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  • 1.
    Conradsson, Mia
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundin-Olsson, Lillemor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindelöf, Nina
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Littbrand, Håkan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Malmqvist, Lisa
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Rosendahl, Erik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Berg Balance Scale: intrarater test-retest reliability among older people dependent in activities of daily living and living in residential care facilities2007Inngår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 87, nr 9, s. 1155-1163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Berg Balance Scale (BBS) is frequently used to assess balance in older people, but knowledge is lacking about the absolute reliability of BBS scores. The aim of this study was to investigate the absolute and relative intrarater test-retest reliability of data obtained with the BBS when it is used among older people who are dependent in activities of daily living and living in residential care facilities. The participants were 45 older people (36 women and 9 men) who were living in 3 residential care facilities. Their mean age was 82.3 years (SD=6.6, range=68-96), and their mean score on the Mini Mental State Examination was 17.5 (SD=6.3, range=4-30). The BBS was assessed twice by the same assessor. The intrarater test-retest reliability assessments were made at approximately the same time of day and with 1 to 3 days in between assessments. Absolute reliability was calculated using an analysis of variance with a 95% confidence level, as suggested by Bland and Altman. Relative reliability was calculated using the intraclass correlation coefficient (ICC). The mean score was 30.1 points (SD=15.9, range=3-53) for the first BBS test and 30.6 points (SD=15.6, range=4-54) for the retest. The mean absolute difference between the 2 tests was 2.8 points (SD=2.7, range=0-11). The absolute reliability was calculated as being 7.7 points, and the ICC was calculated to .97. Despite a high ICC value, the absolute reliability showed that a change of 8 BBS points is required to reveal a genuine change in function among older people who are dependent in activities of daily living and living in residential care facilities. This knowledge is important in the clinical setting when evaluating an individual's change in balance function over time in this group of older people.

  • 2.
    Littbrand, Håkan
    et al.
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Rosendahl, Erik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lindelöf, Nina
    Umeå, Geriatrisk centrum.
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering.
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Nyberg, Lars
    A high-intensity functional weight-bearing exercise program for older people dependent in activities of daily living and living in residential care facilities: evaluation of the applicability with focus on cognitive function2006Inngår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 86, nr 4, s. 489-98Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: Knowledge concerning the applicability and the effect of high-intensity exercise programs is very limited for older people with severe cognitive and physical impairments. The primary aim of this study was to evaluate the applicability of a high-intensity functional weight-bearing exercise program among older people who are dependent in activities of daily living and living in residential care facilities. A second aim was to analyze whether cognitive function was associated with the applicability of the program. SUBJECTS: The subjects were 91 older people (mean age=85.3 years, SD=6.1, range=68-100) who were dependent in personal activities of daily living and randomly assigned to participate in an exercise intervention. Their mean score for the Mini-Mental State Examination (MMSE) was 17.5 (SD=5.0, range=10-29). METHODS: A high-intensity functional weight-bearing exercise program was performed in groups of 3 to 7 participants who were supervised by physical therapists. There were 29 exercise sessions over 13 weeks. Attendance, intensity of lower-limb strength and balance exercises, and occurrence and seriousness of adverse events were the outcome variables in evaluating the applicability of the program. RESULTS: The median attendance rate was 76%. Lower-limb strength exercises with high intensity were performed in a median of 53% of the attended exercise sessions, and balance exercises with high intensity were performed in a median of 73% of the attended exercise sessions. The median rate of sessions with adverse events was 5%. All except 2 adverse events were assessed as minor and temporary, and none led to manifest injury or disease. No significant differences were observed in applicability when comparing participants with dementia and participants without dementia. In addition, there was no significant correlation between applicability and the MMSE score. DISCUSSION AND CONCLUSION: The results suggest that a high-intensity functional weight-bearing exercise program is applicable for use, regardless of cognitive function, among older people who are dependent in activities of daily living, living in residential care facilities, and have an MMSE score of 10 or higher.

  • 3.
    Nordin, Ellinor
    et al.
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering.
    Rosendahl, Erik
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering.
    Timed "Up & Go" test: reliability in older people dependent in activities of daily living - focus on cognitive state2006Inngår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 86, nr 5, s. 646-55Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: It is unknown how cognitive impairment affects the reliability of Timed "Up & Go" Test (TUG) scores. The aim of the present study was to investigate the expected variability of TUG scores in older subjects dependent in activities of daily living (ADL) and with different levels of cognitive state. The hypothesis was that cognitive impairment would increase the variability of TUG scores. SUBJECTS: Seventy-eight subjects with multiple impairments, dependent in ADL, and living in residential care facilities were included in this study. The subjects were 84.8+/-5.7 (mean+/-SD) years of age, and their Mini-Mental State Examination score was 18.7+/-5.6. METHODS: The TUG assessments were performed on 3 different days. Intrarater and interrater analyses were carried out. RESULTS: Cognitive impairment was not related to the size of the variability of TUG scores. There was a significant relationship between the variability and the time taken to perform the TUG. The intraclass correlations were greater than .90 and were similar within and between raters. In repeated measurements at the individual level, an observed value of 10 seconds was expected to vary from 7 to 15 seconds and an observed value of 40 seconds was expected to vary from 26 to 61 seconds for 95% of the observations. DISCUSSION AND CONCLUSION: The measurement error of a TUG assessment is substantial for a frail older person dependent in ADL, regardless of the level of cognitive function, when verbal cuing is permitted during testing. The variability increases with the time to perform the TUG. Despite high intraclass correlation coefficients, the ranges of expected variability can be wide and are similar within and between raters. Physical therapists should be aware of this variability before they interpret the TUG score for a particular individual.

  • 4.
    Skjaerven, Liv H.
    et al.
    Department of Physiotherapy, Faculty of Health and Social Sciences, Bergen University College.
    Kristoffersen, Kjell
    Faculty of Health and Sport, University of Agder, Kristiansand.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    How can movement quality be promoted in clinical practice?: a phenomenological study of physical therapist experts2010Inngår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 90, nr 10, s. 1479-1492Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background In recent years, physical therapists have paid greater attention to body awareness. Clinicians have witnessed the benefits of supporting their patients' learning of movement awareness through the promotion of their movement quality. Objective The aim of this study was to investigate how physical therapist experts promote movement quality in their usual clinical settings. Design A phenomenological research design that included a sampling strategy was devised. Using specific criteria, 6 lead physical therapists nominated a group of physical therapist experts from the fields of neurology, primary health care, and mental health. Fifteen informants, 5 from each field, agreed to participate. Methods In-depth interviews were conducted with a semistructured interview guide. The informants were invited to simply describe what they had experienced to be successful therapeutic processes for promoting movement quality. Each interview was audiotaped and transcribed. The data analysis was based on a multistep model. Results Three main themes emerged from the data. First, the physical therapists' embodied presence and movement awareness served as a precondition and an orientation for practice. Embodied presence is a bodily felt sense, a form of personal knowing that evokes understanding and fosters meaning. Second, creating a platform for promoting movement quality revealed implementation of psychological attitudes. Third, action strategies for promoting movement quality suggested a movement awareness learning cycle and components for clinical use. Conclusions This study demonstrated specific attitudes and skills used by physical therapist experts to promote movement quality in their clinical practice. These results may serve as a therapeutic framework for promoting movement quality in clinical physical therapy, although further research is needed.

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