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  • 1.
    Burgueño, Rafael
    et al.
    Department of Education, University of Almeria, Almeria, Spain.
    Lindqvist, Anna-Karin
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Chillon, Palma
    PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
    Rutberg, Stina
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Basic psychological need satisfaction in active commuting to and from school BPNS-ACS(SWE)2023Inngår i: Journal of Transport & Health, ISSN 2214-1405, E-ISSN 2214-1413, Vol. 30, artikkel-id 101618Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    The absence of appropriate Swedish-language instrumentation to assess active commuting to school has largely hampered the study of the individual factors of the children, such as autonomy, competence, and relatedness to active commuting to school.

    Purpose

    Building upon self-determination theory, the objective of this research was to gather evidence of the validity and reliability of the Swedish version of the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) tool.

    Methods

    The cross-sectional and purposive sample included 273 children (51.28% girls) from urban areas.

    Results

    Confirmatory factor analysis underpinned the three-factor correlated model, which was invariant across gender. Evidence in support of discriminant and convergent validity and reliability was gathered. Criterion validity evidence was met by positive and significant predictions of autonomy, competence, and relatedness satisfaction on active commuting to and from school.

    Conclusions

    The Swedish version of the BPNS-ACS is a psychometrically robust measure of children’s perceptions of autonomy, competence, and relatedness satisfaction in active commuting to school and could be used to assess the effects of school-based interventions on need satisfaction for active commuting to school.

    Fulltekst (pdf)
    fulltext
  • 2.
    Burgueño, Rafael
    et al.
    Faculty of Education, University of Zaragoza, Zaragoza, Spain; Health Research Centre, University of Almeria, Almeria, Spain.
    Rutberg, Stina
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Pauelsen, Mascha
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Chillon, Palma
    PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
    Lindqvist, Anna-Karin
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Adapting the behavioral regulation in active commuting to and from school questionnaire in Sweden: BR-ACS(SWE)2022Inngår i: Transportation Research Interdisciplinary Perspectives, ISSN 2590-1982, Vol. 16, artikkel-id 100721Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Although growing attention has been paid to motivation in explaining active travel to school among young people at the international level, no measures of motivation for active commuting to school (ACS) were found in Sweden. Guided by self-determination theory, this research aimed to adapt the Behavioral Regulation in Active Commuting to and from School (BR-ACS) questionnaire to the Swedish context and test the resulting version’s psychometric properties. The purposive and cross-sectional sample included 273 students (58 % girls, aged 10–12 years) from four Swedish urban schools. Results from confirmatory factor analyses psychometrically supported the six-factor correlated model (intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, and amotivation) and the hierarchical three-factor model (autonomous, controlled motivation, and amotivation), which were invariant across gender. Latent correlations underpinned a symplex-like pattern. Discriminant and convergent validity and reliability were gathered. Criterion validity evidence was met with positive associations from intrinsic motivation, integrated and identified regulation to ACS, and a negative relationship between amotivation and ACS. The Swedish version of the BR-ACS questionnaire is a valid and reliable measure of children’s motivation toward ACS.

  • 3.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordin, Catharina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Eriksson, Margareta K.
    Department of Public Health, Norrbotten County Council, Luleå.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial2017Inngår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 21, nr 6, s. 1110-1120Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUNDWeb-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life.METHODSWe included 99 participants with persistent musculoskeletal pain in a randomized study with two intervention arms: (1) MMR and web-based intervention, and (2) MMR. Data was collected at baseline, 4 and 12 months. Outcome measures were work ability, working percentage, average pain intensity, pain-related disability, and health-related quality of life.RESULTSThere were no significant effects of adding the web-based intervention to MMR regarding any of the outcome variables.CONCLUSIONSThis trial provides no support for adding a self-guided, web-based activity programme to MMR for patients with persistent musculoskeletal pain.SIGNIFICANCEThe comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations

  • 4.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordin, Catharina
    Department of Primary health care, Norrbotten County Council .
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Physiotherapy in combination with personalized counseling and a web-based programme for persistent pain: an early stage evaluationManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Objective

    We evaluated first a self-managed web-based programme for activity compared to waiting list for persons with persistent musculoskeletal pain suited for primary health care. Thereafter, we evaluated the effects and process of a novel multimodal treatment intervention combining the web programme with counselling and physiotherapy. 

     

    Design

    A weekly comparison of measures of outcome data between those using the self-managed web-based programme to those on a waiting list. After that a Single Subject Experimental Design (SSED) evaluation of the multimodal intervention, structured interviews and log data.

     

    Setting

    Clinical setting in primary health care.

     

    Subjects

    Ten participants with persistent musculoskeletal pain.

     

    Intervention

    First, only a self-managed web-based programme for activity. Thereafter a multimodal intervention combining the web programme with counselling and physiotherapy.

     

    Main measures

    Effect measures were work ability, pain intensity, disability and self-efficacy. Process evaluation by interviews of the participants and log data of usage of the modalities.

     

    Results

    There were no conclusive effects of the self-managed web-based programme as compared to waiting list. The SSED analyses of the multi-modal showed promising short-term results regarding disability and pain intensity, but no conclusive results for work ability or self-efficacy. The multimodal intervention process seemed successfully implemented, and the importance of physiotherapy and to some extent counselling was emphasized by the participants.

     

    Conclusion

    For persons with persistent musculoskeletal pain, the newly designed multimodal intervention in primary care seemed feasible and showed some promising short-terms effects, while the implementation of a self-managed web-based programme as a single intervention seemed without effect. 

  • 5.
    Elbe, Pia
    et al.
    Department of Psychology, Umeå University, Umeå, Sweden; Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.
    Marsja, Erik
    Disability Research Division, Department of Behavioural Sciences and Learning, Linköping University.
    Sörman, Daniel
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering. Department of Psychology, Umeå University, Umeå, Sweden.
    Vega-Mendoza, Mariana
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering. Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden; Department of Radiation Sciences and Radiology, UmeåUniversity, Umeå, Sweden; Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway; Department for IntegrativeMedical Biology, Umeå University, Umeå, Sweden.
    Körning-Ljungberg, Jessica
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Effects of auditory and tactile distraction in adults with low and high ADHD symptoms2024Inngår i: Journal of Cognitive Psychology, ISSN 2044-5911, E-ISSN 2044-592XArtikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to investigate whether symptoms of attention deficit hyperactivity disorder (ADHD) impact distraction by unexpected deviant sounds and vibrations. The hypothesis was that there would be a difference between individuals with low and high ADHD symptom severity in deviance distraction. In a cross-modal oddball task, we measured the impact of to-be-ignored deviating auditory and vibro-tactile stimuli in 45 adults who were 18 years or older, and self-reported ADHD symptoms using the screening tool of the adult ADHD self-report scale (ASRS). Results did not show a difference between groups with low and high symptoms of ADHD in their propensity for distraction in any modality using both frequentist and Bayesian methods of analysis. The impact of the deviating sounds and vibrations on performance were similar between groups. However, the amount of missed trials, which possibly reflects mind wandering or attention away from the focal task, was higher in the high symptom group (0.5 % difference in missing data between groups). The findings indicate a difference in missed responses between groups, despite no differences in the likelihood of distraction being indicated between vibro-tactile and auditory modalities. Overall, the complexity of adult ADHD symptomatology, especially behavioral differences in attentional control is reflected in the results of this study.

