| 1. |
- Otten, Julia, 1973-, et al.
(författare)
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Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control : a randomized controlled trial in individuals with type 2 diabetes
- 2017
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Ingår i: Diabetes/Metabolism Research Reviews. - : Wiley. - 1520-7552 .- 1520-7560. ; 33:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMeans to reduce future risk for cardiovascular disease in subjects with type 2 diabetes are urgently needed.MethodsThirty-two patients with type 2 diabetes (age 59 ± 8 years) followed a Paleolithic diet for 12 weeks. Participants were randomized to either standard care exercise recommendations (PD) or 1-h supervised exercise sessions (aerobic exercise and resistance training) three times per week (PD-EX).ResultsFor the within group analyses, fat mass decreased by 5.7 kg (IQR: −6.6, −4.1; p < 0.001) in the PD group and by 6.7 kg (−8.2, −5.3; p < 0.001) in the PD-EX group. Insulin sensitivity (HOMA-IR) improved by 45% in the PD (p < 0.001) and PD-EX (p < 0.001) groups. HbA1c decreased by 0.9% (−1.2, −0.6; p < 0.001) in the PD group and 1.1% (−1.7, −0.7; p < 0.01) in the PD-EX group. Leptin decreased by 62% (p < 0.001) in the PD group and 42% (p < 0.001) in the PD-EX group. Maximum oxygen uptake increased by 0.2 L/min (0.0, 0.3) in the PD-EX group, and remained unchanged in the PD group (p < 0.01 for the difference between intervention groups). Male participants decreased lean mass by 2.6 kg (−3.6, −1.3) in the PD group and by 1.2 kg (−1.3, 1.0) in the PD-EX group (p < 0.05 for the difference between intervention groups).ConclusionsA Paleolithic diet improves fat mass and metabolic balance including insulin sensitivity, glycemic control, and leptin in subjects with type 2 diabetes. Supervised exercise training may not enhance the effects on these outcomes, but preserves lean mass in men and increases cardiovascular fitness.
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| 2. |
- Arnadottir, Solveig A, 1968-, et al.
(författare)
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Application of rasch analysis to examine psychometric aspects of the activities-specific balance confidence scale when used in a new cultural context
- 2010
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 91:1, s. 156-163
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Tidskriftsartikel (refereegranskat)abstract
- Arnadottir SA, Lundin-Olsson L, Gunnarsdottir ED, Fisher AG. Application of Rasch analysis to examine psychometric aspects of the Activities-Specific Balance Confidence Scale when used in a new cultural context. OBJECTIVE: To investigate by using Rasch analysis the psychometric properties of the Activities-Specific Balance Confidence (ABC) Scale when applied in a new Icelandic context. DESIGN: Cross-sectional, population-based, random selection from the Icelandic National Registry. SETTING: Community-based. PARTICIPANTS: Icelanders (N=183), 65 to 88 years old, and 48% women. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: ABC, an instrument used to evaluate how confident older people are in maintaining balance and remaining steady when moving through the environment. An Icelandic translation of the ABC (ABC-ICE) scale was evaluated by implementing Rasch rating scale analysis to transform ordinal ABC-ICE scores into interval measures and evaluating aspects of validity and reliability of the scale. RESULTS: Participants were not able to differentiate reliably between the 11 rating scale categories of the ABC-ICE. Additionally, 3 items failed to show acceptable goodness of fit to the ABC-ICE rating scale model. By collapsing categories and creating a new 5-category scale, only 1 item misfit. Removing that item resulted in a modified version of ABC-ICE with 5 categories and 15 items. Both item goodness-of-fit statistics and principal components analysis supported unidimensionality of the modified ABC-ICE. The ABC-ICE measures reliably separated the sample into at least 4 statistically distinct strata of balance confidence. Finally, the hierarchical order of item difficulties was consistent with theoretic expectations, and the items were reasonably well targeted to the balance confidence of the persons tested. CONCLUSIONS: Rasch analysis indicated a need to modify the ABC-ICE to improve its psychometric properties. Further studies are needed to determine if similar analyses of other versions of the ABC, including the original one, will yield similar results.
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| 3. |
- Arnadottir, Solveig A, 1968-, et al.
(författare)
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Are rural older Icelanders less physically active than those living in urban areas? : a population-based study
- 2009
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:4, s. 409-417
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Older people in rural areas have been labelled as physically inactive on the basis of leisure-time physical activity research. However, more research is needed to understand the total physical activity pattern in older adults, considering all domains of physical activity, including leisure, work, and domestic life. AIMS: We hypothesised that: (a) total physical activity would be the same for older people in urban and rural areas; and (b) urban and rural residency, along with gender and age, would be associated with differences in domain-specific physical activities. METHODS: Cross-sectional data were collected in Icelandic rural and urban communities from June through to September 2004. Participants were randomly selected, community-dwelling, 65-88 years old, and comprised 68 rural (40% females) and 118 urban (53% females) adults. The Physical Activity Scale for the Elderly (PASE) was used to obtain a total physical activity score and subscores in leisure, during domestic life, and at work. RESULTS: The total PASE score was not associated with rural vs. urban residency, but males were, in total, more physically active than females, and the 65-74-year-olds were more active than the 75-88-year-olds. In the leisure domain, rural people had lower physical activity scores than urban people. Rural males were, however, most likely of all to be physically active in the work domain. In both urban and rural areas, the majority of the physical activity behaviour occurred in relation to housework, with the rural females receiving the highest scores. CONCLUSIONS: Older Icelanders in rural areas should not be labelled as less physically active than those who live in urban areas. Urban vs. rural living may, however, influence the physical activity patterns among older people, even within a fairly socioeconomically and culturally homogeneous country such as Iceland. This reinforces the need to pay closer attention to the living environment when studying and developing strategies to promote physical activity.
