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  • 1.
    Sjöholm, Hanna
    et al.
    Rehabilitation Centre, Region Jönköping County, Jönköping and Department of Medical and Health Sciences, Linköping University, Linköping.
    Hägg, Staffan
    Futurum, Region Jönköping County, Jönköping and Department of Medical and Health Sciences, Linköping University, Linköping.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Rolander, Bo
    Futurum, Region Jönköping County, Jönköping.
    Kammerlind, Ann-Sofi
    Futurum, Region Jönköping County, Jönköping.
    The Cone Evasion Walk test: Reliability and validity in acute stroke2019Ingår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, nr 1, artikel-id e1744Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVETo estimate the reliability and validity of the Cone Evasion Walk test (CEW), a new test assessing the ability to evade obstacles, in people with acute stroke.

    METHODSTo estimate the reliability of the CEW, video recordings of 20 people with acute stroke performing the test were assessed by 10 physiotherapists on two occasions, resulting in a total of 400 ratings. Patients performed the CEW (n = 221), functional ambulation classification (FAC; n = 204), Timed Up and Go (TUG; n = 173), TUG cognitive (TUG-cog; n = 139), Serial 7s attention task from the Montreal Cognitive Assessment (MoCA-S7; n = 127), and the Star Cancellation Test (SCT; n = 151). These tests and side of lesion (n = 143) were used to examine construct validity. The predictive validity was evaluated in relation to falls during the following 6 months (n = 203).

    RESULTSThe intraclass correlation coefficients for intrarater and interrater reliability were 0.88-0.98. For validity, there were significant correlations between the CEW and FAC (rs  = -0.67), TUG (rs  = 0.45), MoCA-S7 (rs  = -0.36), and SCT total score (rs  = -0.36). There was a significant correlation between the number of cones touched on the left side and the proportion of cancelled stars on the left (rs  = -0.23) and right (rs  = 0.23) side in the SCT. Among right hemisphere stroke participants (n = 79), significantly more persons hit cones on the left side (n = 25) than the right side (n = 8), whereas among those with a left hemisphere stroke (n = 64) significantly more persons hit cones on the right side (n = 11) than the left (n = 3). Cox regression showed that participants who touched four to eight cones had an increased risk of falls over time (hazard ratio 2.11, 95% CI [1.07, 4.17]) compared with those who touched none.

  • 2.
    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. 

  • 3.
    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.
    On Internal Modeling of the Upright Postural Control in Elderly2018Konferensbidrag (Refereegranskat)
  • 4.
    Sjöholm, Hanna
    et al.
    Department of Medical and Health Sciences, Linköping University.
    Hägg, Staffan
    Department of Medical and Health Sciences, Linköping University.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Kammerlind, Ann-Sofi
    Department of Medical and Health Sciences, Linköping University.
    Reliability of test procedures for postural reactions in people with acute stroke2018Ingår i: International Journal of Therapy and Rehabilitation, ISSN 1741-1645, E-ISSN 1759-779X, Vol. 25, nr 11, s. 576-586Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Regaining and maintaining balance requires postural reactions such as righting reactions, equilibrium reactions, and protective reactions. There is a lack of uniform, standardised, and reliable testing procedures for postural reactions. The aim of the present study was to examine the intra- And interrater reliability of a newly developed postural reactions assessment for use in people with acute stroke. Methods: The Postural Reactions Test was developed based on the literature, on previous tests, and on input from an expert panel. A total of 10 physiotherapists assessed a total of 20 video recordings of people with acute stroke performing each postural reaction. These assessments were carried out on two occasions at least 2 weeks apart. The study thus included 400 ratings. Findings: For intrarater reliability, the overall proportion of agreement was 86 - 93% for the different postural reactions. For interrater reliability, the most common score for each participant and the number of physiotherapists giving that score were noted. A median of 9-10 out of 10 physiotherapists scored the same value. Conclusions: The results indicate that the Postural Reactions Test can be used to reliably assess function in people with acute stroke and that the test can complement the existing assessments for people with affected postural control

  • 5.
    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 trial2017Ingår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 21, nr 6, s. 1110-1120Artikel i tidskrift (Refereegranskat)
    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

  • 6. 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.

