| 1. |
- Bojner Horwitz, Eva, et al.
(författare)
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Arts as an ecological method to enhance quality of work experience of healthcare staff : a phenomenological-hermeneutic study
- 2017
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : TAYLOR & FRANCIS LTD. - 1748-2623 .- 1748-2631. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores the impact of self-chosen arts-based recreational activities, as opposed to the traditional arts therapy activities, on the well-being of healthcare providers. Three qualitative case studies of programs in which arts-based activities were used to work with healthcare providers, lasting for 10 weeks each, are phenomenological-hermeneutically evaluated using interviews and focus groups. The findings show what we refer to as an "ecological" ripple of effects: (1) the arts-based activities helped to reduce individual stress and to enhance mood over time, (2) the activities helped to transform workplace relationships within wards, and (3) the arts humanized the overall work climate in the healthcare setting. These effects go beyond those of using the art production as a strategy for stress reduction and imply potential for a more encompassing role for the arts within healthcare.
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| 2. |
- Cederbom, Sara, et al.
(författare)
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A behavioral medicine intervention for older women living alone with chronic pain - a feasibility study
- 2014
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Ingår i: Clinical Interventions in Aging. - 1176-9092 .- 1178-1998. ; 9, s. 1383-1397
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Tidskriftsartikel (refereegranskat)abstract
- Background: To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women. Materials and methods: The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance. Results: In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study. Conclusion: Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for balance training, and training of personnel to enhance self-efficacy.
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| 3. |
- Idland, Gro, et al.
(författare)
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Predictors of mobility in community-dwelling women aged 85 and older
- 2013
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 35:11, s. 881-887
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe changes in mobility measured with the Timed Up and Go test (TUG) from baseline to follow-up 9 years later, and to examine which of the demographic, physical performance and health variables measured at baseline were predictors of the TUG at follow-up in a sample of women aged 85 or older. Method: This prospective cohort study included 113 community-dwelling women with a baseline mean age of 79.5 years. TUG was measured at baseline and at follow-up. The following baseline measurements were used as predictors: demographics, step-climbing ability, functional reach, and health. Results: At follow-up 110 women had decline in the TUG. Mean TUG scores at baseline and at follow-up were 6.7 s (SD = 1.3) and 13.2 s (SD = 6.8) respectively. Higher age, higher BMI, poorer results on; functional reach, step-climbing and self-rated health were independent predictors of poorer TUG at the 9-year follow-up. Exhibiting sufficient strength to climb a step of 40 cm or more protected significantly against mobility decline. Improving balance measured by the functional reach test by 1 cm lowered the probability of major mobility decline by 7%. Conclusions: Our results suggest that to decrease the risk of mobility decline focus should be on strength, balance and nutrition.
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| 4. |
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| 5. |
- Karlsson, Emelie, et al.
(författare)
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Older patients' attitudes towards, and perceptions of, preoperative physical activity and exercise prior to colorectal cancer surgery : a gap between awareness and action
- 2020
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 28:8, s. 3945-3953
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Time for preoperative optimisation prior to colorectal cancer surgery is limited and older people tend to decline exercise interventions. This study sought to describe attitudes towards, and perceptions of, preoperative physical activity and exercise in older people prior to colorectal cancer surgery.METHODS: This is a qualitative interview study, analysed with inductive content analysis. Seventeen participants scheduled for colorectal surgery were recruited as a purposeful sample from two hospitals in Stockholm, Sweden. Individual semi-structured interviews were conducted, face-to-face (n = 8) or by telephone (n = 9).RESULTS: Nine participants were male, median age was 75 years (range 70-91). The theme, 'a gap between awareness and action', was identified based on two main categories: 'Attitudes towards preoperative physical exercise have a multifactorial base' and 'Preoperative physical exercise is possible with a push in the right direction'. The material described a gap between awareness of the benefits of physical activity and reports of performing physical activity. The reasons for the gap between thoughts and action in this respect seem to be multifactorial. Support from others emerged as an important possibility for overcoming the gap.CONCLUSIONS: A gap between the patients' awareness and action appeared in our material. Understanding this can guide healthcare professionals (HCPs) as to the support needed preoperatively. Advice on physical exercise before surgery should be specific, and individually tailored support for action should be offered. This support should also consider the individual's current physical activity and preoperative attitude towards physical exercise.
