Clinical Research Directory

Relationship Between Fracture Type and Preoperative Nutritional Status With Postoperative Pain

The geriatric patient group is a population that should be considered differently than other age groups due to physiological characteristics that change with age. When literature data is examined, it is seen that patients over the age of 65 are evaluated differently in studies. The rapid aging of the general population causes more elderly patients to need surgery. However, malnutrition is a common comorbidity in surgical patients . In addition, chronic diseases, multiple drug addiction, low nutritional intake, decreased appetite and psychological conditions seen in geriatric patients are risk factors for the development of nutritional deficiencies . Therefore, it is important to specifically consider geriatric patients, who frequently have these risk factors, in terms of malnutrition and to evaluate the nutritional status of these patients before surgery. It is estimated that the prevalence of malnutrition in hospitalized geriatric patients varies between 30% and 60%, depending on the population studied and the assessment tools applied . Despite these high malnutrition rates, this issue has not received sufficient clinical attention. Furthermore, malnutrition is highly associated with the prognosis of elderly perioperative patients, which may lead to poor clinical outcomes, increased morbidity and mortality, complication rates, decreased quality of life, prolonged hospital stay, and increased hospital and healthcare costs. A number of different screening tools are currently available to assess nutritional status in the elderly. However, there is currently no gold standard. The Nutrition Risk Score 2002 (NRS2002) is a nutritional screening tool for adult inpatients, launched in 2002 by the European Society of Clinical Nutrition and Metabolism (ESPEN). The Mini Nutritional Assessment - Short Form (MNA-SF), recommended by the European Union, and the Geriatric Nutrition Risk Index (GNRI), which has recently been evaluated as a new screening tool, has been validated for the diagnosis of malnutrition and the prediction of clinical outcomes, and is based on objective measurements that do not require patient cooperation, and whose validity has been demonstrated in other studies for the prediction of short- and long-term outcomes. In addition, the Prognostic Nutrition Index (PNI) is an indicator used to assess the nutritional status of surgical patients, estimate the risk of surgery, and make prognostic judgments. Although it has been stated that all four nutritional screening tools mentioned above can be used as prognostic indicators in geriatric surgical patients, the relationship between these screening tools and postoperative pain, complications, and hospital stay in geriatric patients undergoing orthopedic hip surgery has not yet been evaluated. Hip fracture is a painful event that is frequently seen in older adults. Hip fractures are generally classified as femoral head fracture, femoral neck fracture, intertrochanteric fracture, and subtrochanteric fracture. Hip fracture is treated with proximal femoral nailing, partial hip replacement, and total hip replacement surgeries. Studies have reported that patients experience very high rates of moderate to severe pain following hip fracture surgery. This situation shows that the approach to pain management in hip surgery is still inadequate and that investigators need different perspectives on postoperative pain in these patients. It is known that hip fracture is associated with serious morbidity, mortality, and disability in the elderly. Inadequate pain management in these patients is associated with low motivation and has a high impact on functional recovery. Therefore, adequate pain management is important in patients with hip fractures to prevent mental and physical complications and to ensure appropriate compliance with rehabilitation. It is known that pain is affected by many factors such as biophysiological, biochemical, demographic, psychosocial, behavioral and moral variables and age. It is known that unmanaged postoperative pain will significantly affect cardiopulmonary and thromboembolic complications, morbidity and mortality, hospital discharge, quality of life and daily activities. In this context, determining the factors that predict acute pain will allow earlier intervention. Thus, short- and long-term morbidity, medication use, hospital stay and, accordingly, healthcare expenses will be reduced.This study aimed to evaluate the relationship between preoperative hip fracture type, surgery type, nutritional status and postoperative pain and prognosis (complications and hospital stay) in geriatric patients who will undergo hip surgery due to hip fracture. Secondly, it was aimed to determine which of the above-mentioned nutritional risk screening tools would be more appropriate in these patients and which nutritional risk screening tool could predict postoperative pain and prognosis in patients who will undergo hip surgery.

