OBJECTIVE: To synthesise evidence evaluating non-pharmacological interventions targeting mobility among people with advanced cancer, considering the type, efficacy and contextual factors that may influence outcome.
METHODS: Systematic review of studies of non-pharmacological interventions in adults (≥ 18 years) with advanced (stage III-IV) cancer, and assessing mobility using clinical or patient-reported outcome measures. Searches were conducted across three electronic databases (MEDLINE, EMBASE and CINAHL) up to June 2024. Methodological quality was assessed using Joanna Briggs Institute tools and contextual factors were evaluated through the Context and Implementation of Complex Interventions framework. A narrative synthesis was conducted due to clinical heterogeneity of included studies.
RESULTS: 38 studies encompassing 2,464 participants were included. The most frequent mobility outcome measure was the 6-min walk test (26/38 studies). Exercise was the most common intervention, (33 studies: 27 aerobic and resistance, 5 aerobic, 1 resistance versus aerobic training) and improvements in mobility were found in 21/33 outcomes. Electrotherapy interventions led to significant improvements in mobility in 3/5 studies. Geographical factors (e.g. distance, transport, parking requirements) potentially limited participation in 18/38 studies. A lack of ethnic diversity among populations was evident and language proficiency was an inclusion criterion in 12 studies.
CONCLUSIONS: Exercise and neuromuscular electrical stimulation appear to improve mobility outcomes in advanced cancer. The evaluation of other non-pharmacological interventions targeting mobility should consider access and inclusivity, and be adaptable to the needs of this population.

Older adults have higher rates of emergency department (ED) admissions when compared to their younger counterparts. Mobility is the ability to move around, but also encompasses the environment and the ability to adapt to it. Walking aids can be used to improve mobility and prevent falls. According to international guidelines, they must be available in Geriatric EDs. This study aims to evaluate the efficacy of a program of training and provision of walking aids (WA), associated or not with telemonitoring, on fear of falling, mobility, quality of life and risk of falls up to 3 and 6 months in older adults cared for in an ED. A randomized controlled trial will be carried out in the ED. Participants will be randomized and allocated into three groups, as follows: A) walking aid group will be trained for the use of a walking aid and receive guidance on safe gait; B) walking aid and telemonitoring group will receive training for the use of a walking aid, guidance on safe gait, and telemonitoring (every two weeks for first three months); C) Control group will receive only guidance on safe gait. Patients will undergo a baseline evaluation encompassing sociodemographic and clinical data, mobility in life spaces, gait speed, muscle strength, functionality, quality of life, fear of falling, history of falls, cognition and mood before the intervention. Gait time and fear of falling will be assessed again after the intervention in ED. Finally, mobility in life spaces, functionality, quality of life, fear of falling, history of falls, cognition, and mood will be assessed 3 and 6 months after discharge from the geriatric ED through a telephone interview. Provision of walking aids in the geriatric ED is currently recommended. This study will be the first randomized controlled trial that will evaluate the impact of training and provision of these devices in the ED. Trial registration number: NCT05950269.

Older patients face increasing challenges in preserving mobility during hospitalization. This retrospective cohort study aimed to evaluate the effect of an Occupational Therapy (OT) program on mobility at discharge in older patients admitted to an Acute Geriatric Unit (AGU). All patients aged ≥65 years consecutively admitted to the AGU in an 18-month period were included in the study if scoring <4 or ≥ 8 at the Clinical Frailty Scale. Overall, 807 patients (median age 85 years, 50.2% females) were included: 665 (82%) received OT, while 142 who did not receive OT were used as controls. The Cumulated Ambulation Scale (CAS) was used to assess mobility at discharge. By multivariable logistic regression, OT was independently associated with higher odds of achieving higher CAS score at discharge. These findings emphasize the potential benefits of OT in acute geriatric settings, providing valuable insights for preserving mobility of frail older individuals during hospitalization.