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| 6. |
- Lammes, Eva, et al.
(författare)
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Effects of nutritional intervention and physical training on energy intake, resting metabolic rate and body composition in frail elderly : a randomised controlled pilot study
- 2012
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Ingår i: The Journal of Nutrition, Health & Aging. - Paris, France : Springer. - 1279-7707 .- 1760-4788. ; 16:2, s. 162-167
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To analyse the effect of nutritional intervention and physical training on energy intake, resting metabolic rate (RmR) and body composition in the frail elderly. Design: Open, randomised, controlled pilot treatment study.Setting: Community-based research centre. Participants: ninety-six community-dwelling frail elderly people aged 75 and older, 40% men.Intervention: Four treatment arms: i) individual nutritional advice and group sessions on nutrition for the elderly, ii) physical training 2 x 45 minutes per week for 3 months, iii) combined nutritional and physical intervention and iv) control group. Measurements: The outcomes were energy intake (4-day food diary); resting metabolic rate (indirect calorimetry) and body composition (anthropometry) performed at baseline, after 3 months’ intervention (completed by 79 individuals), and as a follow-up at 9 months (completed by 64 individuals).Results: The training group showed a significantly increased RmR at 3 months. Otherwise, there were no observed differences within or between the four groups.There was no correlation over time between energy intake, RmR and fat free mass. The participants with a low energy intake who managed to increase their energy intake during the study (‘responders’) had a statistically significantly lower Bmi (21 vs. 24) and a lower fat percentage (23 vs. 30) at baseline than the ‘non-responders.’The ‘non-responders’ showed a small but statistically significant decrease in body fat percentage at F1, and inbody weight, Bmi and FFm at 9 months (F3).Conclusion: individual nutrition counselling and physical exercise had no effect on energy intake, RmR or fat free mass in community-dwelling frail elderly people aged 75 and older. interventions in frail elderly people should be targeted according to the needs of the individual patients. The issues of randomisation, targeting and responders in are problematised and discussed.
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| 7. |
- Lannering, Christina
(författare)
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Experiences and outcomes of systematic preventive work to reduce malnutrition, falls and pressure ulcers in nursing home residents
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Older people living in nursing homes are at a high risk of becoming malnourished, falling and developing pressure ulcers. In Sweden the national quality registry Senior Alert was developed to support prevention in these areas. Prevention according to Senior Alert follows a preventive care process of four steps, including risk assessment, analysis of the causes of risk, to determine and perform appropriate actions, and finally, to evaluate the care given.Aim: The overall aims of this thesis were to investigate how the preventive care process in Senior Alert functions as a tool for preventive work among older persons living in nursing homes, and to investigate the results of risk assessments and actions.Design: The thesis is based on three longitudinal quantitative studies (I, III, and IV) and one qualitative study (II). In Studies I and III, process- and patient results were compared among different groups of nursing home residents, with a follow-up time of 6 months. In Study IV, associations between the assessment instruments and the outcomes of weight loss, falls and pressure ulcers were investigated. The qualitative study (II) was based on focus group interviews with healthcare professionals and was analyzed using content analysis.Results: The residents included in the registry during the later years (2013-2014) had a higher proportion of registered preventive actions in the three areas, and were followed up more frequently regarding weight and new assessments than residents included during the earlier years (2010-2012). Nevertheless, regardless of risk, only 30% were reassessed, and 44% of the residents at risk for malnutrition were followed up for body weight within 6 months. No difference in weight change was found between a group of residents included in Senior Alert and a second group receiving ‘care as usual’. Generally, the mobility variables in the risk assessment instruments had the strongest associations with the tested outcomes of weight loss, fall and pressure ulcers, albeit in different ways. Healthcare professionals described that Senior Alert stimulated better teamwork while at the same time they experienced the increased documentation and time constraints as aggravating circumstances. They also described a lack of reliability of the assessment instruments in that they overrated the risks compared to their own clinical judgement. Healthcare professional’s knowledge about the evaluation part of the process was low.Conclusion: The evaluation and follow-up step of the preventive care process was not sufficiently applied. This was expressed by the participants in the focus groups and was also reflected in registry data by the varying time to follow-up and the poor event registration. As a consequence, the sample to measure outcomes within 6 months became small. Therefore, larger samples are needed to study longitudinal outcomes, if a fixed system-mandatory time point for follow-up is not implemented. A committed leadership is important to improve the preventive work and to stimulate follow-up of results.