Use of Diaphragm Ultrasound and Evaluation of Respiratory Parameters in Determining Weaning Success in Geriatric Patients

This study aims to evaluate the effectiveness of ultrasound-based diaphragmatic measurements in predicting weaning success in patients aged 65 and older who are receiving mechanical ventilation. Additionally, it seeks to contribute to the clinical decision-making process by examining the relationship between these measurements and conventional weaning parameters.

Comparative Effects of Balance and Inspiratory Muscle Training in Older Adults

This study aims to investigate and compare the effects of Inspiratory Muscle Training (IMT), balance training, and a combination of both on respiratory muscle strength and balance in older adults. Aging is often associated with a decline in skeletal and respiratory muscle strength, which can increase the risk of falls and impact overall functionality. Participants aged 60 and over will be randomly assigned to one of three groups: Respiratory Muscle Training group (30 breaths, twice daily), Balance Training group (45-50 minute sessions, 3 days a week), Combined Training group (both IMT and balance exercises). The intervention will last for 8-weeks. Researchers will evaluate respiratory muscle strength, balance, core endurance, and functional capacity before and after the 8-week program to determine which approach is most effective in improving these parameters in the geriatric population.

Influence of Peri-operative Anesthetic and Analgesic Care on the Outcome of Patients Undergoing Hip Fracture Surgeries. A Prospective Study

The purpose of this voluntary research study is to clarify whether or not a single injection nerve block done before surgery and after surgery nerve block catheter can effectively enhance recovery in elderly hip fracture patients in terms of reduced delirium, reduced length of stay and improved surgical and anesthesia outcomes. Delirium is a serious change in mental abilities. It results in confused thinking and a lack of awareness of someone's surroundings. The disorder usually comes on fast - within hours or a few days. Prolonged hospital stay is one of the risk factors for onset of delirium.

Nutritional Status and Patient Characteristics Upon Length of Stay, Clinical Outcome, and Survival in Older Hospitalized Patients

Disease-related malnutrition (DRM) describes undernutrition or imbalances in energy, protein, or other nutrient-needs, caused by a concomitant disease. Nutritional status plays a vital role in the fate of hospitalized patients, and DRM is associated with loss of function and decreased survival. DRM is a common condition in patients with acute illnesses, approximately 30% among medical inpatients are malnourished when admitteed to the hospital, and rise higher among the older or critically ill. Physiologically malnutrition is associated with a) poorer tissue healing and restitution after severe disease, b) suppressed immune function and resistance towards infections, c) poorer metabolic defense towards critical disease, d) delayed and poorer progress of chronic diseases. In addition, inadequate nutrition is coupled to a prolonged hospital stay, resulting in more readmissions, and overall higher mortality in hospital patients. Yet, nutritional status of patients upon hospital admittance is seldom systematically assessed and the consequences of DRM in older acutely admitted patients still needs to be understood. This project will provide a detailed description of nutritional, physiolgical, and biochemical status of 1500 acutely admitted patients. In relation, the study will investigate the relation between patient characteristics and disease progression. The obtained data will also be coupled to patient registers to investigate the link between length of hospital stay, readmissions and acute contact, and mortality.

Comparison of the Effects of Motor and Cognitive Dual Task Exercises on Fall Risk, Balance, and Gait

This study aimed to compare the effects of motor and cognitive dual-task exercise programs on fall risk, balance, and gait performance in older adults residing in nursing homes.The main question it aims to answer is: An eight-week motor or cognitive dual-task exercise program did not provide additional benefits over standard single-task exercise in improving fall risk, balance, or gait performance in nursing home residents. All interventions were administered for approximately 40 minutes per session, three times per week, for eight weeks. Assessments were conducted before and after the intervention using the Five-Repetition Sit-to-Stand Test, 2-Minute Walk Test, Single-Leg Stance Test, Timed Up and Go (TUG) Test, Tinetti Balance and Gait Scale, and Functional Reach Test.