    Fulltekst (pdf)
    fulltext
  • 6.
    Elinge, Eva
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Löfgren, Britta
    Umeå University, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Gagerman, Eva
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    A group learning programme for old people with hip fracture: a randomized study2003Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 10, nr 1, s. 27-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to examine whether a group learning programme would influence the participants' perceived activity performance and ability to participate in social life after a hip fracture. The study comprised 35 people aged 54-90 years with hip fracture who had completed ordinary care and rehabilitation after their hip fractures. They were randomized to an intervention group (n=21) or to a control group (n=14). The intervention group participated in the group learning programme, while the control group received no intervention. Directly after the intervention and at 12 months after the intervention, no significant change was seen in either group, regarding the ability to perform ADL activities measured by the Barthel ADL index, or the performance of activities that were identified as important to the individual. However, in the intervention group, the number of ADL items perceived to be performed with difficulties decreased, and the perceived ability to participate in social life increased. These changes were not found in the control group. When analysed between groups, however, the only significant difference was the ability to participate in social life after the intervention. Further research is needed to investigate whether an intensive or prolonged period of rehabilitation, at the hospital or in the patient's home, would increase the ability to resume meaningful participation in social life

  • 7.
    Elinge, Eva
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Cognitive impairment and hip fracture2003Inngår i: International Journal of Therapy and Rehabilitation, ISSN 1741-1645, E-ISSN 1759-779X, Vol. 10, nr 6, s. 285-Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    There would be few therapists who would whole-heartedly disagree with Staincliffe's (vol 10(4), 2003, p.151) argument for supplying powered mobility to younger disabled children. Even without the sanction of UNICEF and government policy, our moral conscience tells us that children with motor impairment have the right to unimpeded access to their environment. It is the practicalities that impact on opinion.

  • 8.
    Elinge, Eva
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Stenvall, Michael
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    von Heideken Wågert, Petra
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Löfgren, Britta
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Daily life among the oldest old with and without previous hip fractures2005Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 12, nr 2, s. 51-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this cross-sectional study was to describe the oldest old, with and without previous hip fracture with regard to their ability to perform personal and instrumental activities of daily living (ADL); home adaptations received; possession of assistive devices; perceived health and morale. A random sample drawn from the population of 85-year-olds, all 90-year-olds and all > or =95-year-olds (n =253) in Umea, a city in northern Sweden, were examined. Data obtained from assessments and interviews carried out in the participants' homes, as well as data from medical charts, were analysed. Those with an earlier hip fracture (n = 58) had more difficulties in performing both personal and instrumental ADLs than those without (n = 195) but regarding individual home adaptations and the possession of assistive devices for personal care, no differences were detected between the groups. Self-perceived health and morale were equally good in both groups. The conclusion drawn is that lifelong consequences, in the form of reduced abilities to perform ADLs and wheelchair dependency are common among the oldest old after a hip fracture. Therefore, trials concerning the effects of more extensive and prolonged rehabilitation following hip fracture would be of great interest

  • 9.
    Falk, Jimmy
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Strandkvist, Viktor
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Pauelsen, Mascha
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Increased co-contraction reaction during a surface perturbation is associated with unsuccessful postural control among older adults2022Inngår i: BMC Geriatrics, E-ISSN 1471-2318, Vol. 22, nr 1, artikkel-id 438Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: As a strategy to maintain postural control, the stiffening strategy (agonist-antagonist co-contractions) is often considered dysfunctional and associated with poor physical capacity. The aim was to investigate whether increased stiffening is associated with unsuccessful postural control during an unpredictable surface perturbation, and which sensory and motor variables that explain postural stiffening.

    Methods: A sample of 34 older adults, 75.8 ± 3.8 years, was subjected to an unpredicted surface perturbation with the postural task to keep a feet-in-place strategy. The participants also completed a thorough sensory- and motor test protocol. During the surface perturbation, electromyography was measured from tibialis anterior and gastrocnemius to further calculate a co-contraction index during the feed-forward and feedback period. A binary logistic regression was done with the nominal variable, if the participant succeeded in the postural task or not, set as dependent variable and the co-contraction indexes set as independent variables. Further, the variables from the sensory and motor testing were set as independent variables in two separate Orthogonal Projections of Latent Structures (OPLS)-models, one with the feed-forward- and the other with the feedback co-contraction index as dependent variable.

    Results: Higher levels of ankle joint stiffening during the feedback, but not the feed-forward period was associated with postural task failure. Feedback stiffening was explained by having slow non-postural reaction times, poor leg muscle strength and being female whereas feed-forward stiffening was not explained by sensory and motor variables.

    Conclusions: When subjected to an unpredicted surface perturbation, individuals with higher feedback stiffening had poorer postural control outcome, which was explained by poorer physical capacity. The level of feed-forward stiffening prior the perturbation was not associated with postural control outcome nor the investigated sensory and motor variables. The intricate causal relationships between physical capacity, stiffening and postural task success remains subject for future research.

    Fulltekst (pdf)
    fulltext
  • 10.
    Forsberg, Hanna
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Lindqvist, Anna-Karin
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Forward, Sonja
    Swedish Road and Transport Research Institute, VTI, 581 95 Linköping, Sweden.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Rutberg, Stina
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Development and Initial Validation of the PILCAST Questionnaire: Understanding Parents’ Intentions to Let Their Child Cycle or Walk to School2021Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, nr 21, artikkel-id 11651Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Children generally do not meet the recommendation of 60 min of daily physical activity (PA); therefore, active school transportation (AST) is an opportunity to increase PA. To promote AST, the involvement of parents seems essential. Using the theory of planned behavior (TPB), the aim was to develop and validate the PILCAST questionnaire to understand parents’ intentions to let their child cycle or walk to school. Cross-sectional sampling was performed, where 1024 responses were collected from parents. Confirmatory factor analysis indicated acceptable fit indices for the factorial structure according to the TPB, comprising 32 items grouped in 11 latent constructs. All constructs showed satisfying reliability. The regression analysis showed that the TPB explained 55.3% of parents’ intentions to let the child cycle to school and 20.6% regarding walking, increasing by a further 18.3% and 16.6%, respectively, when past behavior was added. The most influential factors regarding cycling were facilitating perceived behavioral control, positive attitudes, subjective and descriptive norms, and for walking, subjective and descriptive norms. The PILCAST questionnaire contributes to a better understanding of the psychological antecedents involving parents’ decisions to let their child cycle or walk to school, and may therefore provide guidance when designing, implementing and evaluating interventions aiming to promote AST.

  • 11.
    Forsberg, Hanna
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Rutberg, Stina
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Lindqvist, Anna-Karin
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Children's intervention participation is associated with more positive beliefs towards active school transportation among parents2023Inngår i: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 38, nr 2, artikkel-id daad016Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Insufficient physical activity among children is a critical issue and health promoting initiatives are required to reverse this trend. In response to the current situation, a school-based intervention aiming to increase physical activity with the aid of active school transportation (AST) was implemented in one municipality in northern Sweden. By adopting the framework of the Theory of Planned Behavior, we aimed to analyse beliefs among parents whose children were or were not involved in the AST intervention. All municipality schools were included. There were 1024 responses from parents, comprising 610 who responded either 'yes' or 'no' to participating in the intervention. An adjusted linear regression analysis showed that children's intervention participation was significantly associated with more positive beliefs towards AST among parents. These results indicates that it is possible to influence beliefs that are important in the parental decision-making process by the use of an AST intervention. Therefore, to make children´s active transport to school the more favorable choice for parents, it seems to be worthwhile to not only give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.Not enough physical activity among children is an important issue and health promoting initiatives are needed to reverse this trend. In response to the current situation, a school-based intervention aiming to increase physical activity using active school transportation (AST) was implemented in one municipality in northern Sweden. Using the Theory of Planned Behaviour framework, we aimed to analyse beliefs among parents whose children were or were not involved in the AST intervention. Children’s participation in the intervention was significantly associated with more positive beliefs towards AST among parents. These results indicate that it is possible to influence beliefs that are important in the parental decision-making process by the use of an AST intervention. Therefore, to make children’s active transport to school the more favourable choice for parents, it seems to be worthwhile to not only give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.