BACKGROUND: Mobility limitations (e.g., using wheelchair) have been closely linked to diminished functional independence and quality of life in older adults. The regulation of mobility is pertaining to multiple neurophysiologic and sociodemographic factors. We here aimed to characterize the relationships of these factors to the risk of restricted mobility in older adults.
METHODS: In this longitudinal study, 668 older adults with intact mobility at baseline completed the baseline assessments of clinical characteristics, cognitive function, sleep quality, activities of daily living (ADL), walking performance, beat-to-beat blood pressure, and structural MRI of the brain. Then 506 of them (mean age = 70.7 ± 7.5 years) responded to the follow-up interview on the mobility limitation (as defined by if using wheelchair, cane, or walkers, or being disabled and lying on the bed) after 18 ± 3.5 months. Logistic regression analyses were performed to examine the relationships between the baseline characteristics and the follow-up mobility restriction.
RESULTS: At baseline, compared to intact-mobility group (n = 475), restricted-mobility group (n = 31) were older, with lower score of ADL and the Montreal Cognitive Assessment (MoCA), greater score of Pittsburgh Sleep Quality Index (PSQI), poorer cardio- and cerebral vascular function, and slower walking speeds (ps < 0.05). The logistic regression analysis demonstrated that participants who were with history of falls, uncontrolled-hypertension, and/or greater Fazekas scale (odds ratios (ORs):1.3 ~ 13.9, 95% confidence intervals (CIs) = 1.1 ~ 328.2), walked slower, and/or with lower ADL score (ORs: 0.0026 ~ 0.9; 95%CI: 0.0001 ~ 0.99) at baseline, would have significantly greater risk of restricted mobility (p < 0.05; VIFs = 1.2 ~ 1.9).
CONCLUSIONS: These findings provide novel profile of potential risk factors, including vascular characteristics, psycho-cognitive and motor performance, for the development of restricted mobility in near future in older adults, ultimately helping the design of appropriate clinical and rehabilitative programs for mobility in this population.

UNASSIGNED: Nursing students often receive insufficient training in older adults\' care.
UNASSIGNED: Examine nursing students\' perceptions of an e-learning module developed to enhance their knowledge about the comfort, safety, and mobility of older adults.
UNASSIGNED: A cross-sectional survey was administered to third-year baccalaureate nursing students at a Canadian university after they had completed the comfort, safety, and mobility module. The survey assessed students\' perceptions of the e-learning module using four 5-pointLikert-type items. The survey also contained demographic questions and one open-ended question that invited participants to make any comments they wished. Descriptive statistics were used to summarize participants\'demographic characteristics. Responses to the open-ended quesiton were summative content analyzed.
UNASSIGNED: The survey was completed by 119 participants, who reported that the module increased their confidence, perceptions and knowledge in working with older adults. Participants also found the method of instruction to be convenient, interactive, and enjoyable.
UNASSIGNED: Results suggest that the learning module has the potential to facilitate student nurses\' learning about comfort, safety, and mobility.

BACKGROUND: Older adults with multiple sclerosis (MS) present with low physical activity participation, cognitive and ambulatory dysfunctions, and compromised quality of life (QOL).
OBJECTIVE: We propose a NIH Stage-I, randomized controlled trial (RCT) that examines the feasibility and efficacy of a 16-week theory-based, remotely-delivered, exercise training program for improving cognitive and physical functions in older adults with MS who have moderate mobility disability without severe cognitive impairment.
METHODS: This Stage-I study utilizes a parallel-group RCT design. Participants (N = 50; age ≥ 50 years) will be randomly assigned into exercise training (combined aerobic and resistance exercise) or active control (flexibility and stretching) conditions. The conditions will be undertaken within a participant\'s home/community over a 16-week period, and monitored remotely and supported by Zoom-based chats guided by social cognitive theory (SCT) via a behavioral coach. Participants will receive training manuals and equipment, one-on-one behavioral coaching, action-planning calendars, self-monitoring logs, and SCT-based newsletters. The primary outcomes include feasibility (e.g., recruitment and retention rates), exercise behavior and physical activity; other outcomes include physical function (lower-extremity function, mobility, walking), cognition (processing speed, learning and memory, executive function), MS symptoms, QOL, and vascular function. We will collect outcome data at baseline (Week 0), post-intervention (Week 16), and follow-up (Week-32). Data analysis will follow intent-to-treat principles using linear mixed-effects models.
CONCLUSIONS: This Stage-I trial adopts an innovative approach for exercise training via telerehabilitation and is convenient and accessible for older adults with MS. If successful, the study will provide foundations for future research using remotely-delivered exercise intervention for managing the consequences of aging with MS.
BACKGROUND: NCT05930821.

