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- Conradsson, Mia, et al.
(författare)
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The Berg Balance Scale : Intra-rater reliability in older people dependent in ADL and living in residential care facilities
- 2006
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this study was to investigate the absolute and the relative intra-rater reliability of the Berg Balance Scale (BBS) among older people who are dependent in activities of daily living (ADL) and living in residential care facilities.Methods: The participants were 45 older people, 36 females and 9 men, who were dependent in ADL and living in three residential care facilities. Their mean age ± SD was 82.3 ± 6.6 (range 68-96) and mean ± SD of Mini Mental State Examination score was 17.5 ± 6.3 (range 4-30). The BBS was assessed twice by the same assessor, at approximately the same time of day, and with 1-3 days in between. The absolute reliability for the difference in score between the two test occasions was calculated with the Bland and Altman analysis of variance with 95 % confidence level. The relative reliability was calculated with Intraclass Correlation Coefficient (ICC).Results: For the first test of the BBS, mean ± SD was 30.1 ± 15.9 (range 3-53) points and for the retest 30.6 ± 15.6 (range 4-54). The absolute difference between the two test occasions was in mean ± SD 2.8 ± 2.7 (range 0-11) points. The absolute intra-rater reliability was calculated to 7.7 points and the ICC value was 0.97. Conclusions: Despite a high ICC value, the result of the absolute reliability show that a change of 8 BBS points is required to reveal a genuine change of function among older people who are dependent in ADL and living in residential care facilities. This knowledge is important in the clinical setting when evaluating an individual's change in balance function over time.
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- Littbrand, Håkan, 1966-, et al.
(författare)
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A high-intensity functional weight-bearing exercise program for older people dependent in activities of daily living and living in residential care facilities : evaluation of the applicability with focus on cognitive function
- 2006
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 86:4, s. 489-498
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Knowledge concerning the applicability and the effect of high-intensity exercise programs is very limited for older people with severe cognitive and physical impairments. The primary aim of this study was to evaluate the applicability of a high-intensity functional weight-bearing exercise program among older people who are dependent in activities of daily living and living in residential care facilities. A second aim was to analyze whether cognitive function was associated with the applicability of the program. SUBJECTS: The subjects were 91 older people (mean age=85.3 years, SD=6.1, range=68-100) who were dependent in personal activities of daily living and randomly assigned to participate in an exercise intervention. Their mean score for the Mini-Mental State Examination (MMSE) was 17.5 (SD=5.0, range=10-29). METHODS: A high-intensity functional weight-bearing exercise program was performed in groups of 3 to 7 participants who were supervised by physical therapists. There were 29 exercise sessions over 13 weeks. Attendance, intensity of lower-limb strength and balance exercises, and occurrence and seriousness of adverse events were the outcome variables in evaluating the applicability of the program. RESULTS: The median attendance rate was 76%. Lower-limb strength exercises with high intensity were performed in a median of 53% of the attended exercise sessions, and balance exercises with high intensity were performed in a median of 73% of the attended exercise sessions. The median rate of sessions with adverse events was 5%. All except 2 adverse events were assessed as minor and temporary, and none led to manifest injury or disease. No significant differences were observed in applicability when comparing participants with dementia and participants without dementia. In addition, there was no significant correlation between applicability and the MMSE score. DISCUSSION AND CONCLUSION: The results suggest that a high-intensity functional weight-bearing exercise program is applicable for use, regardless of cognitive function, among older people who are dependent in activities of daily living, living in residential care facilities, and have an MMSE score of 10 or higher.
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- Littbrand, Håkan, 1966-, et al.
(författare)
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The effect of a high-intensity functional exercise program on activities of daily living : a randomized controlled trial in residential care facilities
- 2009
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Ingår i: Journal of The American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 57:10, s. 1741-1749
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate whether a high-intensity functional weight-bearing exercise program reduces dependency in activities of daily living (ADLs) in older people living in residential care facilities, focusing on people with dementia. DESIGN: Randomized, controlled trial. SETTING: Nine residential care facilities. PARTICIPANTS: One hundred ninety-one older people dependent in ADLs and with a Mini-Mental State Examination score of 10 or greater. One hundred (52.4%) of the participants had dementia. INTERVENTION: A high-intensity functional weight-bearing exercise program or a control activity consisting of 29 sessions over 3 months. MEASUREMENTS: The Barthel ADL Index; follow-up at 3 months (directly after the intervention) and 6 months with intention-to-treat analyses. RESULTS: There were no statistically significant differences between the groups regarding overall ADL performance. Analyses for each item revealed that a smaller proportion of participants in the exercise group had deteriorated in indoor mobility at 3 months (exercise 3.5% vs control 16.0%, P=.01) and 6 months (7.7% vs 19.8%, P=.03). For people with dementia, there was a significant difference in overall ADL performance in favor of the exercise group at 3 months (mean difference 1.1, P=.03) but not at 6 months. CONCLUSION: A high-intensity functional weight-bearing exercise program seems to reduce ADL decline related to indoor mobility for older people living in residential care facilities. The program does not appear to have an overall effect on ADLs. In people with dementia, the exercise program may prevent decline in overall ADL performance, but continuous training may be needed to maintain that effect.