    Fulltekst (pdf)
    fulltext
  • 12.
    Gard, Gunvor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Zingmark, Karin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Eriksson, Margareta K.
    Department of Public Health, Norrbotten County Council, Luleå.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordin, Catharina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Calner, Tommy
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Multimodal pain rehabilitation (MMR) with additional tailored web-based pain rehabilitation: an RCT study2014Konferansepaper (Annet vitenskapelig)
  • 13.
    Gustafson, Yngve
    et al.
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Nyberg, Lars
    Ramnemark, Anna
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Fallolyckor och frakturer inom äldrevården: Accidental falls and fractures in geriatric care1994Inngår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 71, nr 1, s. 26-31Artikkel i tidsskrift (Annet vitenskapelig)
  • 14.
    Hasselgren, Lotta
    et al.
    Geriatric Centre, Umeå University Hospital.
    Olsson, Lillemor Lundin
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Is leg muscle strength correlated with functional balance and mobility among inpatients in geriatric rehabilitation?2011Inngår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 52, nr 3, s. E220-E225Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Determinants of previous termfunctional balance and mobilitynext term have rarely been investigated in geriatric wards. This study examined if leg muscle previous termstrengthnext term correlates to previous termfunctional balance and mobilitynext term among geriatric inpatients. Fifty inpatients, 29 women and 21 men (mean age 79.6 years) were included. previous termFunctional balancenext term was assessed with the Berg previous termBalancenext term Scale (BBS) and previous termmobilitynext term was assessed with the Physiotherapy Clinical Outcome Variable Scale (COVS). previous termStrengthnext term in the leg extension muscles was measured as 1 Repetition Maximum (1RM) in a leg press and previous termstrengthnext term in the ankle muscles was measured with Medical Research Council grades (MRC, 0–5). The sum scores, and most of the single items, of the BBS and the COVS significantly previous termcorrelatednext term to 1RM/body weight, ankle dorsiflexion, and plantar flexion. In a stepwise multiple regression, ankle dorsiflexion and 1RM/body weight together accounted for 39% of the variance of the BBS and 41% of the variance of the COVS. Estimated values of the BBS and the COVS can be calculated from the equation. In clinical work, the knowledge about how leg muscle previous termstrengthnext term associates with previous termbalance and mobilitynext term may be useful in analyzing underlying causes of reduced previous termbalance and mobilitynext term function, and in planning rehabilitation programs.

  • 15. Hasselgren-Nyberg, Lotta
    et al.
    Omgren, Marie
    Norrlands universitetssjukhus, Geriatriskt centrum.
    Nyberg, Lars
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    S-COVS: Den svenske versionen av physical clinical outcome variables1997Inngår i: Nordisk fysioterapi, ISSN 1402-3024, Vol. 1, nr 3, s. 109-113Artikkel i tidsskrift (Annet vitenskapelig)
  • 16.
    Holmgren, Eva
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lindström, Britta
    Umeå University, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Gosman-Hedström, Gunilla
    Vårdalinstitutet.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wester, Per
    Department of Public Health and Clinical Medicine, Umeå Stroke Center, Umeå University.
    What is the benefit of a high intensive exercise program?: a randomized controlled trial2010Inngår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, nr 3, s. 115-124Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to evaluate a high intensive exercise program in stroke subjects with risk of falls regarding balance, activities of daily life, falls efficacy, number of falls and lifestyle activities. The intervention program contained high intensity functional exercises (HIFE) implemented to real-life situations together with education on falls and security aspects. This was a single-center, single-blinded, randomized controlled trial. Consecutive >55-year-old patients with risk of falls were enrolled and randomized 36 months after first or recurrent stroke to the intervention group (IG, n=15) or to the control group (CG, n=19) who received group discussions about hidden dysfunctions after stroke. Outcomes were Berg Balance Scale (BBS) primarily, Barthel Index (BI), Falls Efficacy Scale International (FES-I) and number of falls secondarily and Frenchay Activities Index last 3 months (FAI-3) tertially. Assessments were done at baseline, post-intervention, 3- and 6-month follow-up by two physiotherapists and one nurse blinded to group allocation. Generalized Estimating Equations with Repeated-measure statistics were used to analyze the data. There were no significant differences between the IG and the CG regarding balance (BBS). BI at 6 months and FES-I post-intervention and 3 months follow-up showed significant improvement in the IG compared with the CG (p<0.05). Number of falls and FAI-3 were without significant change. This study suggests that our program consisting of HIFE implemented in real-life situations together with educational discussions may improve performance of everyday life activities and improve falls efficacy in stroke subjects with risk of falls

  • 17.
    Hyyppä, Kalevi
    et al.
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Fredriksson, Håkan
    Innala Ahlmark, Daniel
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Prellwitz, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röding, Jenny
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Projekt: Seende rullstol2012Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Projektet syftar till att göra det möjligt för personer med funktionsnedsättning, som inte själva har full förmåga att styra en rullstol, att ändå nyttja den. Sensorer på rullstolen upptäcker automatiskt hinder i omgivningen och ger därmed den rörelsehindrade hjälp med styrningen.En virtuell blindkäpp som består av en haptisk robotarm kopplad till en laser som mäter avstånd till föremål i omgivningen har även tagits fram. Utifrån informationen skapas en 3D-bild som brukaren av den virtuella blindkäppen kan känna på med robotarmen.Fortsatt forskning kommer att fokusera på den virtuella vita käppen som kommer att ha en mycket längre räckvidd än en vanlig vit käpp. Vi avser att göra den handhållen så att rullstolen inte behövs som bärare av laserskanner och haptisk robot. En mycket viktig del i vår forskning är att åstadkomma en bra användarupplevelse. Synskadade, som har stor erfarenhet av den vanlig vita käppen, skall snabbt lära sig att använda den virtuella vita käppen.

  • 18.
    Innala Ahlmark, Daniel
    et al.
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Prellwitz, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röding, Jenny
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Hyyppä, Kalevi
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    An Initial Field Trial of a Haptic Navigation System for Persons with a Visual Impairment2015Inngår i: Journal of Assistive Technologies, ISSN 1754-9450, E-ISSN 2042-8723, Vol. 9, nr 4, s. 199-206Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose– The purpose of this paper is to describe conceptions of feasibility of a haptic navigation system for persons with a visual impairment (VI). Design/methodology/approach– Six persons with a VI who were white cane users were tasked with traversing a predetermined route in a corridor environment using the haptic navigation system. To see whether white cane experience translated to using the system, the participants received no prior training. The procedures were video-recorded, and the participants were interviewed about their conceptions of using the system. The interviews were analyzed using content analysis, where inductively generated codes that emerged from the data were clustered together and formulated into categories. Findings– The participants quickly figured out how to use the system, and soon adopted their own usage technique. Despite this, locating objects was difficult. The interviews highlighted the desire to be able to feel at a distance, with several scenarios presented to illustrate current problems. The participants noted that their previous white cane experience helped, but that it nevertheless would take a lot of practice to master using this system. The potential for the device to increase security in unfamiliar environments was mentioned. Practical problems with the prototype were also discussed, notably the lack of auditory feedback. Originality/value– One novel aspect of this field trial is the way it was carried out. Prior training was intentionally not provided, which means that the findings reflect immediate user experiences. The findings confirm the value of being able to perceive things beyond the range of the white cane; at the same time, the participants expressed concerns about that ability. Another key feature is that the prototype should be seen as a navigation aid rather than an obstacle avoidance device, despite the interaction similarities with the white cane. As such, the intent is not to replace the white cane as a primary means of detecting obstacles.