  • 7.
    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 studies2016Övrigt (Övrig (populärvetenskap, debatt, mm))
  • 8.
    Ahlmark, Daniel Innala
    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 Impairment2015Ingår i: Journal of Assistive Technologies, ISSN 1754-9450, E-ISSN 2042-8723, Vol. 9, nr 4, s. 199-206Artikel i tidskrift (Refereegranskat)
    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.

  • 9.
    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.

  • 10.
    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.

  • 11.
    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. peter.michaelson@ltu.se .
    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 study2014Konferensbidrag (Övrigt vetenskapligt)
  • 12.
    Röijezon, Ulrik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Paarup, Helene M.
    Research Unit for Occupational & Environmental Medicine, Clinical Institute, University of Southern Denmark.
    Nordic Dedication to Musicians' Health and Performance: A Successful Launch of the First Nordic Conference2014Ingår i: Medical problems of performing artists, ISSN 0885-1158, E-ISSN 1938-2766, Vol. 29, nr 4, s. 243-245Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Within the last 30 years performing arts medicine has grown internationally as a scientific and clinical specialty for investigation, examination, treatment, and prevention of disorders among performing arts professionals and amateurs, i.e., dancers, singers, musicians, actors, and others engaged in performing arts. In the Nordic countries, clinical specialization and research regarding the health situation of musicians and other performing artists has been relatively sparse. However, this has gained speed in the last decade and is today a growing field. Musicians' Health and Performance 1st Nordic Conference 2013 took place June 13-14, 2013, at the Acusticum Concert Hall in Piteå in the northern part of Sweden, close to the Arctic circle

  • 13.
    Nordström, Birgitta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Ekenberg, Lilly
    County Council of Norrbotten, Department of Research and Development.
    Näslund, Annika
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The psychosocial impact on standing devices2014Ingår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 9, nr 4, s. 299-306Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this study was to explore the psychosocial impact of standing devices as experienced by users. Method: This is the second part of a comprehensive survey in five counties in Sweden where all the subjects with standing devices were invited to participate. The impact of standing devices on functional independence, quality of life and wellbeing was assessed using a questionnaire, Psychosocial Impact of Assistive Devices Scale (PIADS). Results: The psychosocial impact of the standing devices was perceived as positive. The highest PIADS scores in relation to age were found in the oldest group, aged 65 years and older. The ability to walk and independence in ambulation resulted in higher scores than the use of a wheelchair and/or dependence on others. Those who stood often awarded higher scores in the PIADS questionnaire compared to those who used the device less frequently. When standing was integrated in various activities, its psychosocial impact received high scores. Conclusion: The psychosocial impact of standing devices was generally experienced positively. The main results indicated that standing in a standing device had a value and we as professionals should ask the users about the intended purpose of their standing in order to prescribe the optimal device.Implications for Rehabilitation •Standing in standing devices has positive psychosocial impact for the user.•As professionals we should broaden our view of the use of standing devices, i.e. to see the standing device as an aid that not only treats the body’s structures or improves the user’s abilities in activities, but also provides a psychosocial impact on the user’s daily life, and to find meaningful goals for the user from a psychosocial perspective

  • 14.
    Wiklund-Axelsson, Sari-Anne
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Melander-Wikman, Anita
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Näslund, Annika
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Older people's health-related ICT-use in Sweden2013Ingår i: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 12, nr 1, s. 36-43Artikel i tidskrift (Refereegranskat)
  • 15.
    Lindelöf, Nina
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Rosendahl, Erik
    Gustafsson, Samuel
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Nygaars, Joachim
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    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)2013Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 57, nr 3, s. 369-376Artikel i tidskrift (Refereegranskat)
    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

  • 16.
    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 stöd2013Övrigt (Övrig (populärvetenskap, 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.

