In 1978, Robert N. Butler, MD, Director of the National Institute on Aging, stated "If exercise could be packaged in a pill, it would be the single most widely prescribed and beneficial medicine in the nation."1 Physical activity and exercise not only promote health and wellness but also prevent certain disability and diseases that plague our patients. We all value our health and want to live long, healthy, and disease-free lives. Despite knowing the benefits of physical activity and exercise, many people disregard the benefits and succumb to a lifestyle of inactivity. In this Thieves' Market issue of Topics in Geriatric Rehabilitation (TGR), we present a variety of research and information on physical activity as it relates to patients' pulmonary, orthopedic, and neurological issues. We also present research on patient examination including various functional testing procedures as well as research on treatment for various conditions. This issue proudly provides research from the United States, Malaysia, Turkey, Spain, Thailand, Brazil, and South Korea. No matter what nationality we are, we all have one thing in common. We have each been gifted with an amazing human body to nourish and provide care. Let us apply research-based evidence to our personal lives as well as our professional lives, as we teach our patients how to be more active and hopefully increase health and longevity.

Several articles in this issue highlight the importance of physical activity for various medical conditions as well as for older adults in general. Patients with chronic obstructive pulmonary disease benefit from physical activity counseling using such techniques pedometers/activity monitors, goal setting, and recording physical activity in a written or electronic diary. One study concluded that grip strength and gait speed were significantly lower among obese versus nonobese women. Although most research regarding physical activity, or lack thereof, is related to prevention of disability and disease, one study from Spain highlighted perceived barriers to retention in competitive sports among older adult athletes. Although older adults have not been expected or encouraged to participate in competitive sports, it seems that we should collectively agree to minimize barriers for senior adult athletes by implementing programs designed to retain them in sports as long as possible.

Although most of our treatment plans include some type of physical activity, we must consider the evaluation and examination tools that we use to be able to develop an effective plan of care. Proven, evidence-based functional examination tools are the gold standard for our profession and therefore are important to research, as they can be applied to different patient conditions. For example, the 2-minute step test can be a valuable tool to evaluate the balance status of a patient with Parkinson's disease in Hoehn & Yahr stages I to IV. One study from Brazil concluded that testing quadriceps muscle function is positively correlated with Mini-BESTest and Timed Up and Go tests in patients with Parkinson's disease. The Iconographical Falls Efficacy Scale (Icon-FES), which uses visual expressions/content and can be administered quickly, can be effectively utilized to evaluate the fear of falling. A study from Thailand analyzed the prevalence of poststroke anxiety using the Hospital Anxiety and Depression Score-anxiety subscale (HADS-A), modified Barthel Index, and WHOQoL-BREF. The results of this study revealed that poststroke anxiety was high with the anxiety being related to depression and complications from stroke.

Finally, in this issue, we highlight the efficacy of a few researched intervention techniques. A study from Turkey concluded that a roller massager may be an effective tool to increase ankle joint range of motion in healthy older individuals. A study from Spain analyzed if a personalized cognitive stimulation program based on preexisting cognitive levels would be more effective than a standard cognitive stimulation program.

We hope you enjoy the treasures found in this Thieves' Market issue of TGR. If we have a patient come to see us with "knee pain," let us consider how we can do more. Let us not only work on addressing the patient's knee pain but also addressing any safety concerns as well as physical activity. Rehabilitation professionals can help with the development and implementation of programs that promote active living. We are in a primary position to advise our patients against the deleterious effects of physical inactivity. Let us confidently and assertively address this public health issue affecting communities worldwide.

-Wendy Powers James, PT

Managing Editor

Topics in Geriatric Rehabilitation

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