Assessing Physical Therapists' Outdoor Walking Recommendations and Neighborhood Walkability for Older Adults.

Background/objectives: Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults' participation in outdoor physical activity. Identifying factors that influence physical therapists' (PTs) decisions about prescribing outdoor walking is needed, especially for those who are aging in place.

Bag-Valve-Mask Ventilation and Survival From Out-of-Hospital Cardiac Arrest: A Multicenter Study.

Background: Few studies have measured ventilation during early cardiopulmonary resuscitation (CPR) before advanced airway placement. Resuscitation guidelines recommend pauses after every 30 chest compressions to deliver ventilations. The effectiveness of bag-valve-mask ventilation delivered during the pause in chest compressions is unknown.

THE COMPENSATORY RESERVE INDEX FOR PREDICTING HEMORRHAGIC SHOCK IN PREHOSPITAL TRAUMA.

Background: The compensatory reserve index (CRI) is a noninvasive, continuous measure designed to detect intravascular volume loss. CRI is derived from the pulse oximetry waveform and reflects the proportion of physiologic reserve remaining before clinical hemodynamic decompensation. Methods: In this prospective, observational, prehospital cohort study, we measured CRI in injured patients transported by emergency medical services (EMS) to a single Level I trauma center.

Age, sex, and survival following ventricular fibrillation cardiac arrest: A mechanistic evaluation of the ECG waveform.

Background: Studies of outcome differences by sex in out-of-hospital cardiac arrest (OHCA) have produced mixed results that may depend on age, a potential surrogate for menopausal status.

Objective: We used quantitative measures of ventricular fibrillation (VF) waveforms - indicators of the myocardium's physiology - to assess whether survival differences according to sex and age group may be mediated via a biologic mechanism.

Methods: We conducted a cohort study of VF-OHCA in a metropolitan EMS system.

Prediction of Shock-Refractory Ventricular Fibrillation During Resuscitation of Out-of-Hospital Cardiac Arrest.

Background: Out-of-hospital cardiac arrest due to shock-refractory ventricular fibrillation (VF) is associated with relatively poor survival. The ability to predict refractory VF (requiring ≥3 shocks) in advance of repeated shock failure could enable preemptive targeted interventions aimed at improving outcome, such as earlier administration of antiarrhythmics, reconsideration of epinephrine use or dosage, changes in shock delivery strategy, or expedited invasive treatments.

Methods: We conducted a cohort study of VF out-of-hospital cardiac arrest to develop an ECG-based algorithm to predict patients with refractory VF.

Instantaneous amplitude: Association of ventricular fibrillation waveform measures at time of shock with outcome in out-of-hospital cardiac arrest.

Background: Prompt defibrillation is key to successful resuscitation from ventricular fibrillation out-of-hospital cardiac arrest (VF-OHCA). Preliminary evidence suggests that the timing of shock relative to the amplitude of the VF ECG waveform may affect the likelihood of resuscitation. We investigated whether the VF waveform amplitude at the time of shock (instantaneous amplitude) predicts outcome independent of other validated waveform measures.

Balance performance and grip strength as predictors of cognitive function among community-dwelling older adults in the USA.

Objectives: To investigate how balance and grip strength predicts the probability of cognitive function impairment (i.e., executive function: mild and mild-to-moderate impairment, and delayed recall) over eight years in community-dwelling older adults in the US, controlling for sex and race/ethnicity.

Continuous assessment of ventricular fibrillation prognostic status during CPR: Implications for resuscitation.

Background: Ventricular fibrillation (VF) waveform measures reflect myocardial physiologic status. Continuous assessment of VF prognosis using such measures could guide resuscitation, but has not been possible due to CPR artifact in the ECG. A recently-validated VF measure (termed VitalityScore), which estimates the probability (0-100%) of return-of-rhythm (ROR) after shock, can assess VF during CPR, suggesting potential for continuous application during resuscitation.

A pilot evaluation of respiratory mechanics during prehospital manual ventilation.

Introduction: Respiratory mechanics, such as tidal volume (V) and inspiratory pressures, may affect outcome in hospitalized patients with respiratory failure. Little is known about respiratory mechanics in the prehospital setting.

Methods: In this prospective, pilot investigation of patients receiving prehospital advanced airway placement, paramedics applied a device to measure respiratory mechanics.

A method for continuous rhythm classification and early detection of ventricular fibrillation during CPR.

Aim: We developed a method which continuously classifies the ECG rhythm during CPR in order to guide clinical care.

Methods: We conducted a retrospective study of 432 patients treated following out-of-hospital cardiac arrest. Continuous ECG sequences from two-minute CPR cycles were extracted from defibrillator recordings and further divided into five-second clips.