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| 8. |
- Mojtaba, Mahnaz, et al.
(författare)
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Downton Fall Risk Index during hospitalisation is associated with fall-related injuries after discharge : a longitudinal observational study
- 2018
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Ingår i: Journal of Physiotherapy. - : AUSTRALIAN PHYSIOTHERAPY ASSOC. - 1836-9553 .- 1836-9561. ; 64:3, s. 172-177
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Tidskriftsartikel (refereegranskat)abstract
- Questions: Among older people who are hospitalised, what is the predictive validity of the Downton Fall Risk Index (DFRI) in relation to fall-related injury after discharge? What is the predictive validity of the DFRI among males and females in this setting? Design: Prospective, longitudinal, observational study. Participants: All hospital admissions during 2012 at three geriatric clinics in the Stockholm County Council were monitored. Patients aged > 65 years who did not die during the admission and who lived in the Stockholm County Council region were included. Outcome measures: The DFRI consists of five modules: previous falls, medication, sensory deficits, mental state, and gait. Three or more points indicate an increased fall risk. Data on DFRI, health status and medications were collected prior to discharge. Data regarding fall-related injuries were collected up to 6 months after discharge. Poisson multivariate regression analyses were conducted to evaluate the association between DFRI and fall-related injuries. Results: In total, 6650 patients were analysed. The cut-off >= 3 points in the DFRI was significantly associated with fall-related injury when confounding variables were controlled for (IRR 1.94, 95% CI 1.60 to 2.38). Among individual modules, only previous falls (IRR 2.58, 95% CI 2.22 to 3.01) and unsafe gait (IRR 1.79, 95% CI 1.53 to 2.09) were associated with fall-related injuries. Stratified analyses showed a higher risk ratio for men compared to women regarding the DFRI, but the test for an interaction effect was not significant. Conclusion: The risk of post-discharge fall-related injury is increased among older hospitalised people with an increased fall risk, according to the DFRI, especially those who had previous falls or unsafe gait. Although the DFRI tool is predictive, previous falls and gait are the measures that are most worthy of focus.
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| 9. |
- Rydwik, Elisabeth, et al.
(författare)
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Effects of a physical and nutritional intervention program for frail elderly people over age 75 : a randomized controlled pilot treatment trial
- 2008
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Ingår i: Aging Clinical and Experimental Research. - Milano, Italy : Editrice Kurtis. - 1594-0667 .- 1720-8319. ; 20:2, s. 159-170
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: There are few studies published that combine the interventions of physical training and nutrition. The aim of the present study was to describe the impact of a physical and nutritional intervention program for frail community- dwelling elderly people over the age of 75. METHODS: Ninety-six community-dwelling elderly people (58 women) were randomized to four different groups: i) a physical training program (aerobic, muscle strength, balance), ii) a nutritional intervention program (individually targeted advice and group sessions), iii) a combination of these interventions, and iv) a control group. At baseline subjects were screened for physical performance such as muscle strength, balance, mobility and activities of daily living, as well as nutritional aspects such as energy intake, body weight and fat-free mass. These measurements were repeated immediately after the intervention, which lasted for 12 weeks, and after another 6 months. RESULTS: The intention-to-treat analysis indicated significant improvements in lower- extremity muscle strength in both training groups compared with the nutrition group at 1st follow-up. There were small significant changes for some of the balance measurements in the training group without nutrition treatment. The nutrition intervention did not show any significant results. CONCLUSIONS: This study shows the positive effect on lower-extremity muscle strength directly after the intervention. Balance training most probably needs to be more individualized in order to be effective for frail elderly people. Further studies are needed, with larger sample sizes, to investigate the effects of these types of interventions before any further conclusions can be drawn.
