| 1. |
- Arkkukangas, Marina, et al.
(author)
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Older persons' experiences of a home-based exercise program with behavioral change support
- 2017
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In: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 33:12, s. 905-913
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Journal article (peer-reviewed)abstract
- Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons.Purpose: This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change.Methods: Semi-structured interviews were conducted with 12 elderly persons aged 75years or older, and a qualitative content analysis was performed.Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.Conclusion: With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.
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| 2. |
- Demmelmaier, Ingrid, 1960-, et al.
(author)
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Does exercise intensity matter for fatigue during (neo-)adjuvant cancer treatment? The Phys-Can randomized clinical trial
- 2021
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In: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 31:5, s. 1144-1159
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Journal article (peer-reviewed)abstract
- Exercise during cancer treatment improves cancer-related fatigue (CRF), but the importance of exercise intensity for CRF is unclear. We compared the effects of high- vs low-to-moderate-intensity exercise with or without additional behavior change support (BCS) on CRF in patients undergoing (neo-)adjuvant cancer treatment. This was a multicenter, 2x2 factorial design randomized controlled trial (Clinical Trials NCT02473003) in Sweden. Participants recently diagnosed with breast (n = 457), prostate (n = 97) or colorectal (n = 23) cancer undergoing (neo-)adjuvant treatment were randomized to high intensity (n = 144), low-to-moderate intensity (n = 144), high intensity with BCS (n = 144) or low-to-moderate intensity with BCS (n = 145). The 6-month exercise intervention included supervised resistance training and home-based endurance training. CRF was assessed by Multidimensional Fatigue Inventory (MFI, five subscales score range 4-20), and Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F, score range 0-52). Multiple linear regression for main factorial effects was performed according to intention-to-treat, with post-intervention CRF as primary endpoint. Overall, 577 participants (mean age 58.7 years) were randomized. Participants randomized to high- vs low-to-moderate-intensity exercise had lower physical fatigue (MFI Physical Fatigue subscale; mean difference −1.05 [95% CI: −1.85, −0.25]), but the difference was not clinically important (ie <2). We found no differences in other CRF dimensions and no effect of additional BCS. There were few minor adverse events. For CRF, patients undergoing (neo-)adjuvant treatment for breast, prostate or colorectal cancer can safely exercise at high- or low-to-moderate intensity, according to their own preferences. Additional BCS does not provide extra benefit for CRF in supervised, well-controlled exercise interventions.
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| 3. |
- Kyhlbäck, Maria, et al.
(author)
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Postoperativ rehabilitering vid ländryggsdiskbråck
- 2011
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In: Fysioterapi. - : Fysioterapeuterna,Swedish Association of Registered Physiotherapists. - 1653-5804. ; :1, s. 32-37
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Journal article (peer-reviewed)abstract
- Sedan några årtionden tillbaka är diskbråcksoperation en standardoperation som utförs på liknande sätt vid Sveriges ortopedkliniker. Det postoperativa omhändertagandet och rehabiliteringen av opererade patienter kan dock se olika ut, beroende på var operationen skett. Under 2008/09 har en grupp sjukgymnaster från olika delar av landet tagit fram nationella riktlinjer, baserat på vetenskaplig evidens och klinisk erfarenhet, vilket tidigare saknats för dessa patienter. Konklusionen är att sjukgymnastiken efter diskbråcksoperation bör vara inriktad på tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation, även om de positiva effekterna av den postoperativa träningen måste betraktas som kortsiktiga. En tidig återgång till aktiviteter som inkluderar ett aktivt förhållningssätt ger, förutom de kortsiktiga förbättringarna, troligen en positiv påverkan på patienternas inställning till smärta och aktivitet. Förhoppningen är att den aktuella, systematiskt sammanställda kunskapen ska bidra till diskussioner på enskilda arbetsplatser och att behandlingsrekommendationerna kan anpassas till lokala förhållanden.
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| 4. |
- Kyhlbäck, Maria, et al.
