Ania Lipat

Purpose: In the rapidly growing older adult demographic, falls are a critical issue as the leading cause of injury. Multifactorial interventions have been shown to improve fall risk, including physical function and fear of falling. This study evaluates the effect of the Physio-fEedback and Exercise pRogram (PEER), an 8-week multifactorial technology-based fall risk intervention. Methods : The longitudinal study included 387 community-dwelling, low-income older adults and was conducted at 4 timepoints at T1 (baseline), T2 (2 months), T3 (4 months), and T4 (6 months). The Timed Up and Go Test, 30-second chair stand test, and BTrackS Score were used as measures of physical function (dynamic balance, lower limb endurance, and static balance, respectively). The PEER intervention consisted of an 8-week technology-based physio-feedback, cognitive reframing, and group-based and at-home exercises (NCT05778604). Results: The PEER intervention mitigated time-related declines in dynamic balance post-intervention ( p <0.001) and subsequent follow-up ( p =0.005). Lower limb endurance and static balance did not show significant improvements. Conclusion: The intervention group showed sustained improvement of dynamic balance, indicating effectiveness of PEER after conclusion of the intervention. However, the lack of significant differences in the other fall risk metrics may be indicative of insufficient duration and/or intensity of the intervention. This study demonstrates both potential for the PEER technology-based mind-body fall prevention for improving dynamic balance and gaps in targeting measures of fall risk. Trial Registration: The trial was registered at ClinicalTrials.gov on March 21, 2023 (NCT05778604).

Background/Objectives: Studies that have investigated the relationship between pain intensity and interference and cognitive function have failed to fully consider the role physical function may play in this relationship. Therefore, the purpose of this study was to examine the mediating role of physical function in the relationship between self-reported pain intensity and interference and cognitive function in middle-to-older aged adults with knee pain. Methods: Middle-to-older aged participants with knee pain (n = 202) completed the Graded Chronic Pain Scale to assess pain intensity and interference, the Short Performance Physical Battery to assess lower-extremity physical function, and the Montreal Cognitive Assessment to assess global cognitive function. Linear regression-based mediation analyses were used to assess associations between pain intensity and interference and cognitive function, with lower-extremity physical function as the mediator. Results: The direct relationship between pain intensity and cognitive function was significant (β = −0.269, p < .001) and remained significant when physical function was included as a mediator (c’=−0.0854, p = .003). The direct relationship between pain interference and cognitive function was also significant (β = −0.149, p = .023) but was attenuated when physical function was included as a mediator (c’=−0.0100, p = .09). Conclusion: Physical function partially mediated the relationship between pain intensity and cognitive function and fully mediated the relationship between pain interference and cognitive function. Significance/Implications: Higher levels of pain intensity and interference may lead to worse cognitive function when physical function is also impaired. Improving physical function may improve cognitive function in those with pain.