Physical Activity During Hospitalization and Hospital-Associated Disability

This study examines physical activity during and after hospitalization in acutely hospitalized older adults and its association with hospital-associated disability (HAD). Older adults have low levels of physical activity during acute hospitalization, which is associated with an increased risk of HAD. HAD is a decline in the ability to perform activities of daily living that occurs in relation to hospitalization and cannot be explained by the acute illness alone. HAD affects up to 30% of acutely hospitalized older adults and is associated with adverse outcomes, including an increased risk of discharge to a nursing home, readmission, and mortality. Furthermore, patients who develop HAD are at risk of not regaining their pre-admission functional level and experiencing persistent functional decline after discharge. Physical activity and exercise are recommended as strategies to prevent HAD. However, many acutely hospitalized older adults have limited capacity or motivation to engage in structured exercise. It therefore remains unclear how much physical activity during hospitalization is sufficient to reduce the risk of HAD and which types of physical activity patients are able and prefer to perform. The study will also examine patients' ability and preferences for different types of physical activity during hospitalization and explore their motivation, barriers, and preferences for physical activity after discharge. The results may help identify clinically relevant levels of physical activity during hospitalization and contribute to more patient-centered approaches to supporting physical activity and preventing functional decline during and after hospitalization.

Understanding Dance for Falls Prevention

Falls are common among older adults, and can lead to both physical and emotional problems. The new World Falls Guidelines suggest that falls prevention programmes should take into account a person's individual priorities and beliefs. At the Older Persons Assessment Unit (OPAU), physiotherapy focuses on helping patients improve their abilities to do everyday tasks and enhancing their quality of life. Personalised treatment is offered to make sure it's as effective and long-lasting as possible. One of the main programmes run in the department is a class designed to improve strength and balance, but even people who complete these classes often struggle to stick to exercise when the classes end. Dance classes are a fun, creative, and social way to exercise, and OPAU has worked with Breathe Arts Health Research to explore dance as a treatment for older adults at risk of falls. So far, the results show that people who chose dance for strength and balance saw the same physical benefits as those who did the more traditional strength and balance exercises, but this evidence on its own isn't enough to widely recommend dance as a way to lower falls risk. To build stronger evidence for dance as a safe and effective activity for reducing fall risks, this project will explore how participants and dance instructors feel about the programme. It will also look at the different exercises in the dance sessions to understand what works best to help improve strength and balance and reduce the risk of falling.

Geriatric Nursing Training Program for Nursing Students

This research will be conducted using a parallel randomized controlled trial design to investigate the effects of a nursing education program grounded in Travelbe's Human-to-Human Relationship theory on willingness to work with elderly individuals, empathy levels, and communication skills. The sample group will consist of third-year nursing students at a state university (intervention: 24; control: 24). The Willingness to Work with Elderly Individuals Scale, the Kiersma-Chen Empathy Scale, and the Communication Skills Scale will be used to collect data. The intervention group will receive a six-session nursing education program based on Travelbe's Human-to-Human Relationship theory. A repeated-measures ANOVA will be used to compare the mean scores across groups on the scales. In addition, independent-samples t-tests will be used for pre-test and post-test comparisons within groups, and Cohen's d and eta-squared will be used to estimate effect sizes. The data will be examined for normality. Parametric tests (One-sample t-test, ANOVA) will be applied to data that show normal distribution, and nonparametric tests (Mann-Whitney U test, Kruskal-Wallis test, Wilcoxon test, Friedman test) will be applied to data that do not show normal distribution.

Evaluation of the Relationship Between Fall Risk, Muscle Strength, and Anticholinergic Burden in Geriatric Patients Presenting to the Emergency Department

Falls are common among older adults and can lead to serious injury. This study looks at whether taking many medications (polypharmacy), the anticholinergic burden of those medications (a measure of side effects that can affect memory, balance, and muscle function), and sarcopenia (age-related loss of muscle mass and strength) are related to fall risk in older adults visiting the emergency department. Patients aged 65 and older who come to the emergency department will be invited to take part. With their consent, researchers will review the medications they are taking and calculate an anticholinergic burden score. Researchers will also measure the patients' hand grip strength and use ultrasound to measure the thickness of the quadriceps muscle in the thigh, both of which are used to assess muscle health. Information about the patients' history of falls in the past year, hospital stays, and other health conditions will also be collected. All measurements are non-invasive, are already used in routine clinical practice, and are performed only once during the emergency department visit. No experimental treatment or medication will be given as part of this study. The goal of this study is to understand how polypharmacy, anticholinergic burden, and sarcopenia relate to fall risk, both individually and together, so that older adults at higher risk of falling can be identified earlier and offered appropriate prevention strategies.