  • 19.
    Innala Ahlmark, Daniel
    et al.
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Prellwitz, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röding, Jenny
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Hyyppä, Kalevi
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Virtuell vit käpp för den seende rullstolen2013Konferansepaper (Annet vitenskapelig)
    Fulltekst (pdf)
    fulltext
  • 20.
    Jafari, Hedyeh
    et al.
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Gustafsson, Thomas
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Predicting balance impairments in older adults: a wavelet-based center of pressure classification approach2023Inngår i: Biomedical engineering online, E-ISSN 1475-925X, Vol. 22, artikkel-id 83Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Aging is associated with a decline in postural control and an increased risk of falls. The Center of Pressure (CoP) trajectory analysis is a commonly used method to assess balance. In this study, we proposed a new method to identify balance impairments in older adults by analyzing their CoP trajectory frequency components, sensory inputs, reaction time, motor functions, and Fall-related Concerns (FrC).

    Methods: The study includes 45 older adults aged 75.2(±4.5)75.2(±4.5) years who were assessed for sensory and motor functions. FrC and postural control in a quiet stance with open and closed eyes on stable and unstable surfaces. A Discrete Wavelet Transform (DWT) was used to detect features in frequency scales, followed by the K-means algorithm to detect different clusters. The multinomial logistic model was used to identify and predict the association of each group with the sensorimotor tests and FrC.

    Results: The study results showed that by DWT, three distinct groups of subjects could be revealed. Group 2 exhibited the broadest use of frequency scales, less decline in sensorimotor functions, and lowest FrC. The study also found that a decline in sensorimotor functions and fall-related concern may cause individuals to rely on either very low-frequency scales (group 1) or higher-frequency scales (group 3) and that those who use lower-frequency scales (group 1) can manage their balance more successfully than group 3.

    Conclusions: Our study provides a new, cost-effective method for detecting balance impairments in older adults. This method can be used to identify people at risk and develop interventions and rehabilitation strategies to prevent falls in this population.

    Fulltekst (pdf)
    fulltext
  • 21.
    Jafari, Hedyeh
    et al.
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Pauelsen, Mascha
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nikolakopoulos, George
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Gustafsson, Thomas
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    A novel data driven model of ageing postural control2019Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background

    Postural control is a complex system. Based on sensorimotor integration, the central nervous system (CNS) maintains balance by sending suitable motor commands to the muscles. Physiological decline due to ageing, affects balance performance through failing postural control – and in turn affects falls self-efficacy and activity participation. Understanding how the CNS adapts to these changes and predicts the appropriate motor commands to stabilize the body, has been a challenge for postural control research the latest years.

    Aims

    To understand and model the performance of the central nervous system as the controller of the human body.

    Methods

    Modelling was based on postural control data from 45 older adults (70 years and older). Ankle, knee and hip joint kinematics were measured during quiet stance using a motion capture system. Principal component analysis was used in order to reduce the measured multidimensional kinematics from a set of correlated discrete time series to a set of principal components. The outcome was utilized to predict the motor commands. The adaptive behaviour of the CNS was modelled by recurrent neural network including the efference copy for rapid predictions. The data from joint kinematics and electromyography (EMG) signals of the lower limb muscles were measured and separated into training and test data sets.

    Results

    The model can predict postural motor commands with very high accuracy regardless of a large physiological variability or balancing strategies. This model has three characteristics: a) presents an adaptive scheme to individual variability, 2) showcases the existence of an efference copy, and 3) is human experimental data driven.

    Conclusion

    The model can adapt to physical body characteristics and individual differences in balancing behaviour, while successfully predict motor commands. It should therefore be utilised in the continued pursuit of a better understanding of ageing postural control.

  • 22.
    Jafari, Hedyeh
    et al.
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Pauelsen, Mascha
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Nikolakopoulos, George
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Gustafsson, Thomas
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    On Internal Modeling of the Upright Postural Control in Elderly2018Inngår i: IEEE ROBIO 2018, IEEE, 2018, s. 231-236Konferansepaper (Fagfellevurdert)
    Abstract [en]

    The second most common cause of injury in the elderly population is falling. In an effort to understand the mechanism behind the reduced ability to maintain balance in any posture or activity, we study the performance of the central nervous system as a controller of the body, while maintaining the balance in some postures or activities. Towards this direction, forty-five subjects aged over 70 were tested in different trials of quiet stance: a) hard stable surface with open eyes, b) stable surface with closed eyes, c) soft unstable surface with open eyes, and d) unstable surface, while eyes were closed. In the sequel, the body kinematics were described by legs and trunk segment angles in the sagittal plane, while the muscle activations were described by a weighted sum of rectified EMG signals from tibialis anterior and gastrocnemius muscles of left and right legs. Using the neuro-science hypothesis and adaptive control theory, a completely novel model was identified for the CNS based on the feedback internal model. The proposed model is able to predict the output commands, based on a recurrent neural network, while the efficiency of the proposed scheme has been proven based on multiple experimental results, showing that the model can sufficiently predict the muscle activity based on the optimum sensory inputs.

    Fulltekst (pdf)
    fulltext
  • 23.
    Jamsa, Timo
    et al.
    Department of Medical Technology, Institute of Biomedicine, University of Oulu.
    Kangas, Maarit
    Department of Medical Technology, Institute of Biomedicine, University of Oulu.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Korpelainen, Raija
    Department of Medical Technology, Institute of Biomedicine, University of Oulu.
    Fall detection in the older people: from laboratory to real-life2014Inngår i: Proceedings of the Estonian Academy of Sciences, ISSN 1736-6046, E-ISSN 1736-7530, Vol. 63, nr 3, s. 253-257Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Falls are an increasing problem of aging population, both in home-dwelling and institutionalized people. Automatic fall detection systems are a choice in supporting the independent and secure living of the older people. Typically, health technology applications such as fall detection systems are tested in experimental falls of young adults. However, sensitivity and specificity, and acceptability and usability of these systems in real-life conditions in end users should be the ultimate aim. This paper overviews our set of studies on the technology and algorithms for fall detection, from laboratory-based experiments to long-term real-life field tests. The data obtained during the incremental set of studies suggest that automatic accelerometric fall detection systems might offer a tool for improving safety among older people. Additional studies are needed for further improvement of fall detection sensitivity and decreasing the false alarm rate, and for the implementation of the technology to elderly care ICT platforms.

  • 24.
    Jensen, Jane
    et al.
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Nyberg, Lars
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Fall and injury prevention in older people living in residential care facilities: A cluster randomized trial2002Inngår i: Annals of Internal Medicine, ISSN 0003-4819, E-ISSN 1539-3704, Vol. 136, nr 10, s. 733-41Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Falls and resulting injuries are particularly common in older people living in residential care facilities, but knowledge about the prevention of falls is limited. OBJECTIVE: To investigate whether a multifactorial intervention program would reduce falls and fall-related injuries. DESIGN: A cluster randomized, controlled, nonblinded trial. SETTING: 9 residential care facilities located in a northern Swedish city. PATIENTS: 439 residents 65 years of age or older. INTERVENTION: An 11-week multidisciplinary program that included both general and resident-specific, tailored strategies. The strategies comprised educating staff, modifying the environment, implementing exercise programs, supplying and repairing aids, reviewing drug regimens, providing free hip protectors, having post-fall problem-solving conferences, and guiding staff. MEASUREMENTS: The primary outcomes were the number of residents sustaining a fall, the number of falls, and the time to occurrence of the first fall. A secondary outcome was the number of injuries resulting from falls. RESULTS: During the 34-week follow-up period, 82 residents (44%) in the intervention program sustained a fall compared with 109 residents (56%) in the control group (risk ratio, 0.78 [95% CI, 0.64 to 0.96]). The adjusted odds ratio was 0.49 (CI, 0.37 to 0.65), and the adjusted incidence rate ratio of falls was 0.60 (CI, 0.50 to 0.73). Each of 3 residents in the intervention group and 12 in the control group had 1 femoral fracture (adjusted odds ratio, 0.23 [CI, 0.06 to 0.94]). Clustering was considered in all regression models. CONCLUSION: An interdisciplinary and multifactorial prevention program targeting residents, staff, and the environment may reduce falls and femoral fractures.