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| 10. |
- Rydwik, Elisabeth, et al.
(författare)
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Effects of a physical training and nutritional intervention program in frail elderly people regarding habitual physical activity level and activities of daily living : a randomized controlled pilot study
- 2010
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 51:3, s. 283-289
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this randomized controlled pilot study is to describe the effects of a physical training and nutritional intervention program on the physical activity level and activities of daily living (ADL) in frail elderly people. Ninety-six community-dwelling frail elderly people (58 women) above the age of 75 were included in the study. The 12-week physical and/or nutritional intervention program was followed by six months of home-based exercises for the training groups, followed up with training diaries. At baseline the subjects were screened for physical activity level, walking habits, and ADL. These measurements were repeated immediately after the intervention at 3 months, and at 2nd follow-up at 9 months. ADL data were also collected 24 months after baseline at 3rd follow-up. The intention-to-treat analyses showed an increase of the habitual physical activity level and walking duration at 1st follow-up for the two training groups compared to the other groups. These increases remained at 2nd follow-up. The nutrition intervention did not show any significant results. No significant effects on ADL were shown however, there were moderate correlations between increases in physical activity level and ADL as well as between the amounts of home-based exercises and ADL for the two training groups.
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| 11. |
- Rydwik, Elisabeth, et al.
(författare)
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Effects of physical training on aerobic capacity in frail elderly people (75+ years). Influence of lung capacity, cardiovascular disease and medical drug treatment : a randomized controlled pilot trial
- 2010
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 22:1, s. 85-94
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Frail elderly people often suffer from a combination of unintentional weight loss and/or low body mass index, as well as a low physical activity level. No studies have investigated the effect of physical training alone or in combination with nutritional intervention on aerobic capacity in frail elderly people. The aim of this pilot study was to determine if a physical training program can affect aerobic capacity in frail elderly people.METHODS: Ninety-six community-dwelling frail elderly people (58 women) were included in the study. Subjects were randomized to four different groups: i) physical training program (aerobic, muscle strength, balance), ii) a nutritional intervention program (individually targeted advice and group sessions), iii) a combination of these interventions, and iv) a control group. At baseline, subjects were screened for aerobic capacity, leg muscle strength, spirometry, heart disease and cardiovascular drugs. Aerobic capacity and leg muscle strength were analyzed immediately after the 3-month intervention period (1st follow-up), and after another 6 months (2nd follow-up).RESULTS: Subjects mean age was 83 years. The mean compliance rate with the physical training program was 65%. There were no observed effects on aerobic capacity measured as maximal workload, or work time, with or without beta-receptor blockade. Subjects in the training groups without lung disease significantly increased maximal work time when compared with subjects with lung disease. Physical training significantly increased lower extremity muscle strength compared with nutrition alone at the 1st follow-up. No serious adverse events occurred during assessment or physical training.CONCLUSIONS: Further studies with larger sample sizes and a more specific aerobic component in the training program are necessary before any further conclusions can be drawn.
