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  • 1.
    Blomgren, Johannes
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Strandell, Erika
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Jull, Gwendolen
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review2018Ingår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 19, artikel-id 415Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:Neck pain is a major health issue with high rates of recurrence. It presents with a variety ofaltered sensorimotor functions. Exercise is a cornerstone of rehabilitation and many training methods areused. Exercise is evaluated in most randomized controlled trials on its pain relieving effects. No review hasassessed the effect of exercise on the altered physiological functions or determined if there are differentialeffects of particular training methods. This review investigated the effects of deep cervical flexor (DCF)training, a training method commonly used for patients with neck pain, and compared it to other trainingmethodsornotrainingonoutcomesofcervicalneuromuscular function, muscle size, kinematics and kinetics.Methods:Web of Science, Scopus, CINAHL, PubMed were searched from inception until January 2018. Twelverandomized controlled trials were included that compared DCF training as sole intervention to other trainingor no interventions in persons with neck pain. The Cochrane Risk of Bias tool was used to assess the methodquality. All outcome measures were analysed descriptively and meta-analyses were performed for measuresevaluated in three or more studies.Results:DCF training was compared to cervical endurance, strength, proprioception and mobility training,muscle stretching, and no intervention control groups. Physiological outcome measures includedneuromuscular co-ordination (craniocervical flexion test), functional tasks, muscle fatigability, muscle size,kinematics (joint position sense, posture and range of motion) and kinetics (strength, endurance andcontraction accuracy). Strong evidence was found for effectiveness of DCF training on neuromuscularcoordination, but it had no or small effects on strength and endurance at higher loads. DCF trainingimproved head and cervical posture, while evidence was limited or contradictory for other measures.Conclusions:DCF training can successfully address impaired neuromuscular coordination, but not cervicalflexor strength and endurance at higher contraction intensities. A multimodal training regime is proposedwhen the aim is to specifically address various impaired physiological functions associated with neck pain

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  • 2.
    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 adults2022Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 22, nr 1, artikel-id 438Artikel i tidskrift (Refereegranskat)
    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.

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  • 3.
    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.
    Vikman, Irene
    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.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    What Explains Successful or Unsuccessful Postural Adaptations to Repeated Surface Perturbations among Older Adults?2021Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, nr 22, artikel-id 12069Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    As we age there are natural physiological deteriorations that decrease the accuracy and flexibility of the postural control system, which increases the risk of falling. Studies have found that there are individual differences in the ability to learn to manage repeated postural threats. The aim of this study was to investigate which factors explain why some individuals are less proficient at adapting to recurrent postural perturbations. Thirty-five community dwelling older adults performed substantial sensory and motor testing and answered surveys regarding fall-related concerns and cognitive function. They were also subjected to three identical surface perturbations where both kinematics and electromyography was captured. Those that were able to adapt to the third perturbation were assigned to the group “Non-fallers” whereas those that fell during all perturbations were assigned to the group “Fallers”. The group designation dichotomized the sample in a hierarchical orthogonal projection of latent structures— the discriminant analysis model. We found that those who fell were older, had poorer physical performance, poorer strength and longer reaction times. The Fallers’ postural control strategies were more reliant on the stiffening strategy along with a more extended posture and they were less skillful at making appropriate feedforward adaptations prior to the third perturbation.

  • 4.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patients' perceptions of quality of care during the perioperative procedure2015Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 30, nr 4, s. 280-289Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To describe patients' perceptions of quality of care during the perioperative period and to identify areas for quality improvement. Design: A cross-sectional descriptive survey design was used. Methods: The data were collected (N = 170) using a questionnaire for perioperative care. The methods were descriptive statistics, reported as percentages, and a manifest content analysis of the free text. Finding: The areas identified for improvement were information and participation. The participants lacked knowledge, preferred to hand over decision making to the hospital staff, and indicated that having personalized information about the surgery and perioperative period was important. However, too detailed information before surgery could cause increased anxiety. Conclusions: This study indicates that participation and information needs in perioperative settings seem to be situation specific. In addition, these needs seem to be personal and surgery specific. Further studies are required to clarify the differences in the satisfaction and quality of care between groups of patients in the perioperative context

  • 5.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patients' perceptions of quality of care during the perioperative procedure2017Ingår i: ACORN: The Journal of Perioperative Nursing in Australia, ISSN 1448-7535, Vol. 30, nr 3, s. 13-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To describe patients' perceptions of quality of care during the perioperative period and to identify areas for quality improvement. Design: A cross-sectional descriptive survey design was used. Method: The data was collected (N=170) using a questionnaire for perioperative care. The methods were descriptive statistics, reported as percentages, and a manifest content analysis of the free text. Finding: The areas identified for improvement were information and participation. The participants lacked knowledge, preferred to hand over decision making to the hospital staff, and indicated that having personalised information about the surgery and perioperative period was important. However, too detailed information before surgery could cause increased anxiety. Conclusions: This study indicates that participation and information needs in perioperative settings seem to be situation specific. In addition, these needs seem to be personal and surgery specific. Further studies are required to clarify the differences in the satisfaction and quality of care between groups of patients in the perioperative context.