  • 17.
    Wiklund-Axelsson, Sari-Anne
    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.
    Melander-Wikman, Anita
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Ready to adopt: Swedish older person’s perceptions of psychosocial impact of existing and future mobile health related ICT applications2013Konferensbidrag (Refereegranskat)
  • 18.
    Wiklund-Axelsson, Sari-Anne
    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.
    Melander-Wikman, Anita
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The anticipated positive psychosocial impact of present web-based e-health services and future mobile health applications: an investigation among older Swedes2013Ingår i: International Journal of Telemedicine and Applications, ISSN 1687-6415, E-ISSN 1687-6423, ISSN 1687-6415, artikel-id 509198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study investigates the anticipated psychosocial impact of present web-based e-health services and future mobile health applications among older Swedes. Random sample’s of Swedish citizens aged 55 years old and older were given a survey containing two different e-health scenarios which respondents rated according to their anticipated psychosocial impact by means of the PIADS instrument. Results consistently demonstrated the positive anticipation of psychosocial impacts for both scenarios. The future mobile health applications scored more positively than the present web-based e-health services. An increase in age correlated positively to lower impact scores. These findings indicate that from a psychosocial perspective, web-based e-health services and mobile health applications are likely to positively impact quality of life. This knowledge can be helpful when tailoring and implementing e-health services that are directed to older people.

  • 19.
    Nordström, Birgitta
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Näslund, Annika
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Eriksson, Margareta
    County Council of Norrbotten, Department of Research and Development.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Ekenberg, Lilly
    County Council of Norrbotten, Department of Research and Development.
    The impact of supported standing on well-being and quality of life2013Ingår i: Physiotherapy Canada, ISSN 0300-0508, E-ISSN 1708-8313, Vol. 65, nr 4, s. 344-352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To identify the characteristics of people who use standing devices and to explore their degree of device use, experiences with and reasons for standing, and perceived impact of the use of standing devices on well-being and quality of life (QOL). Method: Anyone with a current prescription at the time for the study in any of five counties in Sweden (n 1/4 545), according to a national register of prescribed devices, was invited to participate in a descriptive survey; the questionnaire was mailed to respondents for self-rating. Results: People between 2 and 86 years old were represented among respondents. Standing time decreased with increased age. Respondents who were totally dependent for mobilization or who had received their standing device more than 5 years earlier used their device most frequently. The most common reasons given for standing were to improve circulation and wellbeing and to reduce stiffness. Conclusion: It is important to pay attention to the experiences of standing for this vulnerable group of people, as the use of a standing device has a positive impact on well-being and QOL.

  • 20.
    Ahlmark, Daniel Innala
    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 rullstolen2013Konferensbidrag (Övrigt vetenskapligt)
  • 21.
    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.

  • 22.
    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 rullstol2012Övrigt (Övrig (populärvetenskap, 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.

  • 23.
    Mikaelsson, Katarina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lysholm, Jack
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    The relationship between the physical capacity and physical activity of adolescents2012Ingår i: Gazzetta Medica Italiana, ISSN 0393-3660, E-ISSN 1827-1812, Vol. 171, nr 5, s. 639-651Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim. Physical activity and physical capacity are important health related parameters for all age-groups. Yet, little is known about the relationship between physical activity and physical capacity amongst adolescents about to leave compulsory education. The aim of the study was to investigate how physical capacities are related to self-reported energy expenditure on physical activities at different levels of physical activity and amount of time spent sitting among graduates of upper secondary school. Methods. In total, 99 third grade students participated from upper secondary school. Levels of physical activity and the amount of time spent sitting were assessed using the International Physical Activity Questionnaire (IPAQ). The energy expenditure was calculated based on the activity determined by the IPAQ. The participants’ physical capacity was tested using VO2max, muscle strength and balance measures. The relationship between physical activity and physical capacity was addressed using linear regression models. Results. There was significant relationship between Total METs and aerobic capacity (R2 = 0.15), push-ups (R2 = 0.08) and sit-ups (R2 = 0.07). A stronger significant relationship was revealed for activity performed on Vigorous activity METs for aerobic capacity (R2 = 0.23), push-ups (R2 = 0.18) and sit-ups (R2 = 0.10). The regression analyses for Moderate activity METs, Walking activity METs and time spent Sitting showed no significant relationship to any measures of physical capacity. Conclusion. For adolescents, the intensity of physical activity is of importance for achieving high aerobic capacity, and the amount of time spent sitting does not influence physical capacity.