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| 12. |
- Rydwik, Elisabeth
(författare)
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Effects of physical training on physical performance in frail elderly people
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aging is often accompanied by decreased muscle strength, aerobic capacity and balance, which can lead to impaired physical performance. Epidemiological data have demonstrated that low levels of physical activity are strongly related to functional decline. Frailty has been defined as a clinical syndrome comprised of unintentional body weight loss, self-reported exhaustion, muscle weakness, slow walking speed and a low level of physical activity in men and women over the age of 65. There is contradictory evidence regarding the effects of physical training on physical performance in frail elderly people. The primary aim of this thesis is to describe the effects of physical training on physical performance i.e. muscle strength, aerobic capacity, balance, mobility and physical activity level as well as activities of daily living (ADL) and health-related quality of life (HRQL) in frail elderly people. Another aim is to investigate reliability with test re-test in one repetition maximum (1RM) in the arm/shoulder. Ninety-six community-dwelling elderly people (58 women) were randomised to four different groups: i) physical training programme (aerobic, muscle strength, balance), ii) a nutritional intervention programme (individually targeted nutritional advice and group sessions), iii) a combination of these interventions and iv) a control group. At baseline the subjects were screened for physical performance as well as nutrition related variables. These measurements were repeated immediately after the intervention, which lasted for 12 weeks, and again six months later. During the last six months, the subjects in the training groups were encouraged to perform homebased exercises and to fill in training diaries. Two years after baseline, a third followup regarding ADL was conducted through telephone calls. The test re-test procedure with 1RM was conducted at one week-interval, comparing the reliability between test sessions, and also between subjects with or without previous muscle strength training experience. A positive effect of the physical training programme was shown on leg muscle strength and habitual physical activity level for frail elderly people. Adding a nutritional intervention did not affect the results. There were no other significant differences between groups. Subjects with improvements in muscle strength, balance and mobility had significantly higher compliance compared to non-improvers. There were moderate significant correlations between compliance of the home-based exercises and improvements in personal ADL and HRQL. There was a high correlation between the test sessions in 1RM, r=0.97 for both groups. An analysis of 95% limits of agreement for the mean difference was -4.3/+6.9 kg for the group without and -3.0/+6.4 kg for the group with previous muscle strength training experience, respectively. In conclusion, the physical training programme showed a positive effect on leg muscle strength and habitual physical activity level. An individually tailored intervention is probably necessary to achieve a positive result on physical performance such as aerobic capacity, balance and mobility in frail elderly people. 1RM seems to be a reliable and safe method for dosing the intensity and evaluating a muscle strength training programme for elderly people.
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| 13. |
- Rydwik, Elisabeth, et al.
(författare)
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Effects of physical training on physical performance in institutionalised elderly patients (70+) with multiple diagnoses
- 2004
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 33:1, s. 13-23
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: the positive effect of physical training in healthy elderly people is well documented. The aim of this systematic review was to describe the effect of physical training on physical performance in institutionalised elderly patients with multiple diagnoses.DESIGN: systematic literature review of randomised controlled trials regarding effects of physical training of elderly (70+) subjects.METHODS: the randomised controlled trials were evaluated using a modified version of an evaluation form originally developed by the Cochrane Collaboration. It is based on a weighted scale of 0-100 points, and ranks the studies as high, moderate or low methodological quality. A total of 16 randomised controlled trials were included in the review.RESULTS: six studies scored as high quality, eight as moderate and two as low. There was a large heterogeneity in the studies concerning sample size, types of interventions and types of assessments. There is strong evidence for a positive effect of physical training on muscle strength and mobility; moderate evidence for an effect on range of motion; and contradictory evidence regarding gait, activities of daily living, balance and endurance.CONCLUSION: more studies are required, with larger sample sizes, higher specificity as to the types of interventions and assessments, greater focus on clinically relevant outcomes such as endurance and activities of daily living, and also, for example, quality of life and mortality.
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| 14. |
- Rydwik, Elisabeth, et al.