(author)
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Postoperativ rehabilitering vid ländryggsdiskbråck
- 2011
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In: Fysioterapi. - Stockholm. - 1653-5804. ; :1, s. 32-37
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Journal article (other academic/artistic)abstract
- Bakgrund och syfte:Under 2008 har en grupp sjukgymnaster tagit fram nationella behandlingsriktlinjer för patienter som genomgått diskbråcksoperation. Syftet var att dessa skulle baseras på vetenskaplig evidens och klinisk erfarenhet.Metoder:Litteratursökning gjordes i sju olika databaser, sökningen omfattade randomiserade, kontrollerade studier under tidsperioden 1990-2008. Inkluderade studier granskades utifrån ett modifierat kvalitetsindex enligt SBU (Statens Beredning för medicinsk Utvärdering). För bevisvärdering av studieresultat användes SBU:s gradering högt, medelhögt och lågt bevisvärde. Evidensgrad för olika sjukgymnastiska metoder som förekom i de inkluderade studierna kategoriserades i enlighet med SBU:s nivåer för vetenskaplig evidens; starkt vetenskapligt underlag, måttligt starkt vetenskapligt underlag, begränsat vetenskapligt underlag och otillräckligt vetenskapligt underlag. Resultat:Sexton artiklar som uppfyllde kriterierna för granskning inkluderades i granskningen.Baserat på dessa studier finns måttligt stark evidens för att aktiv träning som inkluderar ett mer aktivt förhållningssätt är mer effektiv på kort sikt än mer försiktig/passiv träning och förhållningssätt (< 6 månader efter operation). Det finns ett starkt vetenskapligt stöd för att den aktiva träningen inte påverkar smärta och funktion på lång sikt (ett år efter operation), liksom att tidig, aktiv träning inte ökar komplikationsrisken efter operation. Det vetenskapliga stödet är begränsat vad gäller de positiva effekterna av enbart råd om fysisk aktivitet, motsägande beträffande effekten av övervakad träning jämfört med hemträning och otillräckligt beträffande effekten av beteendemedicinskt inriktad träning.Konklusion:Sjukgymnastiken efter diskbråcksoperation bör ha ett aktivt förhållningssätt inkluderande tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation.
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| 5. |
- Adler, Anneli, et al.
(author)
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Variation of growth and phenology traits in poplars planted in clonal trials in Northern Europe-implications for breeding
- 2021
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In: BioEnergy Research. - : Springer Science and Business Media LLC. - 1939-1234 .- 1939-1242. ; 14, s. 426-444
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Journal article (peer-reviewed)abstract
- The increased demand for wood to replace oil-based products with renewable products has lifted focus to the Baltic Sea region where the environment is favorable for woody biomass growth. The aim of this study was to estimate broad-sense heritabilities and genotype-by-environment (GxE) interactions in growth and phenology traits in six climatically different regions in Sweden and the Baltics. We tested the hypothesis that both bud burst and bud set have a significant effect on the early growth of selected poplar clones in Northern Europe. Provenance hybrids of Populus trichocarpa adapted to the Northern European climate were compared to reference clones with adaptation to the Central European climate. The volume index of stemwood was under low to medium genetic control with heritabilities from 0.22 to 0.75. Heritabilities for phenology traits varied between 0.31 and 0.91. Locally chosen elite clones were identified. GxE interactions were analyzed using pairwise comparisons of the trials. Three different breeding zones for poplars between the latitudes of 55 degrees N and 60 degrees N in the Baltic Sea Region were outlined. The studied provenance hybrids with origin from North America offer a great possibility to broaden the area with commercial poplar plantations in Northern Europe and further improve the collection of commercial clones to match local climates. We conclude that phenology is an important selection criterion after growth.
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| 6. |
- Andersson, Christin, et al.
(author)
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Differential CSF biomarker levels in APOE-epsilon4-positive and -negative patients with memory impairment.
- 2007
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In: Dementia and geriatric cognitive disorders. - Basel : S. Karger AG. - 1420-8008 .- 1421-9824. ; 23:2, s. 87-95
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To investigate the relationships between episodic memory, APOE genotype, CSF markers (total tau, T-tau; phospho-tau, P-tau; beta-amyloid, Abeta42) and longitudinal cognitive decline. METHODS: 124 memory clinic patients were retrospectively divided into 6 groups based on (i) episodic memory function (Rey Auditory Verbal Learning Test, RAVLT): severe, moderate or no impairment (SIM, MIM or NIM), and (ii) APOE genotype (epsilon4+ or epsilon4-). CSF marker levels and cognitive decline were compared across groups. RESULTS: Episodic memory function, according to RAVLT scores, was significantly correlated with CSF marker levels only among epsilon4+ subjects and not among epsilon4- subjects. When comparing the 6 subgroups, SIM epsilon4+ and MIM epsilon4+ groups showed significantly lower Abeta42 levels than the other groups. T-tau and P-tau levels were significantly increased in SIM epsilon4+ when compared to all the other groups, including the SIM epsilon4- group. However, both SIM epsilon4+ and SIM epsilon4- declined cognitively during the follow-up. CONCLUSION: It remains to be determined whether APOE genotype affects the expression of biomarkers in CSF, or whether the different biomarker patterns reflect different types of disease processes in patients with progressive cognitive dysfunction.
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| 7. |
- Andersson, Christin, et al.