  • 24.
    Mikaelsson, Katarina
    et al.
    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. peter.michaelson@ltu.se .
    Inactivity in adolescents, what are the effects on physical capacity?2011Ingår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 97, nr Suppl. 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of the study was to investigate the effect of physical activity on physical capacity among graduates from upper secondary school.Relevance: Physical activity and physical fitness are important health related parameters, which both have declined the last decades. Adolescents who are about to leave compulsory school and physical education are supposed to peak regarding physical capacity. Therefore it is interesting to investigate the effect physical inactivity (according to WHO-recommendation) have on physical performance.Participants: The participants where third grade students (38 female and 61 male) from upper secondary school (18 - 20 years).Methods: International Physical Activity Questionnaire (IPAQ) was used to estimate the level of physical activity. The participants were divided, in accordance with World Health Organizations recommendations for physical activity, to A) physically inactive or B) physically active. Physical fitness was tested using the Åstrand bicycle test and functional tests of muscular strength and balance.Analysis: By Student's independent t-test, separate for females and males, differences in aerobic capacity, push-ups, grip strength, vertical jump height, sit-ups and balance, between physically inactive and active were tested.Results: Maximum oxygen uptake differed significantly between physically inactive and active males (mean ± SD: 3.0 ± 0.6 l/kg, vs. 3.6 ± 0.7 p = 0.002) and females (2.5± 0.3 l/kg, vs. 3.0 ± 0.6 p = 0.016). There was a difference among physically inactive and active males regarding push-ups (28.5 ± 7.0 vs. 37.1 ± 9.0, p < 0.001) and sit-ups (39.6 ± 19.4 vs. 59.2 ± 30.2, p = 0.010). No significant differences were found regarding vertical jump or grip strength among males, any of the muscle strength measurements among females, and balance (in any sex).Conclusions: The level of physical activity was related to aerobic capacity in both sexes, but did not seem to have the same impact on muscular fitness and balance, especially concerning the females. Since aerobic capacity is an important parameter in preventing future health problems, it is crucial to engage all adolescents in physical activity.Implications: According to this study physical activity have positive effects on aerobic capacity, without similar trend in muscle strength. Addressing strength training, as complement to aerobic training should be recommended regardless of level of physical activity performed. Therefore we see a future need for promoting and designing detailed guidelines regarding strength training for children and adolescents.

  • 25.
    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.

  • 26.
    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?2011Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 52, nr 3, s. E220-E225Artikel i tidskrift (Refereegranskat)
    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.