(författare)
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Is Midlife Occupational Physical Activity Related to Disability in Old Age? The SNAC-Kungsholmen Study
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Leisure-time physical activity (PA) has been established to be related to more years lived without disability. However, less is known about the relationship between occupational PA and disability in old age. The aim of the study was 1) to investigate whether midlife occupational PA is related to late-life disability, and 2) to test the hypothesis that the association differs according to the occupational categories of blue and white collar work. Methods: The study population was derived from the Swedish National Study on Aging and Care, and consisted of a random sample of 1804 subjects aged 72 and above. The association of occupational PA during the longest held occupation with disability in old age was determined using logistic regression. Results: There was no significant relationship between occupational PA and disability in personal or instrumental activities of daily living (ADL) after controlling for demographic and health-related factors. However, in stratified analyses moderate levels of occupational PA was associated with a lower odds ratio of dependency in personal ADL amongst white collar workers, compared to low level of occupational PA (OR = 0.34 95% C1 0.12-0.98). Conclusions: Moderate levels of midlife occupational PA were associated with a decreased risk of personal ADL disability in old age among white collar workers, but not among blue collar workers. Our results highlight the importance of encouraging white collar workers to engage in physical activity during or outside work hours.
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| 15. |
- Rydwik, Elisabeth, et al.
(författare)
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Physical training in institutionalized elderly people with multiple diagnoses : a controlled pilot study
- 2005
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 40:1, s. 29-44
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Tidskriftsartikel (refereegranskat)abstract
- Reduction in muscle mass and physical function depends on a variety of interacting factors: age, physical activity level, nutritional state and the type and impact of disease. The aim of this study was to investigate the effect of an individualized moderate intensity physical training program on muscle strength, balance, mobility, ambulation and activities of daily living (ADL) in institutionalized elderly people aged 65 and over with multiple diagnoses. Baseline assessments consisted of strength, balance, mobility/ambulation, and ADL. Twenty-one subjects were included in the intervention program. A control group (21 subjects) was first matched in pairs according to gender, age, ADL and mobility, and then by balance, ambulation and strength. The intervention program was individualized and included strength, mobility, balance and endurance training. Follow-up measures were conducted directly after the intervention and 10 weeks later. After drop-out, 20 subjects in the intervention group and 15 subjects in the control group remained for analyses. Balance and mobility improved significantly in the intervention group while declining in the control group. This pilot study indicates that a physical training program may improve functional capacity for institutionalized elderly persons with multiple diagnoses.
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| 16. |
- Rydwik, Elisabeth, et al.
(författare)
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The effect of exercise of the affected foot in stroke patients : a randomized controlled pilot trial
- 2006
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 20:8, s. 645-655
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the effect of treatment with a portable device called Stimulo on range of motion, muscle strength and spasticity in the ankle joint and its effect on walking ability, balance, activities of daily living (ADL) and health-related quality of life in stroke patients. DESIGN: A randomized controlled pilot study. SETTING: A research centre. SUBJECTS: Ambulatory or partly ambulatory chronic stroke patients with remaining spasticity and/or decreased range of motion in the hemiparetic leg/ankle. Interventions: Standardized and individualized programme including active and passive range of motion of the ankle with a portable device (Stimulo), performed three times a week for 30 min, over a six-week period. MAIN MEASURES: Range of motion, muscle strength, spasticity, gait variables, balance, ADL and health-related quality of life. RESULTS: Eighteen subjects were included in the study with a mean age of 75 years. The compliance rate was 94-99%. There were no significant differences between the groups. CONCLUSION: The study showed no significant effect of an ankle-exercise intervention programme with Stimulo. Further studies with a larger sample size are of importance before any further conclusions can be drawn.
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| 17. |
- Taloyan, Marina, et al.