  • 25.
    Jensen, Jane
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Fall and injury prevention in residential care: effects in residents with higher and lower levels of cognition2003Inngår i: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 51, nr 5, s. 627-35Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To evaluate the effectiveness of a multifactorial fall and injury prevention program in older people with higher and lower levels of cognition. DESIGN: A preplanned subgroup comparison of the effectiveness of a cluster-randomized, nonblinded, usual-care, controlled trial.SETTING: Nine residential facilities in Umea, Sweden. PARTICIPANTS: All consenting residents living in the facilities, aged 65 and older, who could be assessed using the Mini-Mental State Examination (MMSE; n = 378).An MMSE score of 19 was used to divide the sample into one group with lower and one with higher level of cognition. The lower MMSE group was older (mean +/- standard deviation = 83.9 +/- 5.8 vs 82.2 +/- 7.5) and more functionally impaired (Barthel Index, median (interquartile range) 11 (6-15) vs 17 (13-18)) and had a higher risk of falling (64% vs 36%) than the higher MMSE group. INTERVENTION: A multifactorial fall prevention program comprising staff education, environmental adjustment, exercise, drug review, aids, hip protectors, and postfall problem-solving conferences. MEASUREMENTS: The number of falls, time to first fall, and number of injuries were evaluated and compared by study group (intervention vs control) and by MMSE group. RESULTS: A significant intervention effect on falls appeared in the higher MMSE group but not in the lower MMSE group (adjusted incidence rates ratio of falls P =.016 and P =.121 and adjusted hazard ratio P <.001 and P =.420, respectively). In the lower MMSE group, 10 femoral fractures were found, all of which occurred in the control group (P =.006). CONCLUSION: The higher MMSE group experienced fewer falls after this multifactorial intervention program, whereas the lower MMSE group did not respond as well to the intervention, but femoral fractures were reduced in the lower MMSE group

  • 26.
    Jensen, Jane
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, S-901 87, Umeå, Sweden.
    Nyberg, Lars
    Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, S-901 87, Umeå, Sweden.
    Rosendahl, Erik
    Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, S-901 87, Umeå, Sweden.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, S-901 87, Umeå, Sweden.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, S-901 87, Umeå, Sweden.
    Effects of a fall prevention program including exercise on mobility and falls in frail older people living in residential care facilities2004Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 16, nr 4, s. 283-92Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND AIMS: Impaired mobility is one of the strongest predictors for falls in older people. We hypothesized that exercise as part of a fall prevention program would have positive effects, both short- and long-term, on gait, balance and strength in older people at high risk of falling and with varying levels of cognition, residing in residential care facilities. A secondary hypothesis was that these effects would be associated with a reduced risk of falling. METHODS: 187 out of all residents living in 9 facilities, > or =65 years of age were at high risk of falling. The facilities were cluster-randomized to fall intervention or usual care. The intervention program comprised: education, environment, individually designed exercise, drug review, post-fall assessments, aids, and hip protectors. Data were adjusted for baseline performance and clustering. RESULTS: At 11 weeks, positive intervention effects were found on independent ambulation (FAC, p=0.026), maximum gait speed (p=0.002), and step height (> or =10 cm, p<0.001), but not significantly on the Berg Balance Scale. At 9 months (long-term outcome), 3 intervention and 15 control residents had lost the ability to walk (p=0.001). Independent ambulation and maximum gait speed were maintained in the intervention group but deteriorated in the control group (p=0.001). Residents with both higher and lower cognition benefited in most outcome measures. Noassociation was found between improved mobility and reduced risk of falling.CONCLUSIONS: Exercise, as part of a fall prevention program, appears to preserve the ability to walk, maintain gait speed, ambulate independently, and improve step height. Benefits were found in residents with both lower and higher cognitive impairment, but were not found to be associated with a reduced risk of falling

  • 27.
    Jensen, Jane
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Olsson, Lillemor Lundin
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Lars
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Sweden.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Falls among frail older people in residential care2002Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 30, nr 1, s. 54-61Artikkel i tidsskrift (Fagfellevurdert)
  • 28.
    Johansson Strandkvist, Viktor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Stridsman, Caroline
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lindberg, Anne
    OLIN studierna Norrbottens läns landsting , Sverige.
    Project: Physical function and postural control among subjects with Chronic Obstructive Pulmonary Disease – epidemiological and laboratory studies2016Annet (Annet (populærvitenskap, debatt, mm))
  • 29.
    Kallin, Kristina
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Jensen, Jane
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Why the elderly fall in residential care facilities, and suggested remedies2004Inngår i: Journal of family practice, ISSN 0094-3509, E-ISSN 1533-7294, Vol. 53, nr 1, s. 41-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To study precipitating factors for falls among older people living in residential care facilities. DESIGN: Prospective cohort study. SETTING: Five residential care facilities. PARTICIPANTS: 140 women and 59 men, mean age +/- SD 82.4 +/- 6.8 (range, 65-97). MEASUREMENTS: After baseline assessments, falls in the population were tracked for 1 year. A physician, a nurse, and a physiotherapist investigated each event, and reached a consensus concerning the most probable precipitating factors for the fall. RESULTS: Previous falls and treatment with antidepressants were found to be the most important predisposing factors for falls. Probable precipitating factors could be determined in 331 (68.7%) of the 482 registered falls. Acute disease or symptoms of disease were judged to be precipitating, alone or in combination in 186 (38.6%) of all falls; delirium was a factor in 48 falls (10.0%), and infection, most often urinary tract infection, was a factor in 38 falls (7.9%). Benzodiazepines or neuroleptics were involved in the majority of the 37 falls (7.7%) precipitated by drugs. External factors, such as material defects and obstacles, precipitated 38 (7.9%) of the falls. Other conditions both related to the individual and the environment, such as misinterpretation (eg, overestimation of capacity or forgetfulness), misuse of a roller walker, or mistakes made by the staff were precipitating factors in 83 (17.2%) of falls. CONCLUSION: Among older people in residential care facilities, acute diseases and side effects of drugs are important precipitating factors for falls. Falls should therefore be regarded as a possible symptom of disease or a drug side effect until proven otherwise. Timely correction of precipitating and predisposing factors will help prevent further falls.

  • 30.
    Kallin, Kristina
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Jensen, Jane
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Predisposing and precipitating factors for falls among older people in residential care2002Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, nr 5, s. 263-271Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Falls and their consequences are serious health problems among older populations. To study predisposing and precipitating factors for falls among older people in residential care we used a cross-sectional study design with a prospective follow up for falls. Fifty-eight women and 25 men, with a mean age of 79.6 y, were included and prospectively followed up regarding falls for a period of 1 y after baseline assessments. All those who fell were assessed regarding factors that might have precipitated the fall. The incidence rate was 2.29 falls/person years. Antidepressants (selective serotonin reuptake inhibitors, SSRIs), impaired vision and being unable to use stairs without assistance were independently associated with being a 'faller'. Twenty-eight (53.8%) of the fallers suffered injuries as a result of their falls, including 21 fractures. Twenty-seven percent of the falls were judged to be precipitated by an acute illness or disease and 8.6% by a side effect of a drug. Acute symptoms of diseases or drug side effects were associated with 58% of the falls which resulted in fractures. We conclude that SSRIs seem to constitute one important factor that predisposes older people to fall, once or repeatedly. Since acute illnesses and drug side-effects were important precipitating factors, falls should be regarded as a possible symptom of disease or a side-effect of a drug until it is proven otherwise.

