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Anne Shumway-Cook

Bio: Anne Shumway-Cook is an academic researcher from University of Washington. The author has contributed to research in topics: Poison control & Balance (ability). The author has an hindex of 53, co-authored 85 publications receiving 23133 citations. Previous affiliations of Anne Shumway-Cook include American Physical Therapy Association & Good Samaritan Hospital.


Papers
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Journal ArticleDOI
TL;DR: The TUG is a sensitive and specific measure for identifying community-dwelling adults who are at risk for falls and the ability to predict falls is not enhanced by adding a secondary task when performing the TUG.
Abstract: Background and Purpose. This study examined the sensitivity and specificity of the Timed Up & Go Test (TUG) under single-task versus dual-task conditions for identifying elderly individuals who are prone to falling. Subjects. Fifteen older adults with no history of falls (mean age578 years, SD56, range565‐ 85) and 15 older adults with a history of 2 or more falls in the previous 6 months (mean age586.2 years, SD56, range576 ‐95) participated. Methods. Time taken to complete the TUG under 3 conditions (TUG, TUG with a subtraction task [TUG cognitive], and TUG while carrying a full cup of water [TUG manual]) was measured. A multivariate analysis of variance and discriminant function and logistic regression analyses were performed. Results. The TUG was found to be a sensitive (sensitivity587%) and specific (specificity587%) measure for identifying elderly individuals who are prone to falls. For both groups of older adults, simultaneous performance of an additional task increased the time taken to complete the TUG, with the greatest effect in the older adults with a history of falls. The TUG scores with or without an additional task (cognitive or manual) were equivalent with respect to identifying fallers and nonfallers. Conclusions and Discussion. The results suggest that the TUG is a sensitive and specific measure for identifying communitydwelling adults who are at risk for falls. The ability to predict falls is not enhanced by adding a secondary task when performing the TUG. [Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896 ‐903.]

3,023 citations

Journal ArticleDOI
TL;DR: New clinical assessment methods incorporating dual-task paradigms are helpful in revealing the effect of disease on the ability to allocate attention to postural tasks and appear to be sensitive measures in both predicting fall risk and in documenting recovery of stability.

2,331 citations

Book
01 Jan 1995
TL;DR: This text bridges the gap between research/theory and practice by focusing on the scientific and experimental basis of new motor control theories by specifically illustrating how recent findings and theories can be applied to clinical practice.
Abstract: The proliferation of new research in the field of neuroscience and motor control has made it difficult to keep pace with the latest findings. This text bridges the gap between research/theory and practice by focusing on the scientific and experimental basis of new motor control theories. Specific examples of theoretical models are provided to clearly illustrate how recent findings and theories can be applied to clinical practice. Each chapter includes an outline, key terms in boldface type, active learning boxes, and a chapter summary to ensure maximum comprehension of the material. The text is intended for physiotherapy and occupational therapy students.

1,936 citations

Book
01 Aug 2006
TL;DR: Theoretical Framework for Clinical Practice and Clinical Management of the Patient with Reach, Grasp, or Manipulation Disorders.
Abstract: THEORETICAL FRAMEWORK Motor Control: Issues and Theories Motor Learning and Recovery of Function Physiology of Motor Control Physiological Basis of Motor Learning and Recovery of Function Constraints on Motor Control: An Overview of Neurologic Impairments A Conceptual Framework for Clinical Practice POSTURAL CONTROL Normal Postural Control Development of Postural Control Aging and Postural Control Abnormal Postural Control Clinical Management of the Patient with a Postural Control Disorder MOBILITY FUNCTION Control of Normal Mobility A Life Span Perspective of Mobility Abnormal Mobility Clinical Management of the Patient with a Mobility Disorder REACH, GRASP, AND MANIPULATION Normal Reach, Grasp, and Manipulation Reach, Grasp, and Manipulation: Changes Across the Life Span Abnormal Reach, Grasp, and Manipulation Clinical Management of the Patient with Reach, Grasp, and Manipulation Disorders Susan Duff, Anne Shumway-Cook, and Marjorie H. Woollacott References

1,755 citations

Journal ArticleDOI
TL;DR: A simple predictive model based on two risk factors can be used by physical therapists to quantify fall risk in community-dwelling older adults and Identification of patients with a high fall risk can lead to an appropriate referral into a fall prevention program.
Abstract: Background and Purpose. The objective of this retrospective case-control study was to develop a model for predicting the likelihood of falls among community-dwelling older adults. Subjects. Forty-four community-dwelling adults (≥65 years of age) with and without a history of falls participated. Methods. Subjects completed a health status questionnaire and underwent a clinical evaluation of balance and mobility function. Variables that differed between fallers and nonfallers were identified, using t tests and cross tabulation with chi-square tests. A forward stepwise regression analysis was carried out to identify a combination of variables that effectively predicted fall status. Results. Five variables were found to be associated with fall history. These variables were analyzed using logistic regression. The final model combined the score on the Berg Balance Scale with a self-reported history of imbalance to predict fall risk. Sensitivity was 91%, and specificity was 82%. Conclusion and Discussion. A simple predictive model based on two risk factors can be used by physical therapists to quantify fall risk in community-dwelling older adults. Identification of patients with a high fall risk can lead to an appropriate referral into a fall prevention program. In addition, fall risk can be used to calculate change resulting from intervention.

