| 11. |
- Eriksson, Staffan, et al.
(författare)
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Risk factors for falls in people with and without a diagnosis of dementia living in residential care facilities : a prospective study
- 2008
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 46:3, s. 293-306
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Tidskriftsartikel (refereegranskat)abstract
- People with dementia are at increased risk of falling. The purpose of this study was to identify predisposing risk factors for falls in older people with and without a diagnose of dementia living in residential care facilities, and to compare the results. Eighty-three residents without dementia (mean age ± S.D.; 83.5 ± 7.1 years) and 103 with dementia (83.6 ± 6.3 years) in Umeå, Sweden, participated. The baseline assessment included probable risk factors like walking ability, diagnoses and treatment with drugs. The follow-up period was 6 months. In people with dementia, the fall rate was higher (crude incidence rate ratio 2.55, 95% CI 1.60–4.08) and a larger proportion experienced falls (62% versus 41%). In the group without dementia 54.8% of the variation in falls was explained by a model including orthostatism, “women walking with aid”, and treatment with Angiotensin Converting Enzyme (ACE) inhibitors. In the group with dementia 25.5% of the variation in falls was explained by a model including “man walking with aid”. Our results show that with the same set of common risk factors for falls a considerably lower proportion of the variation in falls can be explained in the group of people with dementia.
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| 12. |
- Hellner, Britt Marie, et al.
(författare)
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Systematiskt arbete för äldres säkerhet : om fall, trafikolyckor och bränder
- 2007
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Bok (refereegranskat)abstract
- Äldre personer är överrepresenterade i nästan alla olyckor. Förutom stort personligt lidande för individen leder skadorna ofta till omfattande kostnader för samhället. Därför har Räddningsverket och IMS/Socialstyrelsen tilsammans med forskare vid Umeå Universitet, Karlstad Universitet, Krolinska Insitutet, FoU Välfärd Örebro samt Vägverket gemensamt sammaställt denna bok. Syftet är att inspirera och vägleda ett systematiskt arbete i samhället för att öka säkerheten och minska skadorna till följd av olyckor bland äldre. Boken riktar sig till verksamma inom vård och omsorg för äldre, tjänstemän och politiker på olika nivåer i samhället
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| 13. |
- Holmbom, Johannes, et al.
(författare)
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Motivationsekvationen : att vägleda äldre personer till fysisk aktivitet
- 2008
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Ingår i: Fysioterapi. ; :5, s. 38-45
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Det finns ett tydligt samband mellan ökad ålder och minskande fysisk aktivitet, trots att aktiviteten ger hälsovinster för äldre personer på alla funktionsnivåer. Många äldre har kontakt med hälso- och sjukvården, vilket ger personalen en ypperlig möjlighet att påverka dem. För att vägleda äldre personer till fysisk aktivitet gäller det att finna faktorer som ökar motivationen och att identifiera barriärer. Motivationsekvationen, som presenteras här, är en modell som belyser sambandet mellan fyra faktorer: ”upplevd chans att lyckas” och ”upplevd betydelse av målet” i förhållande till ”upplevd kostnad” och ”benägenhet att bli stillasittande”. Samspelet mellan dem styr våra medvetna och omedvetna val när det gäller att påbörja och bibehålla olika beteenden. Faktorerna kan påverkas, direkt eller indirekt, och genom att öka de båda förstnämnda och minska de båda senare skapas hög motivation. Motivationsekvationen kan användas för att kartlägga patientens motivationsnivå. Tillsammans med det vägledande samtalet ger den möjlighet till individuellt skräddarsydda åtgärder.
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| 14. |
- Lindemann, Ulrich, et al.
(författare)
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Maximum step length as a potential screening tool for falls in non-disabled older adults living in the community.
- 2008
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 20:5, s. 394-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Identification of the risk of falls in a cohort of interest is a prerequisite for a targeted fall prevention study. Motor tasks are widely used as baseline assessment in such studies, but there are only a few well-evaluated tests of motor performance to predict falls prospectively. This study was conducted to find out if the potential of the maximum step length (MSL) test can predict future falls in non-disabled older persons. METHODS: A modified version of the MSL test was used for baseline assessment in 56 community-dwelling, non-disabled elderly persons (mean age 67.7 yrs, SD 6 yrs; 57% women). During a follow-up of 1 year, falls were recorded in a daily calendar. RESULTS: During the follow-up, 30 persons (54%) fell, with no gender difference in reporting of falls between men and women. The adjusted mean valid step length and adjusted maximum valid step length were predictive of future falls with a sensitivity/specificity of 77%/62% and 70%/69%, respectively. Combining MSL test results with fall history increased sensitivity to 93% and 90%, respectively, but decreased specificity to 54% and 58%, respectively. CONCLUSIONS: The MSL test is a feasible tool, with low requirements in space, predicting future falls in community-dwelling older persons. In combination with history of falls, the sensitivity of the test increased considerably.
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| 15. |
- 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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| 16. |
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| 17. |
- 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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| 18. |
- 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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