  • 31.
    Kangas, M.
    et al.
    Department of Medical Technology, Institute of Biomedicine, University of Oulu.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Korpelainen, R.
    Department of Medical Technology, Institute of Biomedicine, University of Oulu.
    Lindblom, J.
    Department of Medical Technology, Institute of Biomedicine, University of Oulu.
    Jämsä, T.
    Department of Medical Technology, Institute of Biomedicine, University of Oulu.
    Comparison of real-life accidental falls in older people with experimental falls in middle-aged test subjects2012Inngår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, ISSN 0966-6362, Vol. 35, nr 3, s. 500-505Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Falling is a common accident among older people. Automatic fall detectors are one method of improving security. However, in most cases, fall detectors are designed and tested with data from experimental falls in younger people. This study is one of the first to provide fall-related acceleration data obtained from real-life falls. Wireless sensors were used to collect acceleration data during a six-month test period in older people. Data from five events representing forward falls, a sideways fall, a backwards fall, and a fall out of bed were collected and compared with experimental falls performed by middle-aged test subjects. The signals from real-life falls had similar features to those from intentional falls. Real-life forward, sideways and backward falls all showed a pre impact phase and an impact phase that were in keeping with the model that was based on experimental falls. In addition, the fall out of bed had a similar acceleration profile as the experimental falls of the same type. However, there were differences in the parameters that were used for the detection of the fall phases. The beginning of the fall was detected in all of the real-life falls starting from a standing posture, whereas the high pre impact velocity was not. In some real-life falls, multiple impacts suggested protective actions. In conclusion, this study demonstrated similarities between real-life falls of older people and experimental falls of middle-aged subjects. However, some fall characteristics detected from experimental falls were not detectable in acceleration signals from corresponding heterogeneous real-life falls.

  • 32.
    Kangas, Maarit
    et al.
    Department of Medical Technology, Institute of Biomedicine, Oulu Deaconess Institute.
    Korpelainen, Raija
    Department of Medical Technology, Institute of Biomedicine, Oulu Deaconess Institute.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Jämsä, Timo
    Department of Medical Technology, Institute of Biomedicine, Oulu Deaconess Institute.
    Sensitivity and false alarm rate of a fall sensor in long-term fall detection in the elderly2015Inngår i: Gerontology, ISSN 0304-324X, E-ISSN 1423-0003, ISSN 0304-324x, Vol. 61, nr 1, s. 61-68Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: About a third of home-dwelling older people fall each year, and institutionalized older people even report a two- or threefold higher rate for falling. Automatic fall detection systems have been developed to support the independent and secure living of the elderly. Even though good fall detection sensitivity and specificity in laboratory settings have been reported, knowledge about the sensitivity and specificity of these systems in real-life conditions is still lacking. Objective: The aim of this study was to evaluate the long-term fall detection sensitivity and false alarm rate of a fall detection prototype in real-life use. Methods: A total of 15,500 h of real-life data from 16 older people, including both fallers and nonfallers, were monitored using an accelerometry-based sensor system with an implemented fall detection algorithm. Results: The fall detection system detected 12 out of 15 real-life falls, having a sensitivity of 80.0%, with a false alarm rate of 0.049 alarms per usage hour with the implemented real-time system. With minor modification of data analysis the false alarm rate was reduced to 0.025 false alarms per hour, equating to 1 false fall alarm per 40 usage hours. Conclusion: These data suggest that automatic accelerometric fall detection systems might offer a tool for improving safety among older people.

  • 33.
    Kangas, Maarit
    et al.
    University of Oulu.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wiklander, Jimmie
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Lindgren, Per
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Jämsä, Timo
    University of Oulu.
    Sensitivity and specificity of fall detection in people aged 40 years and over2009Inngår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, ISSN 0966-6362, Vol. 29, nr 4, s. 571-574Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    About one third of home-dwelling people over 65 years of age fall each year. Falling, and the fear of falling, is one of the major health risks that affects the quality of life among older people, threatening their independent living. In our pilot study, we found that fall detection with a waist-worn triaxial accelerometer is reliable with quite simple detection algorithms. The aim of this study was to validate the data collection of a new fall detector prototype and to define the sensitivity and specificity of different fall detection algorithms with simulated falls from 20 middle-aged (40-65 years old) test subjects. Activities of daily living (ADL) performed by the middle-aged subjects, and also by 21 older people (aged 58-98 years) from a residential care unit, were used as a reference. The results showed that the hardware platform and algorithms used can discriminate various types of falls from ADL with a sensitivity of 97.5% and a specificity of 100%. This suggests that the present concept provides an effective method for automatic fall detection.

  • 34. Kangas, Maarit
    et al.
    Wiklander, Jimmie
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Wikman, Irene
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lindgren, Per
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, EISLAB.
    Jämsä, Timo
    Sensorband fall detector prototype: validation through data collection and analysis2008Inngår i: 2nd International Symposium on Medical Information and Communications Technology: ISMICT'07. Proceedings, Oulu: University of Oulu, 2008Konferansepaper (Fagfellevurdert)
  • 35.
    Karlsson, Stig
    et al.
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Sandman, Per-Olof
    Umeå University, Department of Nursing.
    The use of physical restraints in elder care in relation to fall risk1997Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 11, nr 4, s. 238-242Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Physical restraints are a frequently used but disputed method to prevent falls. The aim of the present study was to investigate how the use of restraints in institutional elder care relates to previous falls and to the estimated fall risk of the individual patient. A total of 1142 patients, mean age 82 years, were included in the study. A questionnaire, the Multi-Dimensional Dementia Assessment Scale (MDDAS), was used to measure motor function, vision, hearing, ADL performance, behavioral symptoms, psychiatric symptoms, cognitive impairment and use of medication. Questions concerning the use of physical restraints and known previous falls were added to the instrument. Based on data from the questionnaire (MDDAS), a score on the Downton Fall Risk Index was calculated for each patient. All in all, 248 (22%) of the patients had been subject to restraints and for 155 of them (14%) such measures had been taken to prevent falls. Only weak connections were found between the restraining of patients to prevent falls and the prevalence of known previous falls during hospital stay (phi = 0.05), and estimated fall risk (phi = 0.07). The results indicate that the use of physical restraints is poorly connected with the estimated fall risk. Therefore, this study may point to a possible overuse of these measures

  • 36. Karlsson, Å.
    et al.
    Stenvall, Michael
    Institutionen för Samhällsmedicin och rehabilitering, geriatrik, Umeå universitet.
    Nyberg, Lars
    Uppföljning av patienter som rehabiliteras efter höftfraktur: En pilotstudie1997Inngår i: Nordisk fysioterapi, ISSN 1402-3024, Vol. 1, nr 4, s. 146-150Artikkel i tidsskrift (Annet vitenskapelig)
  • 37.
    Lindelöf, Nina
    et al.
    Umeå University Hospital, Geriatric Centre.
    Littbrand, Håkan
    Umeå University Hospital, Geriatric Centre.
    Lindström, Britta
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Lars
    Weighted belt exercise for frail older women following hip fracture: a single subject design2002Inngår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 4, nr 2, s. 54-64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to investigate the possibility of increasing lower limb strength, dynamic balance and gait speed in frail older women with residual mobility problems following hip fracture by using a combined and functional training programme with a weighted belt. Three women aged 78-82 participated in this repeated single-subject experimental design study. The intervention phase consisted of a 10-week functional weight-bearing exercise programme performed twice a week. Main outcome measures were assessed twice a week during baseline and intervention phases. Graphic analyses showed substantial improvements in dynamic balance and gait speed, related to the intervention, in all three subjects. During intervention phase, gait speed improved by 16-38% and step test performance (dynamic balance) by 36-67%. The subjects also increased weight load in the belt by 25-80%. No progress was seen regarding isometric knee extension muscle strength, and the control variable, isometric hand-grip strength, remained unchanged. However, dynamic leg strength (one-repetition maximum in leg press, tested before and after intervention) showed substantial increase. Subjects experienced strong improvement and reported no discomfort. In conclusion, functional training with a weighted belt may be suitable for older women to alleviated mobility problems following hip fracture.