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| 4. |
- Arnadottir, Solveig A, et al.
(författare)
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Determinants of self-rated health in old age : a population-based, cross-sectional study using the international classification of functioning
- 2011
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 11, s. 670-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Self-rated health (SRH) is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF) to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas.Methods: The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF.Results: Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, p < 0.001), upper extremity capacity (adjOR = 1.13, p = 0.040), household physical activity (adjOR = 1.01, p = 0.016), and older age (adjOR = 1.09, p = 0.006); but decreased with more depressive symptoms (adjOR = 0.79, p < 0.001).Conclusions: The results highlight a collection of ICF body functions, activities and personal factors associated with higher SRH among community-dwelling older people. Some of these, such as physical capacity, depressive symptoms, and habitual physical activity are of particular interest due to their potential for change through public health interventions. The use of ICF conceptual framework and widely accepted standardized assessments should make these results comparable and relevant in an international context.
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| 5. |
- Arnadottir, Solveig A, 1968-, et al.
(författare)
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Participation frequency and perceived participation restrictions at older age : applying the International Classification of Functioning, Disability and Health (ICF) framework
- 2011
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Ingår i: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 33:23-24, s. 2208-2216
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To identify variables from different components of International Classification of Functioning, Disability and Health (ICF) associated with older people's participation frequency and perceived participation restrictions. Method: Participants (N = 186) were community-living, 65-88 years old and 52% men. The dependent variables, participation frequency (linear regression) and perceived participation restrictions (logistic regression), were measured using The Late-Life Function and Disability Instrument. Independent variables were selected from various ICF components. Results: Higher participation frequency was associated with living in urban rather than rural community (beta = 2.8, p < 0.001), physically active lifestyle (beta = 4.6, p < 0.001) and higher cognitive function (beta = 0.3, p = 0.009). Lower participation frequency was associated with being older (beta = -0.2, p = 0.002) and depressive symptoms (beta = -0.2, p = 0.029). Older adults living in urban areas, having more advanced lower extremities capacity, or that were employed had higher odds of less perceived participation restrictions (adjusted odds ratio [OR] = 5.5, p = 0.001; OR = 1.09, p < 0.001; OR = 3.7, p = 0.011; respectively). In contrast, the odds of less perceived participation restriction decreased as depressive symptoms increased (OR = 0.8, p = 0.011). Conclusions: Our results highlight the importance of capturing and understanding both frequency and restriction aspects of older persons' participation. ICF may be a helpful reference to map factors associated with participation and to study further potentially modifiable influencing factors such as depressive symptoms and advanced lower extremity capacity.
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| 6. |
- Bajraktari, Saranda, et al.
(författare)
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Reaching older people with a digital fall prevention intervention in a Swedish municipality context : an observational study
- 2022
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Ingår i: Frontiers in Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is robust evidence that falls in old age can be prevented by exercise programs that include balance training, functional exercises, and strength training. For the interventions to have a population health impact, outreach to the population of focus with suitable interventions is needed. While digital interventions are promising there is limited knowledge on the characteristics of who is reached. The aim of this study was to describe the recruitment process, estimate reach rate at the population level and to describe participants characteristics and representativeness in a digital fall prevention intervention study.Methods: In a municipality-based observational study, reach of a digital fall prevention intervention was evaluated. The intervention included a digital exercise programme (Safe Step) and optional supportive strategies, complemented with a range of recruitment strategies to optimize reach. Recruitment during a period of 6 months was open to people 70 years or older who had experienced a fall or a decline in balance the past year. Reach was based on data from the baseline questionnaire including health and demographic characteristics of participants. Representativeness was estimated by comparing participants to a sample of older people from the Swedish National Public Health Survey.Results: The recruitment rate was 4.7% (n = 173) in relation to the estimated population of focus (n = 3,706). Most participants signed up within the first month of the intervention (n = 131). The intervention attracted primarily women, older people with high education, individuals who used the internet or digital applications almost every day and those perceiving their balance as fair or poor. Safe step participants lived more commonly alone and had higher education and better walking ability in comparison to the Swedish National Public Health Survey.Conclusions: With a range of recruitment strategies most participants were recruited to a digital fall intervention during the first month. The intervention attracted primarily highly educated women who frequently used the internet or smart technologies. In addition to digital fall prevention interventions, a higher diversity of intervention types (digital and non-digital) is more likely to reach a larger group of older people with different needs.
