| 1771. |
- Lindberg, Åsa, et al.
(författare)
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Yrsel
- 2010
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Ingår i: Äldres hälsa och ohälsa. - Lund : Studentlitteratur AB. - 9789144053530 ; , s. 245-258
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Yrsel är vanligt hos äldre personer och påverkar deras liv negativt. Rädsla, oro och depression är vanligt hos äldre med yrsel. Yrsel är ofta ett tecken på balansstörningar, vilket är en vanlig orsak till fallolyckor och död. Genom att minska yrseln hos äldre skulle antalet fallolyckor också kunna minskas. Fysisk aktivitet minskar risken för yrsel och förbättrar därmed livskvaliteten.
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| 1772. |
- Lindelöf, Nina, et al.
(författare)
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A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers : a co-creative journey
- 2023
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Ingår i: BMC Geriatrics. - London : BioMed Central (BMC). - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The World Health Organization claims that rehabilitation is important to meet the needs of persons with dementia. Rehabilitation programmes, however, are not routinely available. Person-centred, multidimensional, and interdisciplinary rehabilitation can increase the opportunities for older adults with dementia and their informal primary caregivers to continue to live an active life and participate in society. To our knowledge, staff team experiences of such rehabilitation programmes, involving older adults with dementia and their informal caregivers has not been previously explored.Methods: The aim of this qualitative focus group study was to explore the experiences of a comprehensive staff team providing person-centred multidimensional, interdisciplinary rehabilitation to community-dwelling older adults with dementia, including education and support for informal primary caregivers. The 13 staff team members comprised 10 professions who, during a 16-week intervention period, provided individualised interventions while involving the rehabilitation participants. After the rehabilitation period the staff team members were divided in two focus groups who met on three occasions each (in total six focus groups) and discussed their experiences. The Grounded Theory method was used for data collection and analysis.Results: The analysis resulted in four categories: Achieving involvement in rehabilitation is challenging, Considering various realities by acting as a link, Offering time and continuity create added value, and Creating a holistic view through knowledge exchange, and the core category: Refining a co-creative process towards making a difference. The core category resembles the collaboration that the staff had within their teams, which included participants with dementia and caregivers, and with the goal that the intervention should make a difference for the participants. This was conducted with flexibility in a collaborative and creative process.Conclusions: The staff team perceived that by working in comprehensive teams they could provide individualised rehabilitation in creative collaboration with the participants through interaction, knowledge exchange, time and continuity, coordination and flexibility, and a holistic view. Challenges to overcome were the involvement of the person with dementia in goal setting and the mediating role of the staff team members. The staff pointed out that by refinement they could achieve well-functioning, competence-enhancing and timesaving teamwork.
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| 1773. |
- Lindelöf, Nina, et al.
(författare)
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Experiences of a high-intensity functional exercise programme among older people dependent in activities of daily living
- 2012
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Ingår i: Physiotherapy Theory and Practice. - London : Informa Healthcare. - 0959-3985 .- 1532-5040. ; 28:4, s. 307-316
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this qualitative study was to describe the experience of participating in a high-intensity functional exercise programme among older people dependent in activities of daily living (ADL) and living in residential care facilities. Interviews were conducted with nine older people, aged 73-91, and dependent in ADL who had participated in a high-intensity functional exercise programme. Qualitative content analysis was used in analysing the interviews. The findings show that the informants, despite extensive impairments, multiple diagnoses, and advanced age, displayed a belief in the positive effects of the programme, a strong desire to be active, and the will to strive to avoid further loss of capacity. They were struggling with failing bodies that constituted barriers to exercise. Support from the supervisors and belief in personal success facilitated performance of the exercises. The informants related physical and mental improvements that affected their daily life positively and that exercising in a group was stimulating and created a sense of togetherness. The effort was seen as worthwhile because participating in strenuous exercise could imply that they might overcome bodily limitations to achieve increased vitality and improved quality of life.
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| 1774. |
- Lindelöf, Nina, et al.
(författare)
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Experiences of older people with dementia participating in a high-intensity functional exercise program in nursing homes : "While it's tough, it's useful"
- 2017
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 12:11
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to describe the views and experiences of participation in a high-intensity functional exercise (HIFE) program among older people with dementia in nursing homes. The study design was a qualitative interview study with 21 participants (15 women), aged 74-96, and with a Mini-Mental State Examination score of 10-23 at study start. The HIFE-program comprises exercises performed in functional weight-bearing positions and including movements used in everyday tasks. The exercise was individually designed, supervised in small groups in the nursing homes and performed during four months. Interviews were performed directly after exercise sessions and field notes about the sessions were recorded. Qualitative content analysis was used for analyses. The analysis revealed four themes: Exercise is challenging but achievable; Exercise gives pleasure and strength; Exercise evokes body memories; and Togetherness gives comfort, joy, and encouragement. The intense and tailored exercise, adapted to each participant, was perceived as challenging but achievable, and gave pleasure and improvements in mental and bodily strength. Memories of previous physical activities aroused and participants rediscovered bodily capabilities. Importance of individualized and supervised exercise in small groups was emphasized and created feelings of encouragement, safety, and coherence. The findings from the interviews reinforces the positive meaning of intense exercise to older people with moderate to severe dementia in nursing homes. The participants were able to safely adhere to and understand the necessity of the exercise. Providers of exercise should consider the aspects valued by participants, e.g. supervision, individualization, small groups, encouragement, and that exercise involved joy and rediscovery of body competencies.