  • 6.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patients' perceptions of their postoperative recovery for one month2015Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 13-14, s. 1825-1836Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectivesTo explore orthopaedic and general surgery patients' perceptions of their postoperative recovery for one month.BackgroundIn general, nursing research in the postoperative context has been directed towards a single symptom or area, which is valuable. However, there is a lack of studies of orthopaedic and general surgery patients' perceptions of postoperative recovery from a short-term perspective.DesignA quantitative approach with a longitudinal design was used.MethodsA total of 180 patients participated in the study. Data were collected using a standardised questionnaire, the Postoperative Recovery Profile, for self-assessment of recovery. Descriptive statistics reported as proportions were used for the categorical variables. Analytic statistics were used to identify statistically significant differences. Mean values and t-tests were used for quantity variables, and Mann–Whitney U-tests and Chi-squared tests were used for nonparametric variables.ResultsOverall, the orthopaedic patients were substantially less recovered than the general surgery patients. Two-thirds of the orthopaedic patients and half of the general surgery patients perceived severe or moderate pain in the acute recovery phase. Within the general surgery group, there were significant differences in the recovery between the Gastric Bypass patients and colon/ileum surgery patients. The gastric bypass patients were overall more recovered than the other groups of patients. The Gastric Bypass patients reported that they had improved after one month compared to their own status prior to surgery.Conclusions and relevance to clinical practiceNursing support for orthopaedic patients must be improved, especially after they are discharged from the hospital. To structure and monitor individual recovery, a top-five priority profile of the most important problems should be used during follow-up calls after the patient is discharged from the hospital. Postoperative pain continues to represent a clinical problem that requires attention. Heterogeneity in the perceptions of recovery within the general surgery group was indicated, which may depend on the surgical procedure as well as the patients' expectations and comparisons with their lives before surgery. Rather than return to their preoperative levels, certain patients tend to continue towards a new or different life postoperatively.

  • 7.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad. Intensive Care Unit, Sunderby Hospital, Luleå, Sweden.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patterns of changes in patients' postoperative recovery from a short-term perspective2018Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, nr 2, s. 188-199Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To explore patterns of changes in patients' postoperative recovery over 1 month within different surgery groups.

    Design: A quantitative longitudinal survey design was used.

    Methods: A standardized questionnaire was used (N = 167 patients); the postoperative recovery profile for self-assessment of recovery. The postoperative recovery profile developed for hospitalized patients contains 17 items distributed over five dimensions: physical symptoms, physical function, psychological function, social function, and activity.

    Findings: Overall, orthopaedic patients perceived a lower recovery than general surgery patients. All major surgery groups and subgroups except for joint replacement patients indicated significant systematic changes toward lower levels of problems. The orthopaedic patients assessed their psychological functioning as impaired, and the gastric bypass group was the most recovered.

    Conclusions: The patients' expectations should be charted initially, and patients should be given realistic information to achieve a realistic hope for a good life in the future. A patient's recovery trajectory may not start after the surgery is completed. Rather, it has already commenced before surgery.

  • 8.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad. ICU 57, Sunderby Hospital, Luleå, Sweden.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. ICU 57, Sunderby Hospital, Luleå, Sweden.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Rattray, Janice
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. School of Nursing and Health Sciences, University of Dundee, Scotland.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patient's perceptions of perioperative quality of care in relation to self-rated health2018Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, nr 6, s. 834-843Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To explore (1) associations between patient and perioperativefactors and dimensions of quality of care and (2) perioperative patients’self-rated physical health in relation to information, encouragement, andparticipation.Design: A nonexperimental descriptive exploratory design (n 5 170participants).Methods: Analyses were performed using quantitative techniques;collected data were quantitative in nature. Multiple logistic regressionand Mann-Whitney U tests were used to analyze the data.Findings: The factor associatedwith patients’ satisfaction within the dimensionof ‘‘identity-oriented approach of the caregivers,’’ including the qualityof information, encouragement, and participation, was self-estimated physicalhealth. Those who estimated their physical health as being good weregenerally more satisfied. Patients who rated their physical health as beingless thangoodwere significantly less satisfiedwith the informationprovidedbefore surgery about their stay in the postanesthesia care unit (PACU).Conclusions: Nurses should chart patients’ estimations of their physicalhealth initially in care to provide reinforced support for patients who estimatetheir physical health is less than good. Before surgery, patients whohave estimated their physical health as being less than good should begiven realistic information about their stay in the PACU—that they willbe in a PACU after surgery, what that stay means, and why it is necessary.

  • 9.
    Gustafsson, Silje
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Martinsson, Jesper
    Luleå tekniska universitet, Institutionen för teknikvetenskap och matematik, Matematiska vetenskaper.
    Välivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Sävenstedt, Stefan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Influence of self-care advice on patient satisfaction and healthcare utilization2016Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, nr 8, s. 1789-1799Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AimThe aim of this study is to explore the influence of nurse-led self-care advice on healthcare utilization and patients' satisfaction with telephone nursing.BackgroundMany consultations in high-cost settings are for conditions that are manageable through self-care and callers with greater satisfaction with the nurse interaction are nearly four times more likely to engage in self-care.DesignCross-sectional study.MethodsQuestionnaires were sent out to 500 randomly selected callers to the Swedish Healthcare Direct in Northern Sweden during March 2014. Callers were asked about their satisfaction with the consultation, their intended actions prior to consultation, the recommendation given by the nurse and the action undertaken after the call.ResultsYoung callers and persons recommended watchful waiting or recurrence if no improvements were significantly less satisfied with their care. When calling on their own behalf, both men and women rated the severity of their symptoms equally and were advised to self-care to the same extent. Self-care advice had a constricting influence on self-reported healthcare utilization, with 66·1% of cases resulting in a lower level of care than first intended. Feeling reassured after the call was the aspect of nursing care that influenced satisfaction the most.ConclusionReceiving self-care advice rather than referral to a general practitioner influences patient satisfaction negatively. Feeling reassured after consultation is strongly related to satisfaction, which in turn has been found to increase the likelihood of engaging in self-care behaviour.