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| 7. |
- Bråndal, Anna, 1966-, et al.
(författare)
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Reliability and validity of the Swedish Fatigue Assessment Scale when self-administrered by persons with mild to moderate stroke
- 2016
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 23:2, s. 90-97
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine internal consistency, test-retest reliability, floor/ceiling effects and construct validity of the Fatigue Assessment Scale (FAS), when self-administrated by persons with mild to moderate stroke.Method: The FAS was translated into Swedish and tested for psychometric properties when self-administrated by persons with mild to moderate stroke. Participants, consequently selected from the stroke unit admission register received a letter with three questionnaires: the FAS, Short Form Health Survey (SF-36) subscale for vitality and Geriatric Depression Scale, GDS-15. Within two weeks, a second letter with FAS was sent for re-test.Result: Seventy-tree persons with mild to moderate stroke participated in the study. Internal consistency was good (Cronbach’s alpha 0.82). The test and retest reliability of individual items showed that five items out of 10 items were good (weighted kappa > 0.60), four were moderate (0.40-0.60), and one was fair (0.22). The relative reliability between total scores was good (ICC 3.1 = 0.73) and the absolute reliability was nine points, meaning that a change of at least nine points in total score implies a real change of fatigue level. Correlation analysis showed that the Swedish FAS correlated with the SF-36 subscale for vitality (rs = - 0.73) and GDS-15 (rs = 0.62), suggesting convergent construct validity. There were no floor or ceiling effects.Conclusion: The Swedish translation of the FAS used as a self-administrated questionnaire is reliable and valid for measuring fatigue in persons with mild to moderate stroke.
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| 8. |
- Carlsson, Maine, 1955-, et al.
(författare)
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Effects of high-intensity exercise and protein supplement on muscle mass in ADL dependent older people with and without malnutrition : a randomized controlled trial
- 2011
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Ingår i: The Journal of Nutrition, Health & Aging. - : Springer Science and Business Media LLC. - 1279-7707 .- 1760-4788. ; 15:7, s. 554-560
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Tidskriftsartikel (refereegranskat)abstract
- Background Loss of muscle mass is common among old people living in institutions but trials that evaluate interventions aimed at increasing the muscle mass are lacking. Objective, participants and intervention This randomized controlled trial was performed to evaluate the effect of a high-intensity functional exercise program and a timed protein-enriched drink on muscle mass in 177 people aged 65 to 99 with severe physical or cognitive impairments, and living in residential care facilities. Design Three-month high-intensity exercise was compared with a control activity and a protein-enriched drink was compared with a placebo drink. A bioelectrical impedance spectrometer (BIS) was used in the evaluation. The amount of muscle mass and body weight (BW) were followed-up at three and six months and analyzed in a 2 × 2 factorial ANCOVA, using the intention to treat principle, and controlling for baseline values. Results At 3-month follow-up there were no differences in muscle mass and BW between the exercise and the control group or between the protein and the placebo group. No interaction effects were seen between the exercise and nutritional intervention. Long-term negative effects on muscle mass and BW was seen in the exercise group at the 6-month follow-up. Conclusion A three month high-intensity functional exercise program did not increase the amount of muscle mass and an intake of a protein-enriched drink immediately after the exercise did not induce any additional effect on muscle mass. There were negative long-term effects on muscle mass and BW, indicating that it is probably necessary to compensate for an increased energy demand when offering a high-intensity exercise program.
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| 9. |
- Dahlgren, Gunilla, et al.
(författare)
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Reliabilitetstestning av den svenska versionen av Shoulder Rating Questionnaire, SRQ-S
- 2002
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Ingår i: Nordisk fysioterapi. - 1402-3024. ; 6, s. 134-143
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluatethe test-retest reliability of theSwedish version of the ShoulderRating Questionnaire - SRQ-S.This self-rating scale comprises21 questions, divided into sevenweighted domains concerninghealth, pain, daily activities, recreationaland athletic activities, work,satisfaction and areas for improvement.The Shoulder Rating Questionnairewas fi rst translated intoSwedish and slightly adapted. Itwas then sent twice to 38 patientswith clinically stable shoulder disordersat an Orthopaedic Clinicin Sweden. The majority of theanswers were identical or almostidentical on both occasions. Theagreement of the total score wasexcellent (both rs and ICC=0.97).All domains, except ‘recreationaland athletic activities’, also showedan excellent agreement (rs 0.90-0.97, ICC 0.88-0.97). Individualquestions resulted in a very highweighted Kappa value for sevenof the questions (0.81-1.0), elevenquestions with a substantial value(0.61-0.80) and three moderatevalues (0.41-0.60). We concludethat the questions posed wereeasily understood and answeredand that the SRQ–S is test-retestreliable. These qualities wouldmake it a useful instrument for theassessment of the outcome of treatmentof shoulder disorders.
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| 10. |
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