Dialysis Geriatric Care Model

The objectives of this study are to refine the dialysis care model with key stakeholder input and conduct a pilot randomized controlled trial (RCT) to obtain evidence critical to inform a definitive RCT.

The ACT-ON: A Geriatric 5-Ms-Guided Physical Therapy Intervention for Knee Osteo-Arthritis in Older Adults.

The study is a Random control trail study conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, focusing on Application of 5 framework in rehabilitation program of knee arthritis. The study will involve a in each group sample of 20 KOA patients, with a 12-month duration. The sample size was estimated using G\*Power 3.1 software, and the initial power analysis indicated that 40 participants would be required to achieve 80.0% statistical power. The study's participants will be aged between 55 and 80 years, diagnosed with Knee osteoarthritis, without cognitive impairment, knee surgery in the past 6 months, or unstable comorbidities. The study will involve in-person 16 sessions, with the first two lasting approximately one hour and the remaining session 30-45 minutes. The main outcome measures that will be used in this study are Stay Independent Brochure, Iconographical Falls Efficacy Scale (icon-FES), Timed Up and Go, 2-Minute Walk Test, 5 Time Set to Stand Test AND Arthritis Self-Efficacy Scale 8 Item (ASES-8), Patient-Specific Functional Scale (PSFS), and Patient satisfaction level with Physical Therapy service MedRisk. Data will be taken from direct questions to patients, by filling out the questionnaire via Google Form, and through some tests and SPSS will be used for data analysis, with ANOVA Test intervention scores of the outcome measures.

Development and Validation of a Scale of Propensity for Change in Chronic Disease Prevention

Modifiable risk factors are estimated to account for 70% of cardiovascular diseases, 40% of Alzheimer's-type dementias, and 50% of type 2 diabetes cases. Numerous trials have evaluated interventions aimed at modifying these risk factors, whether through the promotion of healthy lifestyle choices (diet, physical activity, etc.) or specific activities (cognitive training, etc.). However, these trials have yielded inconsistent or modest results, potentially due to a failure to adopt the recommended lifestyle changes. To better tailor prevention interventions, it is therefore essential to have scales available that measure the barriers to and facilitators of lifestyle change. The aim of this study is to develop and validate a Patient-Reported Outcome Measure (PROM) to assess the barriers to and facilitators of change following participation in a prevention program. The scale will be structured into three sub-scales (capability, opportunity, and motivation), administered one month after the prevention activity, and will distinguish between the adoption of new habits and the abandonment of existing ones.

Geriatric Trauma Care Program for Living Alone Older Adults With Injuries

To examine the long-term effects of the Geriatric Trauma Care Program (GTCP) regarding pain, functional disability, depression, loneliness, and health-related quality of life among older adults with traumatic injuries who live alone.

Robotic-Assisted System in Enhancing Balance, Postural Stability, Functional Gait and Fall Efficacy in Older Adults

Our study aims to investigate the effectiveness of a more individualized and personalized feedback-oriented approach using a Robotic Assisted System, the Hunova Movendo Robotic System. This system is tailored to specific needs of individuals and is dynamically adjustable relative to patients' balance and functional demands. It will be compared to Otago Exercise Programme which is more generalized. Given the generalized nature of the Otago Exercise Programme, we aim to compare it with the Robotic Assisted Systems in the enhancement of Balance, Postural Stability, Functional Gait and Fall Efficacy in older adults.

