at the end of the walkway. We assessed participants walking speed during normal and adaptive locomotion experimental conditions (walking-while-talking, obstacle, narrow walking, fast walking). We selected walking speed as a measure as it is a good predictor of functional mobility but also is associated with physical and cognitive functioning in older adults. Each of the experimental conditions was conducted twice in a randomized order, with fast walking trials performed last. For intra-session reliability testing, we conducted two blocks of walks within a participant session separated by approximately 30 minutes. Intraclass Correlation Coefficient(A,1) (ICC(A11)) was used to assess the reliability and validity. Linear regression, adjusted for gender, was used to investigate the association between Chirp and cognition and health-related quality of life scores. Results Chirp walking speed inter-sensor reliability ICC(A11) = 0.999[95% Confidence Interval [CI]: 0.997 to 0.999] and intrasession test-retest reliability [ICC(A11)=0.921, 95% CI: 0.725 to 0.969] were excellent across all experimental conditions. Chirp walking speed concurrent validity compared to the ProtoKinetics ZenoTM Walkway was excellent across experimental conditions [ICC(A11)=0.993, 95% CI: 0.985 to 0.997]. We found a weak association between walking speed and cognition scores using the Montreal Cognitive Assessment across experimental conditions (estimated β-value = 7.79, 95% CI: 2.79 to 12.80) and no association between walking speed and health-related quality of life using the 12-item Short Form Survey across experimental conditions (estimated β-value = 6.12, 95% CI: -7.12 to 19.36).
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