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- Hafström, Anna, et al.
(författare)
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Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program : A Randomized Single Arm Crossover Study
- 2016
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Ingår i: Gerontology and Geriatric Medicine. - : SAGE Publications. - 2333-7214. ; 2, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP) designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO), 206% with eyes closed (EC) on solid surface, and 54% EO on compliant surface (p < .001). Posturography confirmed balance improvements when perturbed on solid and compliant surfaces with EO and EC (p ≤ .033). Walking, step stool, and Timed Up and Go speeds increased (p ≤ .001), as did scores in Berg Balance and balance confidence scales (p ≤ .018). Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly.
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| 2. |
- Hafström, Anna
(författare)
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Perceived and functional balance control is negatively affected by diminished touch and vibration sensitivity in relatively healthy older adults and elderly
- 2018
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Ingår i: Gerontology and Geriatric Medicine. - : SAGE Publications. - 2333-7214. ; 4, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Severe diminished foot somatosensation, for example, caused by neuropathies and advanced aging, contributes to balance deficits and increased fall risk. However, little is known about somatosensory impairment and functional and subjective balance problems in relatively healthy elderly. Method: Vibration perception thresholds (VPTs) were assessed with a biothesiometer and tactile pressure sensation thresholds (TPSTs) with 20 monofilaments in 34 relatively healthy community-dwelling older adults (M = 69.4 years). Balance was evaluated with functional balance tests and questionnaires. A stepwise regression analysis was performed to determine the extent to which VPTs, TPSTs, and age could explain balance impairments. Results: High VPTs had negative effects on Berg Balance Scale and Dizziness Handicap Inventory scores (p ≤ .011), as did high TPSTs on walking speed and Figure-8 test (p ≤ .001). With visual information available, one-leg standing time (OLST) was significantly affected by ipsilateral VPTs on solid and TPSTs on compliant surface (p ≤ .002). Without visual information, age was the only factor with a main effect on OLST (p < .001). Age had no significant correlations with TPSTs or VPTs. Discussion: Somatosensation appears to be very important for perceived as well as functional balance control in older adults. Our findings have important clinical implications when assessing balance impairment and impending fall risk.
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| 3. |
- Hafström, Anna, et al.
(författare)
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Sentinel lymph node biopsy staging for cutaneous malignant melanoma of the head and neck.
- 2016
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 1651-2251 .- 0001-6489. ; 136:3
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Tidskriftsartikel (refereegranskat)abstract
- Conclusion Sentinel lymph node biopsies (SLNBs) can be performed safely and with reasonable accuracy in HNM patients. The outcome provides important prognostic information concerning DFS and further treatment. However, one must recognize that SLNB is a multidisciplinary procedure with a learning curve for all. Objectives To evaluate efficacy of performing SLNBs in a series of consecutive patients with cutaneous head and neck melanoma (HNM) ≥ T1b from introduction of the procedure and 10 years onward. Method End-points comprised of SLNB outcome, disease-free survival (DFS), and overall survival (OS). Results SNs were harvested in 128 of 160 patients (median Breslow = 2.0 mm, 29% ulcerated); success rate = 80.0%, or 92.1% if excluding patients where SLNBs were omitted due to non-localization on pre-operative imaging or because of SN-location in the parotid basin. Ten patients (7.8%) had positive SLNBs and were offered early completion neck dissections. Of the 146 patients available for follow-up (median = 27 months), 15.8% had recurrent disease. The risk of a regional nodal recurrence after a negative SLNB was 7.5%. SN-negative patients had improved DFS c.f. SN-positive patients (p < 0.001). A positive SLNB was the most important prognostic predictor of decreased DFS (hazard ratio = 5.70; p < 0.005), but had no significant impact on OS.
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