Screening recall in older cancer survivors detects differences in balance and mobility.

Purpose: Cognitive impairments have been reported by up to two-thirds of cancer survivors whose primary cancer did not occur in the central nervous system. Physical impairments as sequelae of cancer-related cognitive impairment (CRCI) have not been well described in previous studies. Furthermore, there is scarcity of literature describing differences among physical performance in those with and without CRCI.

Machine learning and feature engineering for predicting pulse presence during chest compressions.

Current resuscitation protocols require pausing chest compressions during cardiopulmonary resuscitation (CPR) to check for a pulse. However, pausing CPR when a patient is pulseless can worsen patient outcomes. Our objective was to design and evaluate an ECG-based algorithm that predicts pulse presence with or without CPR.

Determinants of acute care discharge in adults with chronic obstructive pulmonary disease.

In adults with COPD basic mobility scores on the AM-PAC "6-clicks" measure completed at discharge had the best sensitivity and specificity for predicting discharge to home and need for rehab services.

Insights From the Ventricular Fibrillation Waveform Into the Mechanism of Survival Benefit From Bystander Cardiopulmonary Resuscitation.

Background The mechanism by which bystander cardiopulmonary resuscitation (CPR) improves survival following out-of-hospital cardiac arrest is unclear. We hypothesized that ventricular fibrillation (VF) waveform measures, as surrogates of myocardial physiology, mediate the relationship between bystander CPR and survival. Methods and Results We performed a retrospective cohort study of adult, bystander-witnessed patients with out-of-hospital cardiac arrest with an initial rhythm of VF who were treated by a metropolitan emergency medical services system from 2005 to 2018.

Physical function measurement in older long-term cancer survivors.

Objective: To establish reliability, validity, and minimal detectable change in measures of function in older long-term cancer survivors.

Methods: Older cancer survivors were recruited to perform functional measures; 5 Times Sit-to-Stand (5xSTS), 30-second Timed Chair Rise (30sTCR), Short Physical Performance Battery (SPPB), Physical Performance Test-7 (PPT-7). Two testing sessions were completed two weeks apart.

Associations Between Cognitive Function, Balance, and Gait Speed in Community-Dwelling Older Adults with COPD.

Background And Purpose: Older adults with chronic obstructive pulmonary disease (COPD) are at risk for physical and cognitive impairment. Cognitive function is associated with falls in older adults. However, it is unknown whether a relationship exists between cognitive function and falls in patients with COPD.

Cerebral Oximetry during Out-of-Hospital Resuscitation: Pilot Study of First Responder Implementation.

Anoxic brain injury is a common mode of death following out-of-hospital cardiac arrest (OHCA). We assessed the course of regional cerebral oxygen saturation (rSO) at the outset and during first responder resuscitation to understand its relationship with return of spontaneous circulation (ROSC) and functional survival. We undertook a prospective observational investigation of adult OHCA patients treated by a first-responder EMS agency in King County, WA.

Prehospital tourniquet use: An evaluation of community application and outcome.

Background: There is substantial investment in layperson and first responder training involving tourniquet use for hemorrhage control. Little is known however about prehospital tourniquet application, field conversion, or outcomes in the civilian setting. We describe the experience of a metropolitan region with prehospital tourniquet application.

Assessment of Gait Speed and Timed Up and Go Measures as Predictors of Falls in Older Breast Cancer Survivors.

Background: Older breast cancer survivors are at an increased risk of loss of postural balance and accidental falls, however, the ability of clinical mobility measures to predict falls has not been determined. The purpose of this study was to examine the prognostic ability, sensitivity, and specificity to predict accidental falls in measures of gait speed and functional mobility in older breast cancer survivors.

Methods: Thirty-four breast cancer survivors 65 years and older performed 3 measures of gait speed (GS) (usual, fast, dual-task) and Timed Up and Go (TUG) (TUG, TUG-Cognitive, TUG-Manual).

Perceived Neighborhood Walkability is Associated with Recent Falls in Urban Dwelling Older Adults.

Background And Purpose: In rural communities, perceptions of neighborhood walkability, the rating of how easy it is to walk in an area, influence engagement in physical activity outside the home. This has not been studied in older adults residing in urban settings. Additionally, it is not known how perceived walkability is associated with falls.

Balance Confidence and Falls Self-Efficacy in Older Breast Cancer Survivors.

Purpose: The aim of the study was to examine the reliability, validity, and measurement error of balance confidence and fall-related self-efficacy measures in older breast cancer survivors.

Design: A cross-sectional study was performed.

Methods: The Activities-Specific Balance Confidence Scale (ABC), the shorter, six-item version of the ABC (ABC-6), and the Modified Falls Efficacy Scale (MFES) were completed by 35 older breast cancer survivors.