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| 1775. |
- Lindelöf, Nina, et al.
(författare)
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Perceptions of participating in high-intensity functional exercise among older people dependent in activities of daily living (ADL)
- 2013
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 57:3, s. 369-376
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to evaluate how older people, dependent in ADL perceive their participation in a high-intensity, functional exercise program compared to the perceptions of those participating in a control activity. Forty-eight older people living in residential care facilities answered a questionnaire about their perceptions of participating in an activity for three months. They were aged 65-98, had a mean score of 24 on Mini Mental State Examination (MMSE) and 14 on Barthel ADL Index. The participants had been randomized to exercise (n=20) or control activity (n=28). Differences in responses between exercise and control activity were evaluated using logistic and ordinal regression analyses. The results show that a majority of the exercise group perceived positive changes in lower limb strength, balance, and in the ability to move more safely and securely compared to a minority of the control group (p<0.001). Significantly more respondents in the exercise activity answered that they felt less tired due to the activity (p=0.027) and that they prioritized this activity above other activities (p=0.010). More exercise participants reported that meeting for three months was too short, and fewer that it was too long compared to the control group (p=0.038). This study shows that older people living in residential care facilities, dependent in ADL, and with mild or no cognitive impairment had positive perceptions about participating in high-intensity functional exercise. The findings support the use of a high-intensity exercise program in this population of older people.
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| 1776. |
- Lindgren, Helena, et al.
(författare)
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Sociotechnical integration of decision support in the dementia domain
- 2010
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Ingår i: Information Technology in Health Care. - : IOS Press. - 9781607505686 - 9781607505693 ; , s. 79-84
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Bokkapitel (refereegranskat)abstract
- The need for improving dementia care has driven the development of the clinical decision support system DMSS (Dementia Management and Support System). A sociotechnical approach to design and development has been applied, with an activity-centered methodology and user participation throughout the process. Prototypes have been developed based on the characteristics of clinical practice and domain knowledge, while clinical practice has been subjected to different efforts for development such as education and organizational change. This paper addresses the lessons learned and role and impact DMSS has had, and is expected to have on the clinical assessment of dementia in different clinics in Sweden, South Korea and Japan. Furthermore, it will be described in what way the development of DMSS and the development of dementia care in these three areas are interlinked. Results indicate that the most important contribution of DMSS at the point of care, is the educational support that DMSS provides, part from the tailored explanatory support related to a patient case. This effect was partly manifested in a change of routines in the encounter with patients.
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| 1777. |
- Lindh Mazya, Amelie, et al.
(författare)
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Discordance in Frailty Measures in Old Community Dwelling People with Multimorbidity - A Cross-Sectional Study
- 2023
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Ingår i: Clinical Interventions in Aging. - 1178-1998. ; 18, s. 1607-1618
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Assessment of frailty is a key method to identify older people in need of holistic care. However, agreement between different frailty instrument varies. Thus, groups classified as frail by different instruments are not completely overlapping. This study evaluated differences in sociodemographic factors, cognition, functional status, and quality of life between older persons with multimorbidity who were discordantly classified by five different frailty instruments, with focus on the Clinical Frailty Scale (CFS) and Fried's Frailty Phenotype (FP).PARTICIPANTS AND METHODS: This was a cross-sectional study in a community-dwelling setting. Inclusion criteria were as follows: ≥75 years old, ≥3 visits to the emergency department the past 18 months, and ≥3 diagnoses according to ICD-10. 450 participants were included. Frailty was assessed by CFS, FP, Short Physical Performance Battery (SPPB), Grip Strength and Walking Speed.RESULTS: 385 participants had data on all frailty instruments. Prevalence of frailty ranged from 34% (CFS) to 75% (SPPB). Nine percent of participants were non-frail by all instruments, 20% were frail by all instruments and 71% had discordant frailty classifications. Those who were frail according to CFS but not by the other instruments had lower cognition and functional status. Those who were frail according to FP but not CFS were, to a larger extent, women, lived alone, had higher cognitive ability and functional status.CONCLUSION: The CFS might not identify physically frail women in older community-dwelling people with multimorbidity. They could thus be at risk of not be given the attention their frail condition need.
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| 1778. |
- Lindh-Rengifo, Magnus, et al.