(författare)
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Web-based support for individuals with type 2 diabetes - a feasibility study
- 2021
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSelf-care is one of the cornerstones in the treatment of type 2 diabetes. Patients with type 2 diabetes struggle to maintain acceptable levels of blood sugar, blood pressure and lipids, the fundamental for the prevention of macro- and microvascular as well as neuropathic complications. The primary aim of the study was to evaluate the feasibility and describe patients' and caregivers' experiences of using the web- and smartphone-based system Triabetes. The secondary aim was to investigate if the use of the system could improve patients' clinical outcomes.MethodsFeasibility was assessed with describing recruitment rate and the participants views of using the system. Laboratory and anthropometry data were also collected.ResultsThe study showed that recruitment of patients to participate in the intervention was limited and compliance to the study protocol was low. A majority of the patients stated that the system was easy to get an overview of and that the system motivated them and made it easier and fun to handle lifestyle habits. A secondary finding of the study was that there was a significant lowering of LDL values.Conclusions Feasibility in terms of recruitment rate was low. The participants agreed that the application overall was useful but suggested several improvements. Summarized lessons learned from this study are following: (1) we need more knowledge about what motivates a person to use a digital tool for a longer period of time; (2) the tool must be easy and less time consuming to use; (3) the technical structure needs to be improved and automatic recording of data must be improved.
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| 18. |
- Welmer, Anna-Karin, et al.
(författare)
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Association of Cardiovascular Burden with Mobility Limitation among Elderly People : A Population-Based Study
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cardiovascular risk factors (CRFs) such as smoking and diabetes have been associated with mobility limitations among older adults. We seek to examine to what extent individual and aggregated CRFs and cardiovascular diseases (CVDs) are associated with mobility limitation. Methods: The study sample included 2725 participants (age >= 60 years, mean age 72.7 years, 62% women) in the Swedish National Study on Aging and Care in the Kungsholmen district of central Stockholm, Sweden, who were living either at their own home or in institutions. Data on demographic features, CRFs, and CVDs were collected through interview, clinical examination, self-reported history, laboratory tests, and inpatient register. Mobility limitation was defined as walking speed <0.8 m/s. Data were analyzed using multiple logistic models controlling for potential confounders. Results: Of the 2725 participants, 581 (21.3%) had mobility limitation. The likelihood of mobility limitation increased linearly with the increasing number of CRFs (i.e., hypertension, high C-reactive protein, obesity, diabetes and smoking) (p for linear trend<0.010) and of CVDs (i.e., ischemic heart disease, atrial fibrillation, heart failure and stroke) (p for linear trend<0.001). There were statistical interactions of aggregated CRFs with age and APOE epsilon 4 allele on mobility limitation (p(interaction)<0.05), such that the association of mobility limitation with aggregated CRFs was statistically evident only among people aged <80 years and among carriers of the APOE epsilon 4 allele. Conclusion: Aggregations of multiple CRFs and CVDs are associated with an increased likelihood of mobility limitation among older adults; however the associations of CRFs with mobility limitation vary by age and genetic susceptibility.
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| 19. |
- Welmer, Anna-Karin, 1976-, et al.
(författare)
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Can chronic multimorbidity explain the age-related differences in strength, speed and balance in older adults?
- 2012
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 24:5, s. 480-489
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: It is known that physical performance declines with age in general, however there remains much to be understood in terms of age-related differences amongst older adults across a variety of physical components (such as speed, strength and balance), and particularly in terms of the role played by multimorbidity of chronic diseases. We aimed to detect the age-related differences across four components of physical performance and to explore to what extent chronic diseases and multimorbidity may explain such differences.Methods: We analyzed cross-sectional data from a population-based sample of 3323 people, aged 60 years and older from the SNAC-K study, Stockholm, Sweden. Physical performance was assessed by trained nurses using several tests (grip strength, walking speed, balance and chair stands). Clinical diagnoses were made by the examining physician based on clinical history and examination.Results: Censored normal regression analyses showed that the 72- 90+ year-old persons had 17-40% worse grip strength, 44-86% worse balance, 30-86% worse chair stand score, and 21-59% worse walking speed, compared with the 60-66 year-old persons. Chronic diseases were strongly associated with physical impairment, and this association was particularly strong among the younger men. However, chronic diseases explained only some of the age-related differences in physical performance. When controlling for chronic diseases in the analyses, the age-related differences in physical performance changed 1-11 percent.Conclusion: In spite of the strong association between multimorbidity and physical impairment, chronic morbidities explained only a small part of the age-related differences in physical performance.