  • 27.
    Mikaelsson, Katarina
    et al.
    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. peter.michaelson@ltu.se .
    Is self-rated physical activity a good indicator of physical capacity and is time spent sitting negative for physical capacity?2011Ingår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 97, nr Suppl. 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this study was to relate levels of physical activity to physical capacity and to study whether time sitting influences physical capacity among students in upper secondary school.Relevance: Physical activity and physical fitness are important health related parameters. Modern living habits with increased time spent on sedentary behaviors like watching TV and computer gaming have a potential for a negative influence. This calls for reliable and cost-effective measures of physical activities as indicators of physical capacity as tools for identifying people with an inactive lifestyle.Participants: Research participants where 99 third grade students (38 female, 61 male) from upper secondary school in Sweden (18-20 years).Methods: Levels of physical activity was established using the International Physical Activity Questionnaire (IPAQ) and determined for both 1) Level of activity (Total, Vigorous, Moderate, Walking), 2) IPAQ-classification Amount of activity (High, Medium, Low) and 3) Time sitting. Physical fitness was measured using the Åstrand bicycle test and functional tests of muscular strength.Analysis: The relation between 1) Level of activity, 2) IPAQ- amount of activity and 3) Time sitting and physical capacity was investigated by separate linear regression analyses.Results: There were a relation between Total level of activity and A) aerobic capacity (l/min2) (R2 = 0.1, p = 0.001), B) push-ups (R2 = 0.05, p = 0.011), and C) sit-ups (R2 = 0.046, p = 0.016), while other measure of physical capacity was non significant. An identical pattern was reveled for activity performed on Vigorous level with A) aerobic capacity (l/min2) (R2 = 0.2, p < 0.000), B) push-ups (R2 = 0.16, p < 0.000) and C) sit-ups (R2 = 0.082, p = 0.023). For activity on Moderate level the only significant relation was with aerobic capacity (R2 = 0.033, p = 0.033). For Walking no relation was significant. Regarding the IPAQ-classification of High-, Medium, and Low physical activity, no relation with any measures of physical capacity was found. Further, surprisingly, no relation was found between Time sitting and any measures of physical capacity.Conclusions: The results imply that the intensity of physical activity is of importance for achieving high aerobic capacity, while the amount of activity is not. Further, our results indicate that time sitting is not related to physical capacity.Implications: The self-rated questionnaire IPAQ can be questioned for use as a direct indicator of health parameters as physical capacity. Further, it seems that the intensity of activity is of importance for physical performance.

  • 28.
    Mikaelsson, Katarina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Eliasson, Kristina
    Luleå tekniska universitet.
    Lysholm, Jack
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Physical capacity in physically active and non-active adolescents2011Ingår i: Journal of Public Health, ISSN 1741-3842, E-ISSN 1741-3850, Vol. 19, nr 2, s. 131-138Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this study was to investigate differences in physical capacity between physically active and non-active men and women among graduates from upper secondary school. Subject and methods: Research participants were graduates (38 women and 61 men) from upper secondary school. Physical activity was determined using the International Physical Activity Questionnaire, and participants were dichotomously characterized as being physically active or physically non-active according to the recommendations of the World Health Organization (WHO). Aerobic capacity was measured using the Åstrand cycle ergometer test. Participants also underwent tests of muscular strength and balance. Results: Maximum oxygen uptake differed significantly between physically active and non-active men (mean ± SD 3.6 ± 0.7 vs 3.0 ± 0.6 l/kg, p = 0.002) and women (3.0 ± 0.6 vs 2.5 ± 0.3 l/kg, p = 0.016). There was a difference among physically active and non-active men regarding push-ups (37.1 ± 9.0 vs 28.5 ± 7.0, p < 0.001) and sit-ups (59.2 ± 30.2 vs 39.6 ± 19.4, p = 0.010). No significant differences were found regarding vertical jump or grip strength among men, any of the muscle strength measurements among women, and balance (in any sex). Conclusion: Activity levels had impact on aerobic capacity in both sexes, but did not seem to have the same impact on muscular strength and balance, especially in women

  • 29.
    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 trial2010Ingår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, nr 3, s. 115-124Artikel i tidskrift (Refereegranskat)
    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

  • 30.
    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.

  • 31.
    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.

  • 32.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nordin, Ellinor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Lars
    A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities2008Ingår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 20, nr 1, s. 67-75Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND AIMS: Falls are particularly common among older people living in residential care facilities. The aim of this randomized controlled trial was to evaluate the effectiveness of a high-intensity functional exercise program in reducing falls in residential care facilities. METHODS: Participants comprised 191 older people, 139 women and 52 men, who were dependent in activities of daily living. Their mean±SD score on the Mini-Mental State Examination was 17.8±5.1 (range 10-30). Participants were randomized to a high-intensity functional exercise program or a control activity, consisting of 29 sessions over 3 months. The fall rate and proportion of participants sustaining a fall were the outcome measures, subsequently analysed using negative binominal analysis and logistic regression analysis, respectively. RESULTS: During the 6- month follow-up period, when all participants were compared, no statistically significant differences between groups were found for fall rate (exercise group 3.6 falls per person years [PY], control group 4.6 falls per PY), incidence rate ratio (95% CI) 0.82 (0.49-1.39), p=0.46, or the proportion of participants sustaining a fall (exercise 53%, control 51%), odds ratio (95% CI) 0.95 (0.52-1.74), p=0.86. A subgroup interaction analysis revealed that, among participants who improved their balance during the intervention period, the exercise group had a lower fall rate than the control group (exercise 2.7 falls per PY, control 5.9 falls per PY), incidence rate ratio (95% CI) 0.44 (0.21-0.91), p=0.03. CONCLUSIONS: In older people living in residential care facilities, a high-intensity functional exercise program may prevent falls among those who improve their balance.