  • 38.
    Lindelöf, Nina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap. Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-90187 Umeå, Sweden.
    Rosendahl, Erik
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-90187 Umeå, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-90187 Umeå, Sweden.
    Gustafsson, Samuel
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-90187 Umeå, Sweden.
    Nygaars, Joachim
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-90187 Umeå, Sweden.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-90187 Umeå, Sweden.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Perceptions of participating in high-intensity functional exercise among older people dependent in activities of daily living (ADL)2013Inngår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 57, nr 3, s. 369-376Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    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

  • 39.
    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.

  • 40.
    Lundin-Olsson, Lillemor
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Jensen, Jane
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Predicting falls in residential care by a risk assessment tool, staff judgement, and history of falls2003Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 15, nr 1, s. 51-59Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND AIMS: It is of great importance to consider whether a tool's predictive value is generalizable to similar samples in other locations. Numerous fall prediction systems have been developed, but very few are evaluated over a different time period in a different location. The purpose of this study was to validate the predictive accuracy of the Mobility Interaction Fall (MIF) chart, and to compare it to staff judgement of fall risk and history of falls. METHODS: The MIF chart, staff judgement, and fall history were used to classify the risk of falling in 208 residents (mean age 83.2 +/- 6.8 years) living in four residential care facilities in northern Sweden. The MIF chart includes an observation of the ability to walk and simultaneously interact with a person or an object, a vision test, and a concentration rating. Staff rated each resident's risk as high or low and reported the resident's history of falls during the past 6 months. Falls were followed up for 6 months. RESULTS: During the follow-up period, 104 residents (50%) fell at least once indoors. Many of the factors commonly associated with falls did not differ significantly between residents who fell at least once and residents who did not fall. In this validating sample the predictive accuracy of the MIF chart was notably lower than in the developmental sample. A combination of any two of the MIF chart, staff judgement, and history of falls was more accurate than any approach alone; more than half of the residents classified as 'high risk' by two approaches sustained a fall within 3 months. CONCLUSIONS: Residents classified as 'high risk' by any two of the MIF chart, staff judgement, and history of falls should be regarded as particularly prone to falling and in urgent need of preventive measures.

    Fulltekst (pdf)
    fulltext
  • 41.
    Lundin-Olsson, Lillemor
    et al.
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Attention, frailty, and falls: the effect of a manual task on basic mobility1998Inngår i: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 46, nr 6, s. 758-761Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate the effect of a second task on balance and gait maneuvers used in everyday life. Our hypothesis was that those who were more distracted by a familiar manual task performed concurrently with functional maneuvers were more frail and more prone to falls. DESIGN: A cross-sectional design with prospective follow-up for falls. SETTING: Sheltered accommodation in Umea, Sweden. PARTICIPANTS: Forty-two residents (30 women, 12 men; mean age +/- SD = 79.7 +/- 6.1 years), ambulant with or without a walking aid, able to follow simple instructions and able to carry a tumbler. MEASUREMENTS: Timed Up & Go (TUG), i.e., the time taken to rise from an armchair, walk 3 meters, turn round, and sit down again. TUG was repeated with an added manual task (TUGmanual), which was to carry a glass of water while walking. The Montgomery-Asberg Depression Rating Scale, Barthel Index, Functional Reach, Mini-Mental State Examination, and Line Bisection test were used to assess for frailty. The subjects were followed-up prospectively regarding falls indoors for a period of 6-months. RESULTS: Subjects with a time difference (diffTUG) between TUGmanual and TUG of > or = 4.5 seconds were considered to be distracted by the second task. Ten subjects had a difference in time of > or = 4.5 seconds. These subjects were more frail, and seven of them fell indoors during the follow-up period (odds ratio 4.7, 95%Confidence Interval (CI) 1.5-14.2). CONCLUSION: The time difference between the TUGmanual and the TUG appears to be a valid marker of frailty and a useful tool for identifying older persons prone to falling.

  • 42.
    Lundin-Olsson, Lillemor
    et al.
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    "Stops walking when talking" as a predictor of falls in elderly people1997Inngår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 349, nr 9052, s. 617-Artikkel i tidsskrift (Fagfellevurdert)
  • 43.
    Lundin-Olsson, Lillemor
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy and Geriatric Medicine.
    Nyberg, Lars
    Gustafson, Yngve
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy and Geriatric Medicine.
    The Mobility Interaction Fall chart2000Inngår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 5, nr 3, s. 190-201Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: The aim of this study was to develop and evaluate a screening tool for the identification of older people living in residential care facilities who are prone to falling. METHOD: Two tests focusing on attentional demands while walking were performed: 'Stops walking when talking' and the 'diffTUG'. Medical assessment, rating for cognition, depression and activities of daily living were also carried out. Falls indoors were followed up prospectively over a period of six months. A flowchart, the Mobility Interaction Fall (MIF) chart, for the identification of older people who are prone to falling was developed. The MIF chart includes an observation of mobility level and 'Stops walking when talking', the diffTUG, a test of vision and a rating of concentration. Study subjects were 78 residents, aged over 65 years, in one residential care facility (22 M; 56 F; median age 82 years, range 66-99 years) in Umea, Sweden. RESULTS: Thirty-three (42%) subjects suffered at least one fall indoors during the follow-up period. The rate of falls differed significantly between those subjects classified as being at risk of falls and those not so classified (log rank test 39.1; p < 0.001; hazard ratio 12.1; 95% CI 4.6-31.8). The positive predictive value for the classification was 78% (95% CI 67-87%) and the negative predictive value was 88% (95% CI 79-95%). CONCLUSION: The initial findings for the MIF chart indicate a promising way of classifying older people at residential care facilities as being at high or low risk of falling. The classification is quick and easy and requires no expensive equipment

  • 44.
    Lundström, Maria
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Olofsson, Birgitta
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Stenvall, Michael
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Karlsson, Stig
    Umeå University, Department of Community Medicine and Rehabilitation.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Englund, Undis
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Borssén, Bengt
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Svensson, Olle
    Department of Surgical and Perioperative Science, Umeå University.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Postoperative delirium in old patients with femoral neck fracture: a randomized intervention study2007Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 19, nr 3, s. 178-86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND AIMS: Delirium is a common postoperative complication in elderly patients which has a serious impact on outcome in terms of morbidity and costs. We examined whether a postoperative multi-factorial intervention program can reduce delirium and improve outcome in patients with femoral neck fractures. METHODS: One hundred and ninety-nine patients, aged 70 years and over (mean age+/-SD, 82+/-6, 74% women), were randomly assigned to postoperative care in a specialized geriatric ward or a conventional orthopedic ward. The intervention consisted of staff education focusing on the assessment, prevention and treatment of delirium and associated complications. The staff worked as a team, applying comprehensive geriatric assessment, management and rehabilitation. Patients were assessed using the Mini Mental State Examination and the Organic Brain Syndrome Scale, and delirium was diagnosed according to DSM-IV criteria. RESULTS: The number of days of postoperative delirium among intervention patients was fewer (5.0+/-7.1 days vs 10.2+/-13.3 days, p=0.009) compared with controls. A lower proportion of intervention patients were delirious postoperatively than controls (56/102, 54.9% vs 73/97, 75.3%, p=0.003). Eighteen percent in the intervention ward and 52% of controls were delirious after the seventh postoperative day (p<0.001). Intervention patients suffered from fewer complications, such as decubitus ulcers, urinary tract infections, nutritional complications, sleeping problems and falls, than controls. Total postoperative hospitalization was shorter in the intervention ward (28.0+/-17.9 days vs 38.0+/-40.6 days, p=0.028). CONCLUSIONS: Patients with postoperative delirium can be successfully treated, resulting in fewer days of delirium, fewer other complications, and shorter length of hospitalization