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- Littbrand, Håkan, et al.
(författare)
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The effect on ADL of a high-intensity functional exercise program among older people dependent in ADL : a randomized controlled trial
- 2007
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Ingår i: 15th International Congress of the World Confederation for Physical Therapy. - : WCPT.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- PURPOSE: To investigate if a high-intensity functional weight-bearing exercise program reduces the dependency in personal care and mobility among older people dependent in activities of daily living (ADL), with focus on people with dementia. RELEVANCE: The number of older people with disability increases. Physical functional capacity can be improved by high-intensity exercise program, but there is no strong evidence that physical exercise is an effective method to reduce disability. PARTICIPANTS: 191 older people dependent in ADL, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ≥ 10 participated in this study (the FOPANU Study). Their mean score ± SD of the Barthel ADL was 13.1±4.2 and 52% of the participants had a diagnosed dementia disease. METHODS: The participants were randomized to a high-intensity functional weight-bearing exercise program (the HIFE Program) or a control activity, including 29 sessions over 3 months. The Barthel ADL Index, which includes ten items that are summarized to a total score of 20, was used to assess independency in personal care and mobility. The assessments were performed, by persons blinded to the participants’ group allocation, before the intervention, at 3 months (directly after the intervention period), and at 6 months. ANALYSIS: Between-group effects on the total score and each item were analyzed by ANCOVA and by logistic regression, respectively, using the intention-to-treat principle. RESULTS: When analyzing all participants, there was no statistical significant difference between the groups at 3 or 6 months in total score of the Barthel ADL Index. Analyses for each item revealed that a lower proportion of participants in the exercise group had deteriorated regarding mobility indoors (item 7) at 3 and 6 months (4% and 8%) compared to the control group (16% and 20%), P = 0.01 and 0.03, respectively. Among people with dementia, there was a significant difference in total score in favor of the exercise group at 3 months (mean difference 1.1, P = 0.03), but not at 6 months. CONCLUSIONS: A high-intensity functional weight-bearing exercise program does not appear to have an overall effect on ADL according to the Barthel ADL Index among older people who are dependent in ADL and living in residential care facilities, but the exercise program seems to have both short- and long-term effect in maintaining mobility indoors. In the subgroup of people with dementia, the exercise program seems to have a short-term overall effect on ADL. IMPLICATIONS: A high-intensity functional weight-bearing exercise program seems to be a promising method to reduce disability regarding mobility indoors for older people living in residential care facilities. For people with dementia, the exercise program may have an overall effect in personal care and mobility but continuously training may be needed to maintain the effect.
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- Rosendahl, Erik, et al.
(författare)
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A high-intensity functional exercise program is applicable for older people with cognitive impairment
- 2007
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Ingår i: Research and practice in Alzheimer's disease. - Paris : Serdi publisher. - 2914377991 ; , s. 212-215
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Maintaining or improving physical functions among older people with cognitive impairment in effective ways is of great importance, since cognitive decline is associated with a decline in physical performance. Training at high intensity has a greater effect than at a lower intensity, but there are few studies evaluating high-intensity training among older people with severe cognitive impairment. However, results from a recent study (the FOPANU Study) among older people dependent in activities of daily living and living in residential care facilities showed that a high-intensity functional weigh-bearing program had positive long-term effects on balance, gait ability and lower-limb strength. The mean score for the Mini-Mental State Examination was 18 (range 10-29) and 52% of the participants had a dementia disease. Regarding the applicability of the exercise program, no statistically significant differences in attendance, intensity or adverse events were observed when participants with dementia were compared with participants without dementia. A main clinical implication of the FOPANU Study is that people with severe cognitive impairment can be offered high-intensity functional exercise programs.
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