(author)
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Identifying patients at high and low risk of cognitive decline using Rey Auditory Verbal Learning Test among middle-aged memory clinic outpatients
- 2006
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 21:4, s. 251-259
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To investigate whether application of cutoff levels in an episodic memory test (Rey Auditory Verbal Learning Test, RAVLT) is a useful method for identifying patients at high and low risk of cognitive decline and subsequent dementia. METHODS: 224 patients with memory complaints (mean age = 60.7 years, mean MMSE = 28.2) followed-up at a memory clinic over approximately 3 years were assigned retrospectively to one of three memory groups from their baseline results in RAVLT [severe (SIM), moderate (MIM) or no impairment (NIM)]. These groups were investigated regarding cognitive decline. RESULTS: Patients assigned to SIM showed significant cognitive decline and progressed to dementia at a high rate, while a normal performance in RAVLT at baseline (NIM) predicted normal cognition after 3 years. Patients with MIM constituted a heterogeneous group; some patients deteriorated cognitively, while the majority remained stable or improved. CONCLUSIONS: The application of cutoff levels in RAVLT at baseline showed that patients with severely impaired RAVLT performance were at a high risk of cognitive decline and progression to dementia, while patients with normal RAVLT results did not show cognitive decline during 3 years. Furthermore, the initial degree of memory impairment was decisive in the cognitive prognosis 3 years later.
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| 8. |
- Andersson, Christin, et al.
(author)
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Increasing CSF phospho-tau levels during cognitive decline and progression to dementia
- 2008
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In: Neurobiology of Aging. - : Elsevier BV. - 0197-4580 .- 1558-1497. ; 29:10, s. 1466-1473
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Journal article (peer-reviewed)abstract
- BACKGROUND: Little is known about longitudinal changes of cerebrospinal fluid (CSF) biomarkers during cognitive decline in neurodegenerative disease progression. OBJECTIVE: To investigate longitudinal changes in CSF biomarkers--total-tau (T-tau), phospho-tau (P-tau) and beta-amyloid (Abeta42)--during cognitive decline. METHODS: Forty memory clinic patients (47.5% females), aged 61.3+/-7.6 (S.D.) years, non-demented at baseline, underwent lumbar puncture and neuropsychological testing at two occasions. Baseline mean MMSE-score was 28.3+/-1.8. Patients were divided into three groups based on baseline memory functioning; severely impaired (SIM), moderately impaired (MIM) and no impairment (NIM). RESULTS: There was a significant increase in P-tau in the SIM-group during follow-up, while P-tau in MIM and NIM did not change. Eighty-three percent of the SIM-patients converted to dementia (80% AD), while most MIM- and NIM-patients remained non-demented. T-tau- and Abeta42-levels did not change in any of the memory groups during follow-up. CONCLUSION: Increasing P-tau levels during cognitive decline and conversion to dementia suggest that P-tau may be useful as a longitudinal marker of the neurodegenerative process.
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| 9. |
- Arkkukangas, Marina, et al.
(author)
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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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In: Preventive Medicine Reports. - : Elsevier. - 2211-3355. ; 2, s. 134-140
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Journal article (peer-reviewed)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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| 10. |
- Arkkukangas, Marina
(author)
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Evaluation of the Otago Exercise Programme with or without motivational interviewing : Feasibility, experiences, effects and adherence among older community-dwelling people
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Falls and injuries related to falls are one of the most common health problems among older people and are becoming increasingly more frequent. Regular exercise has been identified as one of the most effective fall-prevention activities for older people; however, awareness of the impact of exercise programmes and adherence to recommended exercise among the elderly population is generally low. Research examining how an exercise programme is administered to and experienced by elderly community-dwelling people is needed.The overall aim of this thesis was to investigate the feasibility, experiences and effects of and adherence to the fall-preventive Otago Exercise Programme (OEP) with or without motivational interviewing (MI) among community-dwelling people aged 75 years or older.Four studies were performed from October 2012 to May 2016 in a sample of 175 people. Both quantitative and qualitative research methods were used. The methods included the feasibility for conducting a randomized controlled trial (RCT) (I), individual face-to-face interviews (II), an RCT (III) and a prospective cohort study (IV). The intervention was given to two groups. The participants who received OEP with or without MI were compared with a control group that received standard care.The feasibility of performing an exercise intervention with or without MI was acceptable from the perspective of the participating physiotherapists. From the perspective of the older participants performing the exercise with behavioural change support, the inclusion of monitored exercises in everyday life and daily routines was important. The participants also expressed experiencing more strength, improved physical functioning and greater hope for an extended active life during old age.From the short-term perspective, there were significant improvements within the OEP combined with MI group in terms of physical performance, fall self-efficacy, activity level, and handgrip strength. Improved physical performance and fall self-efficacy were also found within the control group; however, corresponding differences did not occur in the OEP group without MI. There were no significant differences between the study groups after 12 weeks of regular exercise. Adherence to the exercises in the pooled exercise group was 81% at the 12-week follow-up.At the 52-week follow-up, the behavioural factors being physically active and obtaining behavioural support in terms of MI had a significant association with adherence to the exercise programme.These studies provide some support for the combination of OEP with MI as the addition of MI was valuable for achieving adherence to the exercise programme over time in older community-dwelling people.
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