(författare)
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Predictive Factors of Concerns about Falling in People with Parkinson's Disease : A 3-Year Longitudinal Study
- 2019
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Ingår i: Parkinson's Disease. - : Hindawi Limited. - 2042-0080 .- 2090-8083. ; 2019
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Fear of falling (FOF) is more common in people with Parkinson's disease (PD) than in healthy controls. It can lead to several negative consequences such as restrictions in everyday life. Moreover, FOF is a risk factor for future falls. Aim: This study aimed to identify predictive factors of FOF (conceptualized as concerns about falling) after three years, with and without adjusting for concerns about falling at baseline, in people with PD. Methods: This study included 151 participants (35% women) with PD. At baseline, their mean (SD) age and PD duration were 68 (±9.0) and 9 (±6.1) years, respectively. The Falls Efficacy Scale-International (FES-I) was used as the dependent variable in multivariable linear regression analyses. Results: The mean (SD) FES-I score increased from 28.1 (11.9) to 33.1 (14.0) three years later (p<0.001). The strongest (according to the standardized regression coefficient, β) predictor of concerns about falling was walking difficulties (β = 0.378), followed by age (0.227), problems maintaining balance while dual tasking (0.172), and needing help in daily activities (0.171). When adjusting for baseline FES-I scores, the strongest predictive factor was problems maintaining balance while dual tasking (β = 0.161), which was followed by age (0.131) and female sex (0.105). Conclusions: This study pinpoints several predictive factors of concerns about falling that are modifiable and which could be addressed in rehabilitation: perceived walking difficulties, having problems maintaining balance while dual tasking, and dependence on others in daily activities. The importance of dual tasking is a novel finding, which future studies need to confirm or refute. One should be aware of the fact that an increased age predicts concerns about falling with and without adjusting for baseline FES-I scores, whereas female sex predicts concerns about falling only when adjusting for baseline FES-I scores.
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| 1779. |
- Lindholm, Beata, et al.
(författare)
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Does fatigue in Parkinson’s disease impact one’s physical function in daily live?
- 2023
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Ingår i: Movement Disorders. - 0885-3185. ; 38:Suppl 1, s. 824-824
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Konferensbidrag (refereegranskat)abstract
- Objective: To investigate fatigue at baseline and 3.5 years later and its association with balance and gait over time.Background: In Parkinson’s disease (PD), fatigue is considered one of the most common and disabling nonmotor symptoms that may persist or even worsen over time. Fatigue in generally has been described as a significantly diminished energy level or an increased perception of effort disproportionate to attempted activities. Fatigue has been associated to several nonmotor symptoms (e.g., depression, apathy, anxiety, sleep disturbances) and negatively impact quality of life in cross-sectional PD-studies. However, few studies have investigated fatigue over time and its association with other physical symptoms.Method: A prospective cohort of 70 persons with mild to moderate PD was assessed at baseline and 3.5 years later. Mean (SD) age and PD duration at baseline were 66 (8.9) and 4 (4.0) years, respectively and median (q1-q3) “on” phase motor symptoms (Unified PD Rating Scale, UPDRS, part III) were 11 (7-18). Fatigue was investigated with The Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F, higher=better). Multiple linear regression analysis was performed with FACIT-F scores at baseline as dependent variable and a battery of clinical balance and gait tests targeting functional, reactive, and dynamic balance (Bergs Balance Scale vs Nutt Retropulsion Test vs Tandem gait, respectively), comfortable and fast gait speed and functional mobility (Timed up and go, TUG) as independent variables. The results were controlled for age and motor symptoms.Results: The median (q1-q3) FACIT-F scores at baseline (39 (30-36)) were significantly higher than corresponding value 3.5 years later (33.5 (22.5-41)). Significant association was found between FACIT-F scores at baseline and time needed to perform TUG 3.5 years later (B (95% CI); -0,568 (-0,925, -0.211), P=0.002)). These results suggest more than half a second longer time to perform the TUG for every point/score on the FACIT-F.Conclusion: Fatigue in people with PD seem to increase substantially over a relatively short time of 3.5 years. Fatigue also impacts functional mobility incorporating components of balance and gait ability in PD (gait speed, turning and sit-to-stand transfers). More longitudinal studies are needed to investigate long-term impact of fatigue on physical function in daily live.
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| 1780. |
- Lindström, Britta, et al.
(författare)
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Skeletal muscle fatigue and endurance in young and old men and women
- 1997
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Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - 1079-5006 .- 1758-535X. ; 52A:1, s. B59-B66
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Tidskriftsartikel (refereegranskat)abstract
- The effects of increasing age on skeletal muscle fatigue and endurance were assessed in 22 healthy young (14 men and 8 women; mean age, 28 +/- 6 years) and 16 healthy old (8 men and 8 women; mean age, 73 +/- 3 years) individuals. All subjects performed 100 repeated maximum dynamic knee extensions at 90 degrees.s-1 (1.57 rad.s-1) using an isokinetic dynamometer (Cybex II). Peak torque was recorded during every contraction, and for each individual the maximal voluntary contraction (MVC), the fatigue rate, the endurance level, and the relative reduction in muscle force were determined. MVC and endurance level were significantly lower in old men and women, but there was no discernible difference in relative muscle force reduction and fatigue rate between young and old individuals. We conclude that thigh muscles of older individuals are weaker than those of younger individuals, but relative to their strength, older individuals have similar properties as younger individuals with respect to muscle fatigue and endurance.
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