  • 33.
    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)
  • 34.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nordin, Ellinor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Lars
    High-intensity functional exercise program for older people dependent in ADL: a randomized controlled trial evaluating the effects on falls2008Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    PURPOSE: To determine if a high-intensity functional exercise program improves balance, gait ability, and lower-limb strength in older people dependent in activities of daily living (ADL), if an intake of protein-enriched energy supplement immediately after the exercises increases these effects of the training, and if the exercise program reduces falls. RELEVANCE: Impairments in physical functions among older people can lead to dramatic consequences for the individual such as admission to nursing home, falls and fractures. High-intensity exercise programs are effective to improve physical functions among older people but knowledge is limited concerning the effects for older people with severe cognitive or physical impairments. PARTICIPANTS: 191 older people dependent in ADL, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ≥ 10 participated in this study (the FOPANU Study). METHODS: The participants were randomized to a high-intensity functional weight-bearing exercise program (the HIFE Program) or a control activity, including 29 sessions over 3 months, as well as to protein-enriched energy supplement or placebo. Berg Balance Scale, usual and maximum gait speed, and one-repetition maximum in lower-limb strength were followed-up at 3 and 6 months by assessors blinded to group allocation. Fall rate and the proportion of participants sustaining a fall during the six months following the intervention were the outcome measures of the fall preventive effect of the exercise program. ANALYSIS: The intention-to-treat principle was used. Balance, gait ability, and lower-limb strength: 2 x 2 factorial ANCOVA. Falls: Negative binominal analysis and logistic regression analysis. RESULTS: At 3 months, the exercise group had improved significantly in usual gait speed compared with the control group (mean difference 0.04 m/s, P = 0.02). At 6 months, there were significant improvements favoring the exercise group for Berg Balance Scale (1.9 points, P = 0.05), usual gait speed (0.05 m/s, P = 0.009), and lower-limb strength (10.8 kg, P = 0.03). No interaction effects were seen between the exercise and nutrition interventions. When all participants were compared, no statistically significant differences between groups were found for fall rate (exercise group 3.6 falls per person years and control group 4.6 fall per person years) or the proportion of participants sustaining a fall (exercise 53% and control 51%). A subgroup interaction analysis revealed that among participants who improved their balance during the intervention period, the exercise group had a lower fall rate than the control group (exercise 2.7 falls per person years and control 5.9 falls per person years, incidence rate ratio 0.44, P = 0.03). CONCLUSIONS: A high-intensity functional exercise program has positive long-term effects in balance, gait ability, and lower-limb strength for older people who are dependent in ADL. An intake of protein-enriched energy supplement immediately after the exercises does not appear to increase these effects of the training. In addition, the high-intensity functional exercise program may have an effect in preventing falls among those who respond to the intervention. IMPLICATIONS: High-intensity functional exercise can be offered to improve physical functions among older people who are living in residential care facilities and have severe cognitive or physical impairments.

