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Mobility and Quality of Life

Mobility and Quality of Life

Teaser: 

Summer is almost here as I write this editorial. After a long winter in Canada, one of the real pleasures of spring and summer is getting out of the house and walking. It is a wonderful time to see neighbours again and to see the gardens blooming. However, these simple pleasures of life are difficult to enjoy if one’s mobility is limited and, unfortunately, this is often the case as we age. Arthritis is the number one condition impairing the quality of life of community-dwelling older people, but we physicians often do not take it seriously enough. That is why Geriatrics & Aging regularly has theme issues on musculoskeletal problems: we try to remind clinicians of the importance of mobility in maintaining quality of life.

We have all had muscle cramps at one time or another, but are the cramps older adults get different? It will be easy to find out, just read the article “Muscle Cramps in Older Adults” by Dr. David Guay. Modern imaging has made the diagnosis of spinal stenosis much easier to ascertain but has raised many questions about proper management. The article “Management of Spinal Stenosis” by Drs. Maria Frazer and John Markman is an attempt to answer some of these difficult questions. The article “Intra-articular Corticosteroids in Osteoarthritis” by Dr. Sunita Paudyal and Dr. Stephen Campbell will help the primary care physician utilize this treatment modality in a rational manner.

We also have our usual potpourri of articles on various topics. Our cardiovascular column “Orthostatic Hypotension Screening in Older Adults Taking Antihypertensive Agents” is by Dr. Kenneth Madden, who is also the new associate editor of the Canadian Journal of Geriatrics. Our dementia column addresses a difficult and eternal issue in geriatric medicine, “Adherence to Medication in Patients with Dementia: Problems and Solutions,” and is written by Dr. Dan Brauner. Our caregiving column addresses the topic of “Caregiver Stress: The Physician’s Role” and is by Dr. Abisola Famakinwa. Our technology in medicine column this month is relatively low tech but very important to older adults, namely “Canes & Walkers: A Practical Guide to Prescribing” by Dr. Robert Lam and Alison Wong.

Enjoy this month’s issue,
Barry Goldlist

The Future of Wheelchairs: Intelligent Collision Avoidance and Navigation Assistance

The Future of Wheelchairs: Intelligent Collision Avoidance and Navigation Assistance

Teaser: 

Pooja Viswanathan, BMath, MSc Candidate, Department of Computer Science, University of British Columbia, Vancouver, BC.
Jennifer Boger, MASc, Research Manager, Intelligent Assistive Technology and Systems Lab, Department of Occupational Science and Occupational Therapy, University of Toronto; Toronto Rehabilitation Institute, Toronto, ON.
Jesse Hoey, PhD, Lecturer, School of Computing, University of Dundee, Dundee, Scotland; Toronto Rehabilitation Institute, Toronto, ON.
Pantelis Elinas, MSc, PhD Candidate, Department of Computer Science, University of British Columbia, Vancouver, BC.
Alex Mihailidis, PhD, PEng, Assistant Professor and Head of Intelligent Assistive Technology and Systems Lab, Department of Occupational Science and Occupational Therapy, University of Toronto; Toronto Rehabilitation Institute, Toronto, ON.

Mobility and independence are essential components of a high quality of life. Although they lack the strength to operate manual wheelchairs, most physically disabled older adults with cognitive impairment are also not permitted to use powered wheelchairs due to concerns about their safety. The resulting restriction of mobility often leads to frustration and depression. To address this need, the authors are developing an intelligent powered wheelchair to enable safe navigation and encourage interaction between the driver and his/her environment. The assistive technology described in this article is intended to increase independent mobility, thereby improving the quality of life of older adults with cognitive impairments.
Key words: mobility, artificial intelligence, assistive technology, wheelchairs, cognitive impairment.

Assessment of Mobility Impairment

Assessment of Mobility Impairment

Teaser: 


Roger Y. Wong, MD, FACP, FRCPC, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, BC.

Mobility impairment is a common cause of disability in older persons. The etiology is often multiple, with medical illnesses that affect the musculoskeletal, neurologic, cardiac, and/or respiratory systems superimposed on aging-related changes in gait and balance. A detailed history on the onset, duration, nature, and course of the mobility impairment is helpful. Physical examination should focus on direct observation of gait and balance, while performance- based tests can quantify the abnormalities. Simple tests for assessing walking speed, endurance, and balance are available for both outpatient and inpatient settings. The management of mobility impairment requires a multifaceted interdisciplinary approach.
Key words: mobility, gait and balance, impairment, assessment, walk tests.