  • 10.
    Gustafsson, Silje
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sävenstedt, Stefan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Psychometric evaluation of a Swedish self-efficacy scale and recovery locus of control scale in the context of minor illness2013Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 3, s. 765-772Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Reliable and valid instruments are essential when examining the role of self-efficacy and locus of control in the self-care context. The aim of this study was to test the validity and reliability of the Self-Efficacy Scale in Self-Care (SESSC) and the Swedish version of the Recovery Locus of Control scale (RLoC) in the context of minor illness. A descriptive correlational design was used to assess the psychometric characteristics of the scales. The study population was 317 randomly selected Swedish inhabitants aged 18–80. The results from this study showed that the RLoC has limitations in reliability and validity and should not be applied in the context of self-care of minor illness. The SESSC proved to be a reliable and valid instrument in assessing self-efficacy in self-care for minor illness.

  • 11.
    Gustafsson, Silje
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Axelsson, Karin
    Professor Emerita, Enköpingsvägen 8D, 746 52 Bålsta, Sweden.
    Sävenstedt, Stefan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Self-care for minor illness2015Ingår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 16, nr 1, s. 71-78Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To describe experiences with and knowledge of minor illness, self-care interventions used in minor illness and channels of information used when providing self-care for minor illness.Background: Although minor illness is self-limiting, symptoms can be substantial and have a great impact on the affected person’s wellbeing. Possibilities to seek and find information about health and self-care have significantly increased through internet-based communities, forums, and websites. Still, a considerable number of consultations with general practitioners are for conditions that are potentially self-treatable. Seeking advanced care for minor illnesses is costly for society and can create discomfort for patients as they are down-prioritized at emergency departments.Methods: Study participants were recruited randomly from the Swedish Adress Register. A questionnaire was sent out, and the final sample included 317 randomly selected persons aged 18–80 and living in Sweden.Findings: Having experienced a specific illness correlated with self-reported knowledge. Preferred self-care interventions differed between different conditions, but resting and self-medicating were commonly used, along with consulting health care facilities. Compliance to advice was the highest for official information channels, and family members were a popular source of advice.

  • 12.
    Gustafsson, Silje
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Sävenstedt, Stefan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Martinsson, Jesper
    Luleå tekniska universitet, Institutionen för teknikvetenskap och matematik, Matematiska vetenskaper.
    Perceptions of needs related to the practice of self-care for minor illness2015Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 21-22, s. 3255-3265Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectivesThe aim of this study was to describe people's perceptions of needs to feel confident in self-care for minor illnesses as well as their perceptions about supporting and obstructing factors in the practice of self-care.BackgroundMinor illness constitutes a large part of primary care, and patients' attendance to doctors' appointments for minor illness has been seen to increase future attendance for the same condition. Almost half of the consultations with telenurses result in the provision of self-care advice.DesignA cross-sectional survey.MethodPrimary data were collected using a questionnaire, and the study participants (n = 315) were randomly selected from the national Swedish address register.ResultsHaving knowledge and receiving health care advice and reliable information were perceived to be needs in order for participants to feel confident in self-care. Having family or friends to consult with was perceived to be a positive factor influencing confidence in self-care, especially for persons under the age of 35. Health care services were perceived to support self-care practice by offering easy access to care, giving information about self-care, and offering increased follow-up after consultations. Lack of knowledge, along with difficulties being away from work, were obstructing factors in the practice of self-care.ConclusionsYoung age was the factor influencing people's perceptions of needs and supporting factors the most. Young age and low knowledge scores about minor illnesses were the two factors that had the most influence on perceived obstructing factors.Relevance to clinical practiceNurses play a major role in the promotion of self-care and in the dissemination of self-care advice. If health care services fail to meet the needs of care-seekers with minor illnesses, patients might turn to out-of-hours clinics and emergency departments for help.

  • 13.
    Gustavsson, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap. Department of Anaesthesia, Central Operation Ward, Sunderby Hospital.
    Nyström, Cecilia
    Intensive Care Unit 57, Sunderby Hospital.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sore throat and pressure differences in ventilation in women after intubation with an endotrachealtube size 6,5 or 7,02013Konferensbidrag (Övrigt vetenskapligt)
    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 14.
    Gustavsson, Linda
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap. Department of Anaesthesia, Central Operation Ward, Sunderby Hospital.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyström, Cecilia
    Intensive Care Unit 57, Sunderby Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sore throat in women after intubation with 6.5 or 7.0 mm endotracheal tube: a quantitative study2014Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, nr 6, s. 318-324Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Women experience more sore throats than men after endotracheal intubation.Aim: The aim of this study was to investigate the incidence of self-rated sore throat immediately,and 2—4 hours postoperatively, in women after elective gynaecological surgery under generalanaesthesia using an endotracheal tube (ETT) size 6.5 or 7.0 mm in inner diameter.Method: Eighty-two female participants who had undergone elective gynaecological surgeryparticipated, 44 and 38 were intubated with size 6.5 mm ETT and 7.0 mm ETT respectively.They estimated the occurrence of sore throat preoperatively and postoperatively, according toa 4-point Likert scale. Statistical data were analysed using the Package for Social Science (SPSS)19.Results: Sore throat was present in 29.5% of participants who were intubated with size 6.5 mmETT immediately postoperatively and in 39.5% of those who were intubated with size 7.0 mmETT.Conclusion: Nurses specialising in the supervision of daily care specific to the intubated patientshould note and alleviate sore throat as part of their nursing care.