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| 20. |
- Welmer, Anna-Karin, et al.
(författare)
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Education-related differences in physical performance after age 60 : a cross-sectional study assessing variation by age, gender and occupation
- 2013
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13, s. 641-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Having a low level of education has been associated with worse physical performance. However, it is unclear whether this association varies by age, gender or the occupational categories of manual and non-manual work. This study examined whether there are education-related differences across four dimensions of physical performance by age, gender or occupational class and to what extent chronic diseases and lifestyle-related factors may explain such differences. Methods: Participants were a random sample of 3212 people, 60 years and older, both living in their own homes and in institutions, from the Swedish National Study on Aging and Care, in Kungsholmen, Stockholm. Trained nurses assessed physical performance in grip strength, walking speed, balance and chair stands, and gathered data on education, occupation and lifestyle-related factors, such as physical exercise, body mass index, smoking and alcohol consumption. Diagnoses of chronic diseases were made by the examining physician. Results: Censored normal regression analyses showed that persons with university education had better grip strength, balance, chair stand time and walking speed than people with elementary school education. The differences in balance and walking speed remained statistically significant (p < 0.05) after adjustment for chronic diseases and lifestyle. However, age-stratified analyses revealed that the differences were no longer statistically significant in advanced age (80+ years). Gender-stratified analyses revealed that women with university education had significantly better grip strength, balance and walking speed compared to women with elementary school education and men with university education had significantly better chair stands and walking speed compared to men with elementary school education in multivariate adjusted models. Further analyses stratified by gender and occupational class suggested that the education-related difference in grip strength was only evident among female manual workers, while the difference in balance and walking speed was only evident among female and male non-manual workers, respectively. Conclusions: Higher education was associated with better lower extremity performance in people aged 60 to 80, but not in advanced age (80+ years). Our results indicate that higher education is associated with better grip strength among female manual workers and with better balance and walking speed among female and male non-manual workers, respectively.
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| 21. |
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Äldres hälsa : ett sjukgymnastiskt perspektiv
- 2012
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Rehabilitering anpassad för äldre var under många år ett eftersatt kunskapsområde, men de senaste decennierna har forskningen bidragit till att utveckla metoder för att både förebygga och återvinna funktions- och aktivitetsbegränsningar. Med den demografiska utvecklingen som kommer att eskalera under de närmsta 30–40 åren med allt fler äldre över 80 år, så ser man ett allt större behov av att äldre personer bibehåller sin förmåga att vara självständiga i dagliga aktiviteter. Detta för att samhället ska klara vården och omsorgen om de mest sjuka äldre. Kunskap om rehabilitering anpassad för äldre kan här spela en viktig roll.Det finns många orsaker till i vilken takt vi åldras i, och variationen är stor. Heterogeniteten i åldrandet ställer därmed krav på en bred kunskap hos de sjukgymnaster som möter äldre personer i sitt kliniska arbete. Äldres hälsa – ett sjukgymnastik perspektiv spänner därför över ett brett område av olika insatser och metoder för att möta den äldre personens individuella behov, alltifrån hälsopromotion för den friska äldre personen till rehabilitering inom kommunal äldreomsorg och palliativ vård. Andra aspekter som motivation, anhörigstöd, psykisk ohälsa, läkemedel, nutrition och mobil informations- och kommunikationsteknik berörs också.Grundläggande i all sjukgymnastisk rehabilitering anpassad till äldre är att stimulera till rörelse, fysisk aktivitet, oberoende i dagliga aktiviteter och välbefinnande. Att utgå ifrån det biologiska istället för det kronologiska åldrandet är en väsentlig del och förutsätter kunskaper i gerontologi (det normala åldrandet) samt på vilket sätt och till vilken grad äldre personer drabbas av sjukdomar och aktivitetsbegränsningar och vilka insatser och metoder som står till buds för att bemöta dessa.
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