| 1. |
- Arkkukangas, Marina, et al.
(författare)
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A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing
- 2015
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Ingår i: Preventive Medicine Reports. - : Elsevier. - 2211-3355. ; 2, s. 134-140
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this investigation was to study the feasibility of a randomised controlled trial (RCT) based on a multicentre fall prevention intervention including exercise with or without motivational interviewing compared to standard care in community-living people 75. years and older.Method: The feasibility of a three-armed, randomised controlled trial was evaluated according to the following: process, resources, management by questionnaire, and treatment outcomes. The outcome measures were fall frequency, physical performance and falls self-efficacy evaluated after three months. Twelve physiotherapists conducted the measurements and treatments and responded to the questionnaire. The first 45 participants recruited to the ongoing RCT were included: 16 individuals in the Otago Exercise Program group (OEP), 16 individuals in the OEP combined with motivational interviewing group (MI), and 13 individuals in the control group. The study was conducted from November 2012 to December 2013.Results: The feasibility of the study process, resources and management reached the set goals in most aspects; however, the set goal regarding the MI guide and planned exercise for the participating older people was not completely reached. No significant differences were found between the groups regarding the outcome measures.Conclusion: This study confirmed the acceptable feasibility for the study protocol in the ongoing RCT.
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| 2. |
- Arkkukangas, Marina, et al.
(författare)
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Fall Prevention Exercises With or Without Behavior Change Support for Community-Dwelling Older Adults : A 2-Year Follow-Up of a Randomized Controlled Trial
- 2020
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Ingår i: Journal of Aging and Physical Activity. - : Human Kinetics. - 1063-8652 .- 1543-267X. ; 28:1, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates the effectiveness of two fall prevention exercise interventions targeting physical performance, activity level, fall-related self-efficacy, health-related quality of life, and falls: the Otago Exercise Programme (OEP) with and the OEP without behavior change support. In this randomized controlled trial (RCT), 175 participants were randomised into two intervention groups and one control group. A total of 124 community-dwelling older adults over the age of 75 who needed walking aids or home support participated in the two-year follow-up. The OEP with and the OEP without support for behavior change displayed no long-term benefits on physical performance, fall-related self-efficacy, health-related quality of life, and falls compared to a control group. Although no significant differences were detected between the groups, the results implied the control group's physical activity level decreased compared to the intervention groups at two-year follow up.
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| 3. |
- Kierkegaard, Marie, et al.
(författare)
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Online self-management fall prevention intervention for people with multiple sclerosis : a feasibility study protocol of a parallel group randomised trial
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:7
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Falls among people with multiple sclerosis (PwMS) are common and associated with injuries, fear of falling and low health-related quality of life. Considerations of behavioural, environmental, psychological and physical influences (including ambulation status) are needed to meet fall prevention needs for PwMS. Thus, using a codesign process involving key stakeholders a novel online self-management fall prevention intervention was created specifically for ambulatory and non-ambulatory PwMS. The feasibility, acceptability, fidelity and outcome of this complex intervention will be explored. Findings will inform a future full-scale randomised controlled trial.METHODS AND ANALYSIS: A mixed-method design will be used. Forty-eight PwMS, stratified for ambulation level, will be randomised to control (n=24) or intervention (n=24). Both groups will receive a brochure about fall risk factors and fall prevention. The intervention is group-based (eight PwMS in each group); will be delivered online; and involve six, 2-hour weekly sessions and a booster session 8 weeks after the sixth session. Each intervention group will be led by a trained facilitator. Data collection will be performed at baseline, and after seven and 18 weeks. Outcome measures will capture data on fall prevention behaviours, fear of falling, falls self-efficacy, social and everyday activities, perceived impact of MS and number of falls. Feasibility of recruitment process, data collection procedures, outcome measures, and delivery, and intervention acceptability, fidelity and outcomes will be evaluated. Both quantitative and qualitative methods will be used.ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Swedish Ethical Review Authority (registration number 2021-04817). Results will be disseminated in peer-review journals, at conferences, research meetings, in social media and through the patient organisation Neuro Sweden.TRIAL REGISTRATION NUMBER: NCT04317716.
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| 4. |
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| 5. |
- Tuvemo Johnson, Susanna, 1964-
(författare)
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Falls and fall prevention in community-dwelling older adults
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Falls are the primary cause of injuries among older adults, and accidents that result from falls can lead to personal suffering and extensive societal burdens. The overall aims of this thesis were to explore and describe falls and fall prevention strategies in community-dwelling older adults and to evaluate a fall prevention home exercise program, the Otago Exercise Program (OEP), with or without motivational interviewing (MI).Methods: Qualitative and quantitative research methods were uses. The designs were as follows: a cross-sectional, descriptive and comparative study (study I); a descriptive feasibility investigation (study II) and a randomized controlled trial (RCT) with two interventions, the OEP and OEP+MI, as well as a control group, with a 12-month follow-up (study III); and a prospective and descriptive study (study IV). The four studies comprised community-dwelling individuals aged 75 years or older. Study I included 262 individuals and studies II-IV had 175 participants who needed walking aids or home support. Study II also included 12 physical therapists. Data collection was performed via self-reported questionnaires, fall calendars, exercise diaries, physical performance tests and a semi-structured questionnaire. Results and conclusions: Suggested actions to prevent falls significantly differed between high and low active older adults (study I). Support for self-directed behavioral strategies could be important for preventing falls in older adults who have low physical activity levels. The study protocol for the RCT had acceptable feasibility (study II), and only minor changes of the protocol were needed. There were no benefits for OEP or OEP+MI with personal support implemented nine times over the 12-month period. However, all groups maintained physical functioning and activity (study III). To increase physical functioning and reduce falls in this sub-group of older adults, more frequent personal support and/or an alternative delivery format may be required for efficient intensity and challenge in home exercises. Over 12 months, falls and fall-related injuries in the RCT sample were the most common when moving around within the home and transitioning from sitting to standing (study IV). Special attention to these activities might be important for preventing falls in community-dwelling older adults who need walking aids or home support.