  • 15.
    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-life2014Ingår i: Proceedings of the Estonian Academy of Sciences, ISSN 1736-6046, E-ISSN 1736-7530, Vol. 63, nr 3, s. 253-257Artikel i tidskrift (Refereegranskat)
    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.

  • 16.
    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 subjects2012Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, ISSN 0966-6362, Vol. 35, nr 3, s. 500-505Artikel i tidskrift (Refereegranskat)
    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.

  • 17.
    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 elderly2015Ingår i: Gerontology, ISSN 0304-324X, E-ISSN 1423-0003, ISSN 0304-324x, Vol. 61, nr 1, s. 61-68Artikel i tidskrift (Refereegranskat)
    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.

  • 18.
    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 over2009Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, ISSN 0966-6362, Vol. 29, nr 4, s. 571-574Artikel i tidskrift (Refereegranskat)
    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.

  • 19.
    Melander-Wikman, Anita
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Andersson, Susanne
    Sunderby sjukhus, Sjukgymnastiken.
    Vikman, Irene
    Jansson, Maria
    MobiHealth projektet - mobil teknik2003Ingår i: Abstractbok för sjukgymnasdagarna 2003, Stockholm: Legitimerade sjukgymnasters riksförbund , 2003, s. 49-Konferensbidrag (Övrigt vetenskapligt)
  • 20.
    Melander-Wikman, Anita
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Eriksson, Lisbeth
    Gard, Gunvor
    Hur kan information och kommunikationsteknik (IKT) användas inom sjukgymnastisk verksamhet?: en interaktiv workshop2007Ingår i: Abstraktbok Sjukgymnastdagarna 10-12 oktober 2007, Stockholm: LSR , 2007, s. 24-Konferensbidrag (Övrigt vetenskapligt)
    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 21.
    Nilsson, Emma
    et al.
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Igelström, Helena
    Department of Neuroscience, Physiotherapy, Uppsala University, SE 752 37 Uppsala, Sweden.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Larsson, Agneta
    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.
    Positive Self-Perceptions of Aging Play a Significant Role in Predicting Physical Performance among Community-Dwelling Older Adults2021Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, nr 21, artikel-id 11151Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Self-perceptions of aging (SPA) is associated with various health-related outcomes, including physical performance. No previous study has investigated the potential predictive influence of SPA on physical performance among Swedish community-dwelling older adults. This was a cross-sectional study using a random sample of 153 Swedish community-dwelling individuals aged 70 and older. Multiple logistic regression analysis was performed, using the subscale “Attitude Towards Own Aging” of the Philadelphia Geriatric Center Morale Scale, as a measure of SPA. The Short Physical Performance Battery (SPPB) was dichotomized and used as the outcome variable. SPA was a significant predictor (OR = 1.546, CI = 1.066–2.243) of physical performance, adjusted for age, cognitive function, and life-space mobility. Further analyses revealed significant sex differences, with SPA not being included in the model for the men whilst it was still a significant predictor (OR = 1.689, CI = 1.031–2.765) of physical performance in the group of women. SPA plays a significant role in predicting physical performance among Swedish community-dwelling older adults. To further clarify this relationship and its consequences, future longitudinal research should focus on the relationship between SPA, physical performance, and fall risk.

  • 22.
    Nyberg, Lars
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Pauelsen, Mascha
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Johansson, Viktor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The relation between fall-related concerns and mobility in older age may be explained by underlying physical capacity and psychological factors2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background:

    Mobility is one essential aspect of healthy and active ageing. Fall related concerns have shown very strong detrimental effects on activity levels among older people. Recent perspectives on these concerns suggest they may be seen as consequences of a lower appraisal of one´s own abilities, in turn deriving from perceived balance problems, fears and other psychological factors. The relation between fall-related concerns and mobility might therefore be explained by the interaction of such underlying factors, for instance physical performance.

    Aim:

    To attempt a multivariate exploration of underlying factors that might explain the relation between fall-related concerns and mobility

    Method:

    We visited 153 randomly selected citizens aged 70 or more in a North Swedish municipality. We used the Life Space Assessment (LSA) in order to describe participants’ individual patterns of mobility in various life spaces. By means of Orthogonal Projections to Latent Structures (O-PLS) we explored whether presumed association of LSA ratings to fall related concerns (FES-I), age, and sex could be mediated by physical performance and psychological factors.

    Results:

    As expected, we found that LSA scores (95% CI: 65-72) were strongly associated to age, sex, and FES-I scores in univariate analyses. However, the O-PLS analysis resulted in a model explaining 60% of the LSA variance, in which motricity-related physical performance (SPPB), dyspnoea (mMRC Dyspnoea Scale), morale (PGCM), and type of housing contributed significantly, while variables such as age, sex, FES-I, and also falls experience, did not. Fall consequence concerns bordered on significance.

    Conclusions:

    Physical capacities and psychological factors are important mediators of the previously observed associations of fall related concerns to mobility. This opens for new intervention opportunities to be considered. The significance of type of housing should be further researched.