Comparıson of the Effıcacy of Conventıonal Exercıse and Pılates ın Pre-fraıl and Fraıl Older Adults

Brief Summary This clinical study aims to compare the effects of a conventional exercise program and a Pilates exercise program in prefrail and frail older adults. A total of 40 participants aged 60 years and older who are classified as prefrail or frail according to the FRAIL Scale will be included in the study. Participants will be randomly assigned to either the conventional exercise group or the Pilates group. Both exercise programs will be conducted twice weekly for 6 weeks. The interventions will focus on stretching exercises, balance and perturbation training, and strength exercises targeting major muscle groups. Primary outcomes will include changes in frailty status assessed before and after the intervention. Secondary outcomes will include functional mobility and balance assessed by the Timed Up and Go Test, dynamic balance assessed by the Functional Reach Test, lower extremity strength assessed by the 30-Second Sit-to-Stand Test, gait speed assessed by the 10-Meter Walk Test, depressive symptoms and psychological well-being assessed by the Yesavage Geriatric Depression Scale, independence in daily activities assessed by the Lawton Instrumental Activities of Daily Living Scale, cognitive status assessed by the Mini-Mental State Examination, and fatigue assessed by the Modified Borg Scale. Frailty status will be evaluated using the FRAIL Scale. Throughout the study, participant safety will be monitored, and any adverse events, such as injuries or discomfort occurring during exercise sessions, will be recorded and managed appropriately. This study is expected to provide valuable clinical evidence regarding the effectiveness of conventional exercise and Pilates programs in improving physical health and reducing frailty in prefrail and frail older adults, thereby contributing to the identification of best practice approaches for the management of this vulnerable population.

Impact of Medication Reconciliation at Discharge on Potentially Inappropriate Medications in the Elderly : Community-hospital Coordination

The geriatric population is exposed to poly-medication. Furthermore, old people have important pharmacodynamic and pharmacokinetic changes that expose to much drug iatrogenic. Adverse drug effects are a great cause for hospitalization that is why the knowledge of the complete list of medications taken by the patient is necessary. The poly-medication in elderly can lead to extremely serious clinical consequences and significant costs. Reference documents specific to geriatrics guide the doctor in therapeutic choices. On the one hand, the Laroche's criteria lists all PIM of the French pharmacopoeia in elderly. On the other hand, STOPP/START criteria are a tool for detect PIM listing inappropriate drugs and criteria of potentially drug omissions. This has been validated in French language. It is important that any changes proposed by the geriatrician resulting in just prescription is sustainable beyond the hospitalization to prevent the recurrence of adverse effects. Effective community-hospital coordination is essential. Medication reconciliation is defined as the formal process of checking the complete, accurate list of a patient's previous medication - including drug name, dosage, frequency, and route - and comparing it with the prescription after a transition of care (on admission, after transfer to another medical unit, and/or at discharge). Two groups of patients will be created, one for which medication reconciliation at discharge will be practiced and the other a similar process but not standardized. Four to eight weeks after the discharge, the member of the pharmacy team is calling the usual community pharmacy to get the first non-hospital prescription by fax and compare the number of PIM with the prescription before hospitalization.

Detecting Delayed Discharge in Acute Geriatric Unit Using Natural Language Processing

Delayed discharge in geriatric units is a health and economic issue. There is no algorithm to automatically measure the appropriateness of admissions or hospital days. 30% of the days of hospitalization in acute geriatric units (AGU) are not appropriate. Waiting for a transfer to a follow-up care and rehabilitation unit (SSR) is the main risk factor for inappropriate days. The purpose of this project is to develop an algorithm using natural language processing to predict the appropriateness of an admission to UGA, or a day at UGA.

