Browsing by Author "Rudisch, Julian"

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    Cognitive, physical and emotional determinants of activities of daily living in nursing home residents : a cross-sectional study within the PROCARE-project
    (2023) Wollesen, Bettina; Schott, Nadja; Klotzbier, Thomas; Bischoff, Laura Luise; Cordes, Thomas; Rudisch, Julian; Otto, Ann-Kathrin; Zwingmann, Katharina; Hildebrand, Claudia; Jöllenbeck, Thomas; Vogt, Lutz; Schoene, Daniel; Weigelt, Matthias; Voelcker-Rehage, Claudia
    Background. Interdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents. Methods. The study included n  = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05). Results. Indices showed (Chi 2 (148) = 217, PCMIN/DF = 1.47; p  < .001; Comparative Fit Index = .940; Tucker Lewes Index = .902, RMSEA = .033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p < .01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance. Discussion and conclusion. Objective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance.
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    An interrater reliability study of gait analysis systems with the dual task paradigm in healthy young and older adults
    (2021) Klotzbier, Thomas J.; Wollesen, Bettina; Vogel, Oliver; Rudisch, Julian; Cordes, Thomas; Jöllenbeck, Thomas; Vogt, Lutz
    Background and aims: One reason for the controversial discussion of whether the dual task (DT) walking paradigm has an added value for diagnosis in clinical conditions might be the use of different gait measurement systems. Therefore, the purpose was 1) to detect DT effects of central gait parameters obtained from five different gait analysis devices in young and old adults, 2) to assess the consistency of the measurement systems, and 3) to determine if the absolut and proportional DT costs (DTC) are greater than the system-measurement error under ST. Methods: Twelve old (72.2 ± 7.9y) and 14 young adults (28.3 ± 6.2y) walked a 14.7-m distance under ST and DT at a self-selected gait velocity. Interrater reliability, precision of the measurement and sensitivity to change were calculated under ST and DT. Results: An age effect was observed in almost all gait parameters for the ST condition. For DT only differences for stride length (p < .029, ɳ2 p = .239) as well as single and double limb support (p = .036, ɳ2 p = .227; p = .034, ɳ2 p = .218) remained. The measurement systems showed a lower absolute agreement compared to consistency across all systems. Conclusions: When reporting DT effects, the real changes in performance and random measurement errors should always be accounted for. These findings have strong implications for interpreting DT effects.