  • 23.
    Nyberg, Lars
    et al.
    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.
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Jäger, Jenny
    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.
    Falk, Jimmy
    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.
    Teknik ska minska fallolyckor bland äldre2023Ingår i: Äldre i Centrum, nr 1Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Ladda ner fulltext (pdf)
    fulltext
  • 24.
    Näslund, Annika
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Projekt: Pilotprojekt - budo som rehabilitering efter stroke2013Övrigt (Övrig (populärvetenskap, debatt, mm))
  • 25.
    Pauelsen, Mascha
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Jafari, Hedyeh
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Strandkvist, Viktor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Gustafsson, Thomas
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Frequency domain shows: Fall-related concerns and sensorimotor decline explain inability to adjust postural control strategy in older adults2020Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 15, nr 11, artikel-id e0242608Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Human postural control is a complex system and changes as we age. Frequency based analyses have been argued to be useful to identify altered postural control strategies in balance tasks. The aim of this study was to explore the frequency domain of the quiet stance centre of pressure of older adults with various degrees of fall-related concerns and sensorimotor functioning. We included 45 community dwelling older adults and used a force plate to register 30 seconds of quiet stance with eyes open and closed respectively. We also measured sensory and motor functions, as well as fall-related concerns and morale. We analysed the centre of pressure power spectrum density and extracted the frequency of 4 of its features for each participant. Orthogonal projection of latent structures–discriminant analysis revealed two groups for each quiet stance trial. Group 1 of each trial showed less sensory and motor decline, low/no fall-related concerns and higher frequencies. Group 2 showed more decline, higher fall-related concerns and lower frequencies. During the closed eyes trial, group 1 and group 2 shifted their features to higher frequencies, but only group 1 did so in any significant way. Higher fall-related concerns, sensory and motor decline, and explorative balancing strategies are highly correlated. The control system of individuals experiencing this seems to be highly dependent on vision. Higher fall-related concerns, and sensory and motor decline are also correlated with the inability to adjust to faster, more reactive balancing strategies, when vision is not available.

  • 26.
    Pauelsen, Mascha
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Jafari, Hedyeh
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Using the frequency power spectrum to learn more about aging postural control and fall-related concerns2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    Backgound:

    Posturography is widely used to describe and analyze human postural control. The traditional features of the center of pressure (CoP) trajectory during open eyes quiet standing tests have been used to show the association between declined sensorimotor systems and the variation in fall-related concerns (FrC), but seem to be too crude to separate each sensorimotor system’s contribution. Therefore, research has moved towards analysing the frequency domain of the CoP trajectory.

    Aim:

    To explore the frequency domain of CoP trajectory signals in an effort to learn more about ageing postural control and how it mediates and is mediated by FrC 

    Method:

    We recruited 45 people aged 70 or more. To measure body sway during quiet stance, we registered CoP trajectories using a force plate. A power spectral density analysis was performed on the CoP signal of all participants, from which we then extracted features: peak power, mean power, 50% power and 80% power. Principal component analysis, orthogonal projection to latent structures (OPLS), and OPLS-discriminant analysis were used to explore patterns of explanation of the features by a wide range of sensorimotor variables and FrC measured on the participants. A PLS-tree was used for the initial grouping.

    Results:

    The PLS-tree gave 2 groups. Group 2 had significantly more FrC, lower morale, larger errors in knee proprioception, slower reaction times, and weaker lower limb strength. They also had lower frequencies at all four features (significant at all but peak power).

    Conclusions:

    Under the assumption that the vision feedback loop generates more power in the lower frequencies of quiet stance sway, one explanation of the findings could be that once an individual starts experiencing postural control decline, vision gets weighed heavier in the integration process. More research is needed to find the most accurate ways to investigate postural control changes.

  • 27.
    Pauelsen, Mascha
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Both psychological factors and physical performance are associated with fall-related concerns2018Ingår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 30, nr 9, s. 1079-1085Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Fall-related concern strongly correlates to activity avoidance in older people.  In this complex phenomenon, different terminology and instruments are often used interchangeably. Three main concepts make up fall-related concerns: fear-of-falling, consequence concern, and falls self-efficacy. It is suggested that fall-related concerns are mediated by psychological and physical factors.

    Aims Our aims were to describe the prevalence of fall-related concerns and find explanatory factors for its most studied concept – falls self-efficacy – in an older population.

    Methods We executed a cross sectional study on a random sample of 153 community dwelling older people (70 years or older). We used validated and reliable instruments as well as structured interviews to gather data on the three concepts of fall-related concerns and possible mediating factors. We then calculated descriptive statistics on prevalence and regression models for the total group, and men and women separately.

    Results 70% of the total sample (80% of women and 53% of men) reported at least one of the three concepts of fall-related concern. For the total sample, fear-of-falling, morale and physical performance were associated factors with falls self-efficacy. For women, number of prescription medications was added. For men, physical performance and concerns for injury were associated.

    Conclusion Fall-related concern is prevalent in large proportions with higher prevalence for women than for men. Important factors are fear of falling, morale, and physical performance. Gender differences in the emergence and variance of fall-related concern and the relation between physical performance and fall-related concern should be targeted in future research endeavors. 