    Fulltekst (pdf)
    fulltext
  • 45.
    Löfgren, Britta
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Division of Geriatric medicine.
    Gustafson, Yngve
    Umeå University, Department of Community Medicine and Rehabilitation, Division of Geriatric medicine.
    Nyberg, Lars
    Cross-validation of a model predicting discharge home after stroke rehabilitation: validating stroke discharge predictors2000Inngår i: Cerebrovascular Diseases, ISSN 1015-9770, E-ISSN 1421-9786, Vol. 10, nr 2, s. 118-125Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A new sample of 116 stroke patients was collected in order to validate a logistic regression model, predicting the chances of severely affected stroke patients being discharged home to independent living. The model was found to be accurate in the new sample, especially for those patients who had a high estimated probability of being discharged home. When the dividing line for the predicted probability for discharge home was set at a value of >/=0.5, the positive and negative predictive values were 74 and 73%, respectively. Further modelling resulted in a new extended model including the variables postural stability on admission, cohabiting, age and perceptual impairment on admission that formed the basis for an index predicting discharge home. This index was then validated in the sample of 93 patients that the first developed model was derived from and showed positive and negative predictive values of 85 and 77%, respectively

  • 46.
    Löfgren, Britta
    et al.
    Umeå University, Department of Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Psychological well-being 3 years after severe stroke1999Inngår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 30, nr 3, s. 567-572Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: Stroke often has a very negative influence on the victims' perception of their life situation. The aim of this study was therefore to assess the subjects' long-term psychological well-being and to explore associations between subject characteristics, impairments, disabilities, and psychological well-being. METHODS: Of 100 subjects rehabilitated at a specialized geriatric stroke ward after the acute phase, 47 survivors were assessed in their homes 3 years after discharge and interviewed regarding their psychological well-being with the Philadelphia Geriatric Center Morale Scale (PGCMS). RESULTS: Sixty-four percent of the subjects were classified as having high scores for psychological well-being or fell within the middle range. In a cluster analysis, depression was shown to have the strongest association with the subjects' PGCMS scores. Variables including the subjects' social situation and functions as well as age, gender, ability to communicate, and need for help showed a much weaker association with the PGCMS. CONCLUSIONS: More than half of the stroke subjects were classified as having levels of psychological well-being that were good or fairly good. The strong association between PGCMS scores and depression indicates the importance of detecting and treating depression and of following up initiated therapy after stroke.

  • 47.
    Löfgren, Britta
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Nyberg, Lars
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Rehabilitation of stroke patients who are older and severely affected: short- and long-term perspectives2000Inngår i: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 6, nr 4, s. 20-29Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This review has focused on older and severely affected patients. The following aspects have been studied: the suffering of a stroke, experiences of stroke units, rehabilitation, long-term perspective, and psychological well-being. The conclusion is that older and severely affected patients can make substantial progress during rehabilitation. Most patients can maintain or even improve this progress in the long-term perspective. The review shows that many can stay in independent living with support from home help services and relatives, home adjustments, and assistive devices. In long-term follow-ups, some indications show that stroke patients assess their psychological well-being as good, or fairly good, but detection and treatment of depression are essential

  • 48.
    Löfgren, Britta
    et al.
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Mattsson, M.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Three years after in-patient stroke rehabilitation: A follow-up study1999Inngår i: Cerebrovascular Diseases, ISSN 1015-9770, E-ISSN 1421-9786, Vol. 9, nr 3, s. 163-170Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A 3-year follow-up study was performed aimed at describing the outcome for severely affected stroke survivors who had undergone geriatric in-patient rehabilitation. Living conditions, psychological well-being, and changes in functions were assessed in 55 survivors. Twenty-five people were living in the community, 15 in apartment hotels or homes for the aged and 15 in nursing homes. From discharge to follow-up 11 people had had to move to an accommodation offering more support. Living alone, recurrent strokes and functional decline were associated with moving. Many of those living in the community were supported by relatives or home help services. Home adjustments and assistive devices were common and in most cases were aimed at facilitating transfers and bathroom activities. Motor function had deteriorated from discharge to follow-up, otherwise no statistically significant changes were seen in the survivors' abilities and functions. Most survivors had in fact been able to maintain their functions or to make further improvements. Also, their psychological well-being seemed quite good. These results should encourage rehabilitation efforts for elderly people severely affected by stroke

  • 49.
    Löfgren, Britta
    et al.
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Arbetsterapi.
    Nyberg, Lars
    Österlind, Per-Olov
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    In-patient rehabilitation after stroke: outcome and factors associated with improvement1998Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 20, nr 2, s. 55-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A study aimed at examining the outcome of activities of daily living (ADL) of patients undergoing geriatric stroke rehabilitation was performed. Background and admission data of 99 patients surviving the acute phase and needing further hospital rehabilitation were registered. Forty per cent of the patients improved their ADL ability. The logistic regression modelling with the dichotomous dependent variable improvement versus no improvement showed the following factors associated with improvement: a diagnosis of intracerebral haemorrhage, male sex, high postural stability score at the admission and cohabitation. In conclusion, the most severely affected stroke patients, especially patients with intracerebral haemorrhage, have a great potential for improving their ADL. The results of the logistic regression model can serve as a useful guide when it comes to identifying patients that stand a fair chance of improving during their rehabilitation stay. Equally important, patients with a poor rehabilitation prognosis who may need intensified rehabilitation efforts to achieve optimum improvement can now be identified.

  • 50.
    Melander-Wikman, Anita
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Näslund, Annika
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wiklund-Axelsson, Sari-Anne
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wikberg-Nilsson, Åsa
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design.
    Lindahl Norberg, Annika
    Uppsala universitet, Sverige.
    Projekt: Äldre personers förväntningar på användandet av informations- och kommunikationsteknologi som stöd2013Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Informations- och kommunikationsteknologi används idag inom hälso- och sjukvård för bland annat livsstilsrelaterade sjukdomar som tillexempel vid övervikt och fetma, IKT är en del av den verksamhet som hälso- och sjukvården satsar på i framtiden. Användning av IKT i hälsorelaterade sammanhang för större befolkningsgrupper förutsätter en viss grad av beredskap hos befolkningen som sannolikt inte bara är relaterad till kännedom om möjligheterna och vana vid teknologin, utan en förväntan om att det kan vara av värde för personen själv. Kunskaperna är magra om befolkningens beredskap för och inställning till IKT som ett verktyg för kontakten mellan vårdtagare och vårdgivare, och de undersökningar som finns över detta visar på en bild av återhållna förväntningar. I projektet studeras vilken betydelse informations- och kommunikationsteknik har för äldre personers livskvalitet och vilka förväntningar som finns framtida IKT lösningar som stöd för viktnedgång. Datainsamlingar genomförs via enkäter som skickas ut till slumpmässigt valda personer i Sverige och genom intervjuer gemomförda individuellt och i grupp.

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