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- Ringsberg, Karin, et al.
(författare)
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Is there a relationship between balance, gait performance and muscular strength in 75-year-old women?
- 1999
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Ingår i: Age and Ageing. - 1468-2834. ; 28:3, s. 289-293
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To see if there is a relationship between clinical and laboratory tests of balance, muscular strength and gait in elderly women. DESIGN: A randomized population-based study. SETTINGS: Malmo, Sweden. METHODS: We investigated balance with a simple test of standing on one leg, as well as a computerized balance platform. Muscular strength was tested by computerized dynamometer. Extension and flexion of the knee and dorsiflexion of the ankle were tested. We measured the time and number of steps taken to walk a certain distance and the subjects' height and weight. PARTICIPANTS: 418 randomly selected 75-year-old women, of whom 230 took part. RESULTS: There was no relation between the computerized balance tests and any of the other tests. The non-computerized balance test was correlated with gait time and number of steps (r = -0.50, P<0.001 and r = -0.40, P<0.001, respectively). Tests of extension and flexion, strength of the knee and ankle dorsiflexion were related to gait, speed and number of steps. Heavy women had poorer balance when assessed by the non-computerized test (r = -0.32, P<0.001) and with the computerized, stable platform, eyes-open test (r = 0.27, P<0.001) and eyes-closed test (r = 0.44, P<0.001). The heavier an individual was, the slower her gait and the shorter her steps, despite having stronger knee muscles. CONCLUSION: There is no relationship between the simple balance tests and computerized platform tests. Muscle strength of the leg is not necessarily linked to balance, but rather to gait performance.
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- Ringsberg, Karin
(författare)
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Patients with asthma-like symptoms but negative asthma tests and patients with bronchial asthma
- 1997
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Patients with asthma-like symptoms but with negative results in asthma tests have recently been identified. The symptoms are mainly triggered by strong odours, physical exercise and mental stress. These patients are often misdiagnosed and mistreated. They mostly have to find coping strategies by themselves. Patients with diagnosed bronchial asthma sometimes are 'educated in their own disease' by health care professionals in order to increase their compliance and to help them to find coping strategies.The overall aim of this thesis was to identify and describe patients with asthma-like symptoms but negative asthma tests and to find diagnostic instruments to differentiate these patients from patients with bronchial asthma and healthy subjects and to investigate some possible mechanisms behind the disorder. A further aim was to describe the effects of a cognitive and affective treatment of patients with diagnosed bronchial asthma and to discuss if this model might also be applicable to patients with asthma-like symptoms but negative asthma tests.Altogether 24 patients with asthma-like symptoms but negative asthma: tests, 28 patients with bronchial asthma and 10 healthy controls participated in four studies. Only women aged 18-60 years were included. They were investigated with psychological tests, questionnaires and provocation with physical exercise, voluntary hyperventilation and mental stress. In-depth interviews were also performed. In a fifth study, the effects of a cognitive and affective model for treating patients with bronchial asthma, an "asthma school'', were studied by means of different questionnaires and lung function testo;, Althogether 38 patients with bronchial asthma, women and men aged· 18-70 yrs, participated.The results showed that the patients with asthma-like symptoms suffered more frequently from a greater variety of symptoms compared to the patients with asthma and healthy contJ:ols. They were more depressed, less hedonic, more hypochondriac and had lower trust in others than the patients of the astluna group. They had a higher health care consumption compared to the patients with asthma The physical exercise test did not provoke any bronchoconstriction in the patients with asthma-like symptoms. Neither could the symptoms be explained by physical unfitness. The provocations with voluntary hyperventilation and mental stress revealed that hyperventilation might be present in these patients and that mental stress might be one trigger factor. In a qualitative study, the patients stated that they felt dejected, confused and non confirmed by health care professionals, family and friends. Their subjective hyperreactivity limited them socially. They lacked adequate coping strategies. The findings were characterised by numerous self-reinforcing vicious circles where the circles comprised subjective hyperreactivity, social limitations and non confinnation. Patients with bronchial asthma benefit from being treated in an "asthma-school''. After having attended an "asthma-school", the patients increased their knowledge of the disease slightly more than a control group. They also increased their quality of life and decreased their health care conswnption.In summary, no evidence was found for the diagnosis of asthma in the patients with asthmalike symptoms but negative asthma tests. It is possible to separate them from patients with bronchial asthma by using different lung function tests, and different provocation tests. Patients with bronchial asthma benefit from taking part in an "asthma school". A similar treatment, with both a cognitive and an affective approach, might also be applicable in patients with asthma-like symptoms but negative asthma tests. A multidisciplinary approach and confirmation of these patients is important.
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