  • 28. Pauelsen, Mascha
    et al.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Fear, morale, and physical performance, not past falls, mediate fallsefficacy in community dwelling older people2017Ingår i: WCPT 2017 congress proceedings, 2017Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Fallrelatedconcerns have a large impact on wellbeing,balance performance and future falls. Theprimary focus in fallrelatedconcern research has generally been related to physical factors andprevious falls. This is mirrored by the use of the traditional fear avoidance model for falls in clinicalsettings, in which actual falls play a pivotal part in creating and perpetuating the cycle of fear activityavoidance fallsfear.Many researchers and clinicians, however, have started toacknowledge that more factors play a part in this complex issue.

    Purpose: We aimed at investigating fallsefficacyin relation to several psychological, demographic andphysical factors in an effort to discover a more fitting model for explaining fallrelatedconcern.

    Methods: We have visited a random population sample of 115 people, aged 70 or more and living in amunicipality in Northern Sweden. The participants were assessed for falls efficacy by means of theFalls Efficacy Scale International(FESI).We also collected data on selected potential covariatessuch as fear of falling, fall consequence concerns, falls history, physical performance, activity,cognitive performance, morale, medication and selected demographics. We then used multipleregression analyses in order to model covariate associations to prevalence and degree of fallrelatedconcern.

    Results: The analyses show the following: The sample presents a median FESIscore of 21, and 36 % (CI.95limits: 27 %; 44 %) score 22 or higher, indicating poor fallrelatedefficacy. Further, 39% (CI.95 limits:30 %; 48 %) express some degree of fear of falling while 54 % (CI.95 limits: 45 %; 63 %) areconcerned about sustaining injuries from a fall (consequence concern). The correlation betweenfear of falling and falls efficacy seems weak (r = .55), indicating related but separate phenomena.Moreover, data indicate no significant associations between previous falls and falls efficacy, fear offalling, or consequence concern. On the other hand, FESIscores seem to be explained to a degreeof 48 % by the three variables physical performance, fear of falling, and morale (as measured by thePhiladelphia Geriatric Centre Morale scale).

    Conclusion(s): These findings may contribute to a better understanding of fallrelatedconcerns. Perhaps fear,morale, and physical ability are stronger mediators than actual falls experience in itself. If so, thiswould call for the development of a new model which more adequately describes how fallrelatedconcerns are mediated while excluding falls as a cause.

    Implications: The clinical implications of this model would mean a shift to include more psychosocial aspects toreduce fallrelatedconcern and risk of falling. An approach directed more towards morale, as well asincreasing efficacy and improving physical performance.

  • 29.
    Pauelsen, Mascha
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Johansson, Viktor
    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.
    Decline in sensorimotor systems explains reduced falls self-efficacy2018Ingår i: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 42, s. 104-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Physical performance including balance tasks is one of the main factors explaining the variance in falls self-efficacy in older adults. Balance performance is often measured by use of gross assessment scales, which assess the result of integration of all systems involved in postural control. We aimed to investigate which measurements of postural control correlate to falls self-efficacy scores as measured by the FES-I instrument, and which sensory and motor systems best explain them. A cross sectional study was designed, in which 45 older adults performed quiet stance and limits of stability trials during which their center of pressure (CoP) excursion was recorded. Falls self-efficacy was measured using the Falls Efficacy Scale - International. Eyesight, vestibular function, proprioception, reaction time and strength were also measured. Hierarchical orthogonal projection of latent structures was used to model FES-I with the CoP trials and then with the sensory and muscle function data. Fes-I could be explained to 39%, with the eyes open trials and the limits of stability trials loading the heaviest. The base model could be explained to 40% using the sensory and muscle function data, with lower limb strength, leg proprioception, neck proprioception, reaction time and eyesight loading the heaviest.

    Ladda ner fulltext (pdf)
    fulltext
  • 30.
    Strandkvist, Viktor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering. Department of Public Health and Clinical Medicine, The OLIN Unit, division of Occupational and Environmental Medicine, Umeå University, Robertsviksgatan 9, 971 89 Luleå, Sweden..
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Pauelsen, Mascha
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, division of Medicine, Umeå University, Robertsviksgatan 9, 971 89, Luleå, Sweden.
    Gustafsson, Thomas
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, Hälsa, medicin och rehabilitering.
    Hand grip strength is strongly associated with lower limb strength but only weakly with postural control in community-dwelling older adults2021Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 94, artikel-id 104345Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Hand grip strength is frequently used as a measurement of muscle strength, especially among older adults. Muscle strength is only one of the many components in postural control and it is currently unclear to what extent hand grip strength is associated with postural control. The aim was to analyze the association between hand grip strength and lower limb muscle strength, and postural control among older adults.

    Methods:

    Forty-five community-dwelling individuals over 70 years of age provided isometric hand grip strength and lower limb strength (including hip extension and abduction, knee flexion and extension, and ankle dorsiflexion and plantarflexion), as well as postural control measurements. In the latter, center of pressure excursions were recorded for quiet stance and limits of stability tests on a force plate. Orthogonal projection of latent structures regression models were used to analyze associations between hand grip strength and lower limb strength as well as postural control, respectively.

    Results:

    Lower limb strength explained 74.4% of the variance in hand grip strength. All lower limb muscle groups were significantly associated with hand grip strength. In a corresponding model, postural control measured with center of pressure excursions explained 20.7% of the variance in a statistically significant, albeit weak, model.

    Conclusions:

    These results support that hand grip strength is a valid method to estimate lower limb strength among older adults on a group level. However, strength measurements seem insufficient as a substitute for measuring postural control, and therefore specific balance tests are necessary.