1,679 citations


Cited by
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Journal ArticleDOI
06 Jun 1986-JAMA
TL;DR: The editors have done a masterful job of weaving together the biologic, the behavioral, and the clinical sciences into a single tapestry in which everyone from the molecular biologist to the practicing psychiatrist can find and appreciate his or her own research.
Abstract: I have developed "tennis elbow" from lugging this book around the past four weeks, but it is worth the pain, the effort, and the aspirin. It is also worth the (relatively speaking) bargain price. Including appendixes, this book contains 894 pages of text. The entire panorama of the neural sciences is surveyed and examined, and it is comprehensive in its scope, from genomes to social behaviors. The editors explicitly state that the book is designed as "an introductory text for students of biology, behavior, and medicine," but it is hard to imagine any audience, interested in any fragment of neuroscience at any level of sophistication, that would not enjoy this book. The editors have done a masterful job of weaving together the biologic, the behavioral, and the clinical sciences into a single tapestry in which everyone from the molecular biologist to the practicing psychiatrist can find and appreciate his or

7,563 citations

Journal ArticleDOI
TL;DR: The evidence reviewed in this Position Stand is generally consistent with prior American College of Sports Medicine statements on the types and amounts of physical activity recommended for older adults as well as the recently published 2008 Physical Activity Guidelines for Americans.
Abstract: The purpose of this Position Stand is to provide an overview of issues critical to understanding the importance of exercise and physical activity in older adult populations. The Position Stand is divided into three sections: Section 1 briefly reviews the structural and functional changes that characterize normal human aging, Section 2 considers the extent to which exercise and physical activity can influence the aging process, and Section 3 summarizes the benefits of both long-term exercise and physical activity and shorter-duration exercise programs on health and functional capacity. Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. The evidence reviewed in this Position Stand is generally consistent with prior American College of Sports Medicine statements on the types and amounts of physical activity recommended for older adults as well as the recently published 2008 Physical Activity Guidelines for Americans. All older adults should engage in regular physical activity and avoid an inactive lifestyle.

4,264 citations

Journal ArticleDOI
TL;DR: These interventions were more effective in people at higher risk of falling, including those with severe visual impairment, and home safety interventions appear to be more effective when delivered by an occupational therapist.
Abstract: As people get older, they may fall more often for a variety of reasons including problems with balance, poor vision, and dementia. Up to 30% may fall in a year. Although one in five falls may require medical attention, less than one in 10 results in a fracture. This review looked at the healthcare literature to establish which fall prevention interventions are effective for older people living in the community, and included 159 randomised controlled trials with 79,193 participants. Group and home-based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures. Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow-up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined. Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti-slip shoe device worn in icy conditions can also reduce falls. Taking vitamin D supplements does not appear to reduce falls in most community-dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment. Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls. Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure. In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling. The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.

3,124 citations

Journal ArticleDOI
TL;DR: The TUG is a sensitive and specific measure for identifying community-dwelling adults who are at risk for falls and the ability to predict falls is not enhanced by adding a secondary task when performing the TUG.
Abstract: Background and Purpose. This study examined the sensitivity and specificity of the Timed Up & Go Test (TUG) under single-task versus dual-task conditions for identifying elderly individuals who are prone to falling. Subjects. Fifteen older adults with no history of falls (mean age578 years, SD56, range565‐ 85) and 15 older adults with a history of 2 or more falls in the previous 6 months (mean age586.2 years, SD56, range576 ‐95) participated. Methods. Time taken to complete the TUG under 3 conditions (TUG, TUG with a subtraction task [TUG cognitive], and TUG while carrying a full cup of water [TUG manual]) was measured. A multivariate analysis of variance and discriminant function and logistic regression analyses were performed. Results. The TUG was found to be a sensitive (sensitivity587%) and specific (specificity587%) measure for identifying elderly individuals who are prone to falls. For both groups of older adults, simultaneous performance of an additional task increased the time taken to complete the TUG, with the greatest effect in the older adults with a history of falls. The TUG scores with or without an additional task (cognitive or manual) were equivalent with respect to identifying fallers and nonfallers. Conclusions and Discussion. The results suggest that the TUG is a sensitive and specific measure for identifying communitydwelling adults who are at risk for falls. The ability to predict falls is not enhanced by adding a secondary task when performing the TUG. [Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896 ‐903.]

3,023 citations

Journal ArticleDOI
TL;DR: New clinical assessment methods incorporating dual-task paradigms are helpful in revealing the effect of disease on the ability to allocate attention to postural tasks and appear to be sensitive measures in both predicting fall risk and in documenting recovery of stability.

2,331 citations