Effect of Enzymatic-Containing Mouth Spray (Oral7®) on Xerostomia Symptoms, Salivary Flow Rate, and Oral Health-Related Quality of Life in Older Patients

Background: Xerostomia, or dry mouth, is a prevalent condition among older adults and has significant implications for oral and systemic health. It is associated with impaired chewing, swallowing, and speech, and increases the risk of oral infections, dental caries, and gum disease. Xerostomia may also contribute to malnutrition and aspiration pneumonia. Objective: This study aims to evaluate the effectiveness of an enzymatic-containing mouth spray (Oral7®) on xerostomia symptoms, unstimulated salivary flow rate, and oral health-related quality of life (OHRQoL) in older patients with xerostomia. Methods: A single-center, randomized, double-blind, placebo-controlled trial will be conducted at Hospital Universiti Sains Malaysia from August 2025 to July 2026. Eligible participants aged 60 and above with self-reported xerostomia will be randomly assigned to receive either Oral7® Mouth Spray or a placebo spray for four weeks. The primary outcome is the mean change in Summated Xerostomia Inventory (SXI) scores between groups from baseline to post-intervention. Secondary outcomes include changes in unstimulated salivary flow rate using the sialometry technique and OHRQoL measured by the Geriatric Oral Health Assessment Index (GOHAI) at baseline and three months post-intervention. Data will be analyzed using SPSS version 29. Conclusion: This trial will provide evidence on the efficacy of Oral7® Mouth Spray in alleviating xerostomia symptoms and improving salivary function and oral health-related quality of life in older adults, potentially guiding future clinical management of this condition.

Effect of Lateral Decubitus Position After Spinal Anesthesia on Hemodynamic Stability in High-Risk Geriatric Patients

Spinal anesthesia is a common and preferred anesthetic technique for lower extremity orthopedic surgery in elderly patients. However, it can cause a significant drop in blood pressure (hypotension), especially in high-risk older patients with multiple medical conditions. This complication can lead to serious consequences such as heart attack, stroke, or death in vulnerable patients. This study investigates whether keeping patients in a lateral (side-lying) position for 15 minutes after spinal anesthesia - instead of immediately turning them onto their back (supine position) - can reduce the risk of hypotension. When a patient lies on their side after receiving spinal anesthesia with a heavy (hyperbaric) local anesthetic, the medication tends to stay concentrated on the lower (operative) side, resulting in a more limited nerve block. This may help preserve blood pressure stability. We will enroll 70 patients aged 65 years or older with high anesthetic risk (ASA physical status III or IV) scheduled for unilateral lower extremity orthopedic surgery under spinal anesthesia. Patients will be randomly assigned to two groups: one group will be kept in the lateral decubitus position (operative side down) for 15 minutes before being turned supine, and the other group will be turned supine immediately after spinal anesthesia. Blood pressure, heart rate, and oxygen saturation will be monitored continuously. The primary outcome is the incidence of hypotension during the first 15 minutes after spinal anesthesia.

Validity and Reliability of the Turkish Form of the Enjoyment of Physical Activity Scale-8 in Geriatrics With Minimal Cognitive Impairment

The main objective of this study is to examine the validity and reliability of the Turkish form of the Enjoyment of Physical Activity Scale-8 (PACES-8) in individuals aged 65 and over with Minimal Cognitive Impairment (MCI).

This Study Investigates β-hydroxy-β-methylbutyrate (HMB) and 2-hydroxybenzylamine (2-HOBA), When Administered Either Individually or in Combination Contributes to an Increased Quality of Health, Specifically Improving Muscular Strength and Cognitive Functioning in Adults Over the Age of 65.

In this study, participants will be assigned to receive HMB, 2-HOBA, a combination of both, or a comparison supplement for a set period of time. During the study, participants will attend scheduled visits where researchers will assess muscle strength, physical function, and overall health. Blood samples may be collected to measure markers related to metabolism, inflammation, and oxidative stress. Study staff will also monitor safety and any side effects throughout the study.

Validity and Reliability of the Exercise-Related Health Beliefs Attitude Scale in Geriatric Individuals

The main purpose of this research is to test the validity and reliability of the "Exercise Health Beliefs Attitude Scale" (EYSİTÖ), developed by Caz, Paktaş and Yazıcı (2023) for adult individuals, in geriatric individuals aged 65 and over.

Comparison of Hand Grip Strength in Different Shoulder Positions in Geriatric Individuals: Position-Dependent Strength Analysis

The aim of this study is to examine the relationship between hand grip strength, measured in different shoulder positions, and upper extremity muscle strength, and to reveal the clinical significance of position-dependent strength variation.