  • 31.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå, Sweden.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?2018Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, nr 7, s. 652-659Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Knowledge is limited concerning the type of symptoms and the time from onset of symptoms to first medical contact at first and second myocardial infarction in the same patient.

    AIM:

    This study aimed to describe the type of symptoms and the time from onset of symptoms to first medical contact in first and second myocardial infarctions in men and women affected by two myocardial infarctions. Furthermore, the aim was to identify factors associated with prehospital delays ≥2 h at second myocardial infarction.

    METHODS:

    A retrospective cohort study with 820 patients aged 31-74 years with a first and a second myocardial infarction from 1986 through 2009 registered in the Northern Sweden MONICA registry.

    RESULTS:

    The most common symptoms reported among patients affected by two myocardial infarctions are typical symptoms at both myocardial infarction events. Significantly more women reported atypical symptoms at the second myocardial infarction compared to the first. Ten per cent of the men did not report the same type of symptoms at the first and second myocardial infarctions; the corresponding figure for women was 16.2%. The time from onset of symptoms to first medical contact was shorter at the second myocardial infarction compared to the first myocardial infarction. Patients with prehospital delay ≥2 h at the first myocardial infarction were more likely to have a prehospital delay ≥2 h at the second myocardial infarction.

    CONCLUSIONS:

    Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient's behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.

  • 32.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men2017Ingår i: EuroHeartCare 2017, 2017Konferensbidrag (Övrigt vetenskapligt)
  • 33.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Lundblad, Dan
    Department of Public Health and Clinical Medicine, Sunderby Research Unit, Umeå University.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Time from onset of symptoms to medical presence at the first and at the second myocardial infarction: a comparative study2013Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 57, nr Suppl. 120, s. 27-Artikel i tidskrift (Övrigt vetenskapligt)
  • 34.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men. The Northern Sweden MONICA study2017Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr 5, s. 418-424Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Several studies have examined various parameters and experiences when patients suffer their first myocardial infarction (MI), but knowledge about when they suffer their second MI is limited.

    AIM: To compare risk factors for MI, that is, diabetes, hypertension and smoking, for the first and second MI events in men and women affected by two MIs and to analyse the time intervals between the first and second MIs.

    METHODS: A retrospective cohort study of 1017 patients aged 25-74 years with first and second MIs from 1990 through 2009 registered in the Northern Sweden MONICA registry.

    RESULTS: More women than men have diabetes and hypertension and are smokers at the first MI. Similar differences between the genders remain at the time of the second MI for diabetes and hypertension, although both risk factors have increased. Smoking decreased at the second MI without any remaining difference between genders. Women suffer their second MI within a shorter time interval than men do. Within 16 months of their first MI, 50% of women had a second MI. The corresponding time interval for men was 33 months.

    CONCLUSION: Patients affected by an MI should be made aware of their risk of recurrent MI and that the risk of recurrence is highest during the first few years after an MI. In patients affected by two MIs, women have a higher risk factor burden and suffer their second MI earlier than men do and thus may need more aggressive and more prompt secondary prevention.

  • 35.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study2017Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S62-S63, artikel-id 165Artikel i tidskrift (Refereegranskat)
  • 36.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa, medicin och rehabilitering.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad och medicinsk teknik.
    To be seen as a unique person after suffering a second myocardial infarction: Expressed needs of patients and descriptions of personnel2020Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 57, artikel-id 102797Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

    The aim of this study was to describe patients’ expressed needs during cardiac rehabilitation after suffering a second myocardial infarction in comparison to personnel’s descriptions of how they work with these patients.

    Research methodology

    A descriptive qualitative design. Interviews were conducted with patients affected by two myocardial infarctions and registered nurses, physiotherapists and cardiologists working with cardiac rehabilitation. Data were analysed with qualitative content analysis.

    Findings

    An interpretation of the underlying meaning in the categories was formulated into one theme: ‘To be seen as a unique person’. Patients expressed a need for individualised care; they wanted the cardiac rehabilitation to be customised to their condition and prognosis; however, they did not perceive their care was individualised. Personnel described the importance of the care being individualised, although they had guidelines to follow. It was crucial for them to see the individual and discover what was important for each patient.

    Conclusions

    There was a shared opinion from patients and personnel that individual care is essential. Using the concept and working in accordance with person-centred care could meet the patients’ need for individualised care.

