| 81. |
- Nordin, Ellinor, et al.
(författare)
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Timed Up&Go Test : Reliability in Older People dependent in Activities of Daily Living - Focus on Cognitive State
- 2006
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background and Purpose: It is unknown how cognitive impairment affects the reliability of Timed Up&Go Test (TUG). The aim of the present study was to investigate the expected variability of Timed Up&Go in older persons, dependent in activities of daily living (ADL), and with different levels of cognitive state. The hypothesis was that cognitive impairment would increase the variability of TUG scores.Subjects: Seventy-eight persons with multiple impairments, dependent in ADL and living in residential-care facilities were included in this study. The subjects were 84.8±5.7 (mean±SD) years old, and their Mini-mental State Examination score was 18.7±5.6. Methods: TUG assessments were performed on three different days. Intra- and inter rater analyses were carried out. Results: Cognitive impairment was not related to the size of the variability of TUG scores. There was a significant relationship between the variability and the time taken to perform TUG (p<0.001). The intraclass correlation were greater than .90, and were similar within and between raters. In repeated measurements at the individual level, an observed value of 10 seconds was expected to vary from 7 to 15 seconds, and an observed value of 40 seconds was expected to vary from 26 to 61 seconds for 95% of the observations. Discussion and Conclusions: The measurement error of a TUG assessment is substantial for a frail, older person dependent in ADL, regardless of the level of cognitive function, when verbal cuing is permitted during testing. The variability increases with the time to perform TUG. Despite high intraclass correlation coefficients, the ranges of expected variability can be wide and are similar within and between raters. Physical therapists should be aware of this variability before they interpret the TUG score for a particular patient.
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| 82. |
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| 83. |
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| 84. |
- Nyberg, Lars, et al.
(författare)
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Fall-olyckor kan förebyggas
- 1999
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Ingår i: Sjukgymnasten. - 0037-6019. ; :2, s. 18-24
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 85. |
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| 86. |
- Nyberg, Lars, et al.
(författare)
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The development of a virtual reality system to study tendency of falling among older people
- 2005
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Ingår i: International Journal on Disability and Human Development. - 1565-012X. ; 4:3, s. 239-243
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Tidskriftsartikel (refereegranskat)abstract
- Injuries related to falls are a major threat to the health of older persons. A fall may result not only in an injury but also in a decreased sense of autonomy in the daily life. To be able to prevent such falls, a need to further understand the complex mechanisms involved in balance and walking is needed. Here we present an immersive virtual reality system, in which a person can move around while being subjected to various events, which may influence balance and walking
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| 87. |
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| 88. |
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| 89. |
- Pettersson, Beatrice, et al.
(författare)
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Effectiveness of a self-managed digital exercise programme to prevent falls in older community-dwelling adults : study protocol for the Safe Step randomised controlled trial
- 2020
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Exercise interventions have a strong evidence base for falls prevention. However, exercise can be challenging to implement and often has limited reach and poor adherence. Digital technology provides opportunities for both increased access to the intervention and support over time. Further knowledge needs to be gained regarding the effectiveness of completely self-managed digital exercise interventions. The main objective of this study is to compare the effectiveness of a self-managed digital exercise programme, Safe Step, in combination with monthly educational videos with educational videos alone, on falls over 1 year in older community-dwelling adults.Methods and analysis: A two-arm parallel randomised controlled trial will be conducted with at least 1400 community-living older adults (70+ years) who experience impaired balance. Participants will be recruited throughout Sweden with enrolment through the project website. They will be randomly allocated to either the Safe Step exercise programme with additional monthly educational videos about healthy ageing and fall prevention, or the monthly education videos alone. Participants receiving the exercise intervention will be asked to exercise at home for at least 30 min, 3 times/week with support of the Safe Step application. The primary outcome will be rate of falls (fall per person year). Participants will keep a fall calendar and report falls at the end of each month through a digital questionnaire. Further assessments of secondary outcomes will be made through self-reported questionnaires and a self-test of 30 s chair stand test at baseline and 3, 6, 9 and 12 months after study start. Data will be analysed according to the intention-to-treat principle.Ethics and dissemination: Ethical approval was obtained by The Regional Ethical Review Board in Umeå (Dnr 2018/433-31). Findings will be disseminated through the project web-site, peer-reviewed journals, national and international conferences and through senior citizen organisations’ newsletters.Trial registration number: NCT03963570.