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| 6. |
- Tuvemo Johnson, Susanna, et al.
(författare)
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Older adults' opinions on fall prevention in relation to physical activity level
- 2018
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Ingår i: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 37:1, s. 58-78
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to explore and describe older adults' opinions regarding actions to prevent falls and to analyze differences in the opinions of highly versus less physically active older adults. An open-ended question was answered by 262 individuals aged 75 to 98 years living in the community. The answers were analyzed using qualitative content analysis, and differences in the categories were compared between highly and less physically active persons. Physical activity was measured according to a five-level scale. The content analysis resulted in eight categories: assistive devices, avoiding hazards, behavioral adaptive strategies, being physically active, healthy lifestyle, indoor modifications, outdoor modifications, and seeking assistance. Behavioral adaptive strategies were mentioned to a greater extent by highly active people, and indoor modifications were more often mentioned by less active older adults. Support for active self-directed behavioral strategies might be important for fall prevention among less physically active older adults.
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| 7. |
- Tuvemo Johnson, Susanna, et al.
(författare)
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Self-management of falls in people with multiple sclerosis : A scoping review
- 2023
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 37:2, s. 162-176
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Tidskriftsartikel (refereegranskat)abstract
- Objective Falls are common in people with multiple sclerosis. There is rising interest in how the multifactorial and chronic nature of fall risk among people with multiple sclerosis can be addressed through self-management. Thus, the aims were to investigate the extent and the scope of publications on self-management of falls in people with multiple sclerosis, and to identify how the concept of self-management was defined and used. Data sources A systematic literature search in Medline, Cochrane, Web of Science and PsycInfo was conducted to identify publications until July 2022. Review methods Published methodological guidance was followed. Articles targeting: (1) people with multiple sclerosis, (2) falls, and (3) self-management were selected. Of 1656 records, 203 publications were assessed for eligibility, of which 173 did not meet the inclusion criteria, and 16 publications did not contain empirical data. The type of publication, study focus, and study design was extracted. If applicable, key findings, self-management tasks and skills, and the definition of self-management were extracted. Results Fourteen original articles met all inclusion criteria. Ten articles represented six different fall prevention interventions. Three publications were randomized controlled trials. Self-management content was variable and not comprehensive in nature. None of the 14 publications included a self-management definition. Conclusion The limited number of original articles and the even fewer intervention studies show that the research on self-management of falls in people with multiple sclerosis is in its infancy. To progress in the research area of self-management of falls, a more robust, consensus-based description of self-management frameworks and activities is needed.
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| 8. |
- Tuvemo Johnson, Susanna, et al.
(författare)
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The Otago Exercise Program With or Without Motivational Interviewing for Community-Dwelling Older Adults : A 12-Month Follow-Up of a Randomized, Controlled Trial.
- 2021
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Ingår i: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 40:3, s. 289-299
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Tidskriftsartikel (refereegranskat)abstract
- age = 83 years). Measures were physical performance, physical activity level, balance, grip strength, fall-related self-efficacy, fall rate, and fall injury rate. The OEP with and the OEP without MI, with the support of a physical therapist (six home visits and three phone calls), demonstrated no benefits in any of the measures compared with a control group. In this subgroup of pre-frail older adults, more frequent support by personnel may be required to secure efficient intensity and progression in the exercises performed on your own at home.
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| 9. |
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| 10. |
- Tuvemo Johnson, Susanna, et al.
(författare)
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What Predicts Falls, and what are the Circumstances and Consequences of Falls in Community-Dwelling Older Adults Who Need Walking Aids or Home Help Service
- 2022
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Ingår i: Gerontology and geriatric medicine. - : Sage Publications. - 2333-7214. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to analyze predictive variables for falls in older community-dwelling adults who needed walking aids or home help service, to describe the circumstances and consequences of falls and fall injuries, and to describe the activities preceding falls, n = 175, mean age 83 years. Falls were self-reported monthly in a fall calendar and were followed up by a telephone interview. A logistic regression analysis was performed to investigate predictive baseline variables for falls. Injuries were reported in 82 of the 185 fall events. Previous falls and a high level of education had a significant association with falls odds ratios 1.9 (95% CI 1.3-2.7), and 2.7 (95% CI 1.4-5.3). Activities preceding the falls were classified according to the International Classification of Functioning (ICF). Falls and fall injuries were most common while moving around within the home and rising from sitting to standing.
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