  • 37.
    Sundbaum, Johanna
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Back, Johan
    Institutionen för medicinska vetenskaper, Uppsala Universitet.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Baecklund, Eva
    Institutionen för medicinska vetenskaper, Uppsala Universitet.
    Kontrollprovtagning vid metotrexatebehandling av RA patienter: Erfarenheter från en reumatologklinik2014Konferensbidrag (Övrigt vetenskapligt)
    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 38.
    Sundbaum, Johanna
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Berglund, V.
    Uppsala University, Dermatologic Section, Department of Medical Science.
    Back, Johan
    Institutionen för medicinska vetenskaper, Uppsala Universitet.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Rollman, O.
    Uppsala University, Dermatologic Section, Department of Medical Science.
    Baecklund, Eva
    Enheten för reumatologi, Institutionen för medicinska vetenskaper, Uppsala universitet, Institutionen för medicinska vetenskaper, Uppsala Universitet.
    Methotrexate in rheumatoid arthritis and psoriasis/psoriatic arthritis: a comparative study of hepatotoxicity2014Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 43, s. 29-Artikel i tidskrift (Refereegranskat)
  • 39.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Falls, perceived fall risk and activity curtailment among older people receiving home-help service2011Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Falls and fall-related concern and fear of falling are not well understood when it comes to old people receiving home-help services, a transitional population in-between those living independently in the community and those living in residential care facilities. The psychological distress attributable to the perceived risk of falling among this population needs further exploration, which is also the case regarding possible ways to increase their feeling of security. The aims of this thesis were to investigate the incidence of falls, fall-related concern, fear of falling and fall-related activity curtailment amongst older people receiving homehelp services, as well as exploring the validity and user expectations of an automatic fall detector and alarm prototype. In a one-year prospective cohort study of 614 home-help recipients in one municipality in northern Sweden, the fall incidence was estimated to be 626 (95% CI: 479 – 773) per 1,000 person-years. The fall risk was significantly associated with receiving help for personal ADL needs: IRR 2.8 (95 % CI: 2.1 - 3.8). An unexpected finding was that the fall incidence was significantly correlated to the amount of daylight (r: -0.78, r2: 0.61; p: 0.003). A cross-sectional study of 51 home-help recipients in three municipalities in northern Sweden revealed that 65% (95% CI: 52% – 78%) had a high degree of concern about falling according to the Falls Efficacy Scale International (FES-I). This concern was significantly associated with concern about the consequences of falling, mobility and morale, but its correlation to fear of falling was moderate. The proportion reporting that they needed assistance to perform a specific activity or avoided one owing to a fear of falling was 57% and 26%, respectively. Such fear-dependent need for assistance was associated with morale and mobility, and fear-dependent activity avoidance with morale and fallrelated concern. While wearing a fall sensor attached to their hips, twenty middle-aged people performed six different intentional falls. For reference, these people, and 21 older people from a residential care unit, walked through a sequential ADL track. The results showed that the sensor could discriminate various types of falls from daily life activities with a sensitivity of 97.5% and a specificity of 100%. When the principle of the automatic fall sensor and alarm system were described for them, 74% of the 51 elderly home-help recipients stated that it would increase their security, 66% that it would decrease their fear of falling and 57% that it would increase their freedom to move about, while 28% feared it could influence their privacy. In conclusion, falls and fall-related concern seem to be common amongst the elderly recipients of home-help services, and this should be taken into account when planning the provision of services. Mobility, concern about the consequences of falling and morale seem to be connected both with a concern about falling and fall-related activity curtailment. Furthermore, a fall detector system has promising potential for use among homehelp recipients. The correlation between the incidence of falling and the amount of daylight should be further explored.

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 40.
    Vikman, Irene
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordlund, Anders
    Stockholms Universitet.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Falls among old people receiving home-help services2008Konferensbidrag (Övrigt vetenskapligt)
  • 41.
    Vikman, Irene
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordlund, Anders
    Stockholm University.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Incidence of falls among old people recieving home help services in a swedish municipality2009Ingår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 13, nr 6, Suppl. 1, s. S428-Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Falls among old people are a well-mapped phenomenon, however, falls among people living in the community and receiving home-help services have been scarcely studied. Therefore, we investigated falls among community living home-help receivers in a Swedish municipality. This prospective cohort study included all 614 persons aged 65 and over, receiving municipality home help during one year from October 2005 in a particular community. Data on age, sex, and home help service use were collected from home-help services records, and falls were reported by staff on report forms specifically designed for the study. The overall fall incidence was 626 per 1000 PY, and incidence rate ratios were significantly correlated to total amount of services (p<0,001), as well as to the amounts of help for I-ADL needs (p<0,001), P-ADL needs (p<0,001), meal distribution (p<0,001) and escort service (p=0,004).The proportion of falls reported as resulting in injury was 33 %. In conclusion, the fall incidence rate among home-help receivers aged 65 and over seems strongly correlated to the amount of services. This implies that fall prevention should be considered when planning the care for old people with ADL and mobility needs.

  • 42.
    Vikman, Irene
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordlund, Anders
    Department of Social Work, Stockholm University.
    Näslund, Annika
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Incidence and seasonality of falls amongst old people receiving home help services in a municipality in northern Sweden2011Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 70, nr 2, s. 195-204Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives. Falls among old people is a well-documented phenomenon; however, falls among people living in the community and receiving home help services have been under-researched. The aim of this study was to investigate the incidence, including possible seasonal variation, circumstances and injuries related to falls among community living home help receivers, and to investigate whether fall incidence is associated with the type and amount of home help services received. Study design. Prospective cohort study. Methods. All 614 persons aged 65 and over who were living in a particular northern Swedish community and receiving municipality home help were included. Data on age, sex and home help service use were collected from home help service records, and falls were reported by staff on report forms specifically designed for the study. Results. A total number of 264 falls were recorded among 122 participants. The overall fall incidence was 626 per 1,000 PY, and incidence rate ratios were significantly correlated to the total amount of services used (p<0.001), as well as to the degree of help for I-ADL needs (p<0.001), P-ADL needs (p<0.001) and escort service (p=0.007). The proportion of falls reported as resulting in injury was 33%. The monthly fall incidence was significantly associated to daylight photoperiod, however it was not associated to temperature. Conclusions. Fall incidence among home help receivers aged 65 and over seems correlated to the amount of services they receive. This is probably explained by the fact that impairments connected to ADL limitations and home help needs also are connected to an increased risk of falls. This implies that fall prevention should be considered when planning home help care for old people with ADL limitations. Further research on the connection between daylight photoperiod and fall incidence in populations at different latitudes is needed.

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