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| 90. |
- Pettersson, Beatrice, 1987-
(författare)
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Fall prevention exercise for older adults : self-management with support of digital technology
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Falls are a major public health issue, which can cause physical and psychological suffering for the individual as well as large costs for the society. To increase access and adherence to evidence-based fall prevention exercise, utilisation of older adults’ own capabilities and digital health offers promising solutions. The aim of this thesis was to explore a digital programme as support for self-management of fall preventive exercises in community-dwelling older adults with a focus on participant experiences, behaviour change, and intervention reach.Methods: This thesis comprises four papers, of which Papers I and II report from a feasibility study comparing two self-managed fall prevention exercise programmes, a paper booklet and the digital Safe Step programme. Papers III and IV describes a randomised controlled trial, which evaluates the effectiveness of the Safe Step programme in combination with educational videos, to reduce falls in comparison with educational videos alone. In Paper I, individual interviews were analysed with inductive qualitative content analysis to explore older adults’ experiences of self-managing their fall prevention exercise. In Paper II, a deductive and inductive approach was utilised for the analysis of comments in questionnaires, individual, and focus group interviews to explore experiences of self-determination when using the Safe Step programme. The classification system of motivational and behaviour change strategies based on Self-determination theory was utilised as a categorisation matrix. An additional analysis of behavioural regulation for exercise according to the Self-determination theory was performed in this thesis. Paper III is a protocol for a randomised controlled trial, and Paper IV describes the recruitment strategies, and reach of this trial through comparison with another representative sample of adults 70 years or older by descriptive statistics.Results: Results from Papers I and II show that the older adults appreciated the autonomy of a self-managed exercise programme. They expressed a capability to independently select exercises and manage their progression with support from the programme. However, some wanted the support of others in their training. The behaviour change support in the Safe Step programme was voiced as motivating and supportive, and the diversity of behaviour change strategies was emphasized as important to suit many older adults’ preferences. In Paper II, the behaviour change support were found supportive for the basic human psychological needs according to the Self-determination theory, although, support for autonomy and competence were more clearly stated than for relatedness. An additional category was formed and proposed as an amendment to the classification system used as an analytical matrix. In the thesis, expressions of intrinsic and extrinsic motivations for doing the exercise from participants in Paper I were triangulated with results from the Behavioural Regulations in Exercise Questionnaire-2. The results confirmed the trend found in the qualitative analysis of more intrinsically motivated expressions in the group using the Safe Step programme. A study protocol was written that described the design of the Safe Step randomised controlled trial, including the aims, methodology and overall organisation of the research (Paper III). In Paper IV, the most successful recruitment strategy to the randomised controlled trial was identified as advertisement in social media. The recruited participants were predominantly women, highly educated, and frequently used applications or internet on mobile devices.Conclusion: Finding of this thesis support implementation of fall prevention strategies through increased utilisation of older adults' self-management capabilities. Older adults’ experiences of exercising with a self-managed digital exercise program can be understood as managing pieces of a personal puzzle and was shaped more by the sum of the features and behaviour change support in the programme than by parts of the programme. The Safe step programme seems to provide support for more self-determined exercise motivation, than a paper booklet, which can support maintenance of the new exercise routines. The older adults’ experiences, as well as the characteristics of the participants reached, highlight the necessity for a variety of fall prevention strategies that reflect the diversified needs and preferences of older adults.
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