UNASSIGNED: This study explores the influence of COVID-19 public health mandates on people with mobility disabilities in the United States in their everyday lives. It highlights the intersection of disability with social determinants of health, emphasizing the need for a comprehensive policy response.
UNASSIGNED: Qualitative data were collected through 76 semi-structured interviews with people with mobility disabilities. Interviews focused on experiences with COVID-19 mandates and community access, analyzed using thematic analysis and coded for emergent subthemes.
UNASSIGNED: The relationship between community participation and COVID-19 compliance was complex for people with disabilities. Inaccessible environments and inflexible policies made it difficult for people with disabilities to practice good safety measures, while widespread noncompliance by community members limited their community participation. The findings revealed additional mixed lived experiences of COVID-19 policies on community participation, accessibility, and access to resources and support. While technology facilitated some aspects of community participation, issues with accessibility, public transportation, and personal assistance services were exacerbated.
UNASSIGNED: COVID-19 policies have complex implications for people with mobility disabilities. Findings suggest a need for inclusive policymaking, improved disability awareness, and continued support for accessible technology and services. Future research should further explore these dynamics to inform policy and practice.

OBJECTIVE: To describe a home program for a child with medical complexity using an over-ground body weight support (BWS) system.
CONCLUSIONS: Children with medical complexity often use home programs due to challenges with regular therapy attendance. In this case, effective home program components including child centered design, family leadership, and best practice principles were prioritized around the PUMA (portable mobility aid for children). This BWS system was to be used for 1 hour per day to support mobility and active play.
CONCLUSIONS: The CMC and family demonstrated high adherence, using over-ground BWS 87% of the 135 days it was accessible with an average daily usage of 59 min spread across 1-3 bouts per day. The average daily fun index during usage was 7/10.
CONCLUSIONS: This home program demonstrated over-ground BWS technology as a feasible, fun platform for functional mobility and socialization in a child with significant medical and physical limitations.

Mobility is crucial for independent living in old age. Older people with reduced physical ability (frailty) begin to limit their personal range of activities to their immediate living environment and ultimately to their immediate home. Diseases of the musculoskeletal system as well as neurological, psychological, cognitive, sensory, and circulatory disorders can limit functional competence (ability to live independently).In the Longitudinal Urban Cohort Ageing Study (LUCAS), from which selected results are reported in this article, participants were categorized into different functional classes (Robust, postRobust, preFrail, Frail) using the LUCAS functional index. The results show that losses in functional competence were associated with impaired mobility and reduced car driving. Impaired mobility led to restricted radius of action.The aim of healthcare in old age is to preserve independence and quality of life as long as possible. Car driving is an important part of older peoples\' activities of daily living. Therefore, primary care physicians should address car driving regularly because preventive measures to strengthen functional health also strengthen car driving ability in older persons.
UNASSIGNED: Mobilität ist auch im höheren Alter maßgeblich für die selbstständige Lebensführung. Ältere Menschen beginnen bei geringerer körperlicher Leistungsfähigkeit (Gebrechlichkeit, engl. Frailty) ihren persönlichen Aktionsradius auf das nähere Wohnumfeld und schließlich die unmittelbare Häuslichkeit zu begrenzen. Erkrankungen des Bewegungsapparates, neurologische, psychische, kognitive, Sinnes- oder Kreislaufstörungen können die funktionale Kompetenz (Fähigkeit, unabhängig zu leben) einschränken.In einer Längsschnittstudie zur Alterung urbaner Kohorten (LUCAS), aus der in diesem Artikel ausgewählte Ergebnisse berichtet werden, wurden die Teilnehmenden mittels des LUCAS-Funktions-Index unterschiedlichen Funktionsklassen zugeordnet (Robust, postRobust, preFrail und Frail). Die Ergebnisse zeigen, dass zunehmende Verluste funktionaler Kompetenz mit abnehmender Mobilität und weniger häufigem selbstständigen Autofahren verknüpft waren. Beeinträchtigungen der Mobilität engten den Aktionsradius ein.Das Ziel der gesundheitlichen Versorgung im Alter ist es, Unabhängigkeit und Lebensqualität der Menschen lange zu erhalten. Autofahren ist ein wichtiger Teil der Alltagsaktivitäten älterer Menschen. Deshalb sollte insbesondere hausärztlich auch regelmäßig wiederholt die Frage nach dem Autofahren gestellt werden, denn präventive Maßnahmen zum Erhalt funktionaler Gesundheit dienen auch dem Erhalt der Fahreignung älterer Menschen.

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