  • 35. 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 analysis2008Ingår i: 2nd International Symposium on Medical Information and Communications Technology: ISMICT'07. Proceedings, Oulu: University of Oulu, 2008Konferensbidrag (Refereegranskat)
  • 36.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Littbrand, Håkan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lindelöf, Nina
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundin-Olsson, Lillemor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Yngve, Gustafson
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    A high-intensity functional exercise program is applicable for older people with cognitive impairment2007Ingår i: Research and practice in Alzheimer's disease, Paris: Serdi publisher , 2007, s. 212-215Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    Maintaining or improving physical functions among older people with cognitive impairment in effective ways is of great importance, since cognitive decline is associated with a decline in physical performance. Training at high intensity has a greater effect than at a lower intensity, but there are few studies evaluating high-intensity training among older people with severe cognitive impairment. However, results from a recent study (the FOPANU Study) among older people dependent in activities of daily living and living in residential care facilities showed that a high-intensity functional weigh-bearing program had positive long-term effects on balance, gait ability and lower-limb strength. The mean score for the Mini-Mental State Examination was 18 (range 10-29) and 52% of the participants had a dementia disease. Regarding the applicability of the exercise program, no statistically significant differences in attendance, intensity or adverse events were observed when participants with dementia were compared with participants without dementia. A main clinical implication of the FOPANU Study is that people with severe cognitive impairment can be offered high-intensity functional exercise programs.

  • 37.
    Stenvall, Michael
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Olofsson, Birgitta
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Lundström, Maria
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    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 Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    A multidisciplinary, multifactorial intervention program reduces postoperative falls and injuries after femoral neck fracture2007Ingår i: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 18, nr 2, s. 167-75Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study evaluates whether a postoperative multidisciplinary, intervention program, including systematic assessment and treatment of fall risk factors, active prevention, detection, and treatment of postoperative complications, could reduce inpatient falls and fall-related injuries after a femoral neck fracture. METHODS: A randomized, controlled trial at the orthopedic and geriatric departments at Umea University Hospital, Sweden, included 199 patients with femoral neck fracture, aged >/=70 years. RESULTS: Twelve patients fell 18 times in the intervention group compared with 26 patients suffering 60 falls in the control group. Only one patient with dementia fell in the intervention group compared with 11 in the control group. The crude postoperative fall incidence rate was 6.29/1,000 days in the intervention group vs 16.28/1,000 days in the control group. The incidence rate ratio was 0.38 [95% confidence interval (CI): 0.20 - 0.76, p = 0.006] for the total sample and 0.07 (95% CI: 0.01-0.57, p=0.013) among patients with dementia. There were no new fractures in the intervention group but four in the control group. CONCLUSION: A team applying comprehensive geriatric assessment and rehabilitation, including prevention, detection, and treatment of fall risk factors, can successfully prevent inpatient falls and injuries, even in patients with dementia.

  • 38.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lindelöf, Nina
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Littbrand, Håkan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Yifter-Lindgren, Elinor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nordin, Ellinor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Håglin, Lena
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    High-intensity functional exercise program for older people dependent in ADL: an RCT evaluating the effects on physical functions and falls2007Ingår i: 15th International Congress of The World Confederation for Physical Therapy: 2-6 June 2007, Vancouver, Canada, WCPT , 2007Konferensbidrag (Övrigt vetenskapligt)
  • 39.
    Stenvall, Michael
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Olofsson, Birgitta
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundström, Maria
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Improved performance in activities of daily living and mobility after a multidisciplinary postoperative rehabilitation in older people with femoral neck fracture: a randomized controlled trial with 1-year follow-up2007Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 3, s. 232-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the short- and long-term effects of a multidisciplinary postoperative rehabilitation programme in patients with femoral neck fracture. DESIGN AND SUBJECTS: A randomized controlled trial in patients (n = 199) with femoral neck fracture, aged >or= 70 years. METHODS: The primary outcomes were: living conditions, walking ability and activities of daily living performance on discharge, 4 and 12 months postoperatively. The intervention consisted of staff education, individualized care planning and rehabilitation, active prevention, detection and treatment of postoperative complications. The staff worked in teams to apply comprehensive geriatric assessment, management and rehabilitation. A geriatric team assessed those in the intervention group 4 months postoperatively, in order to detect and treat any complications. The control group followed conventional postoperative routines. RESULTS: Despite shorter hospitalization, significantly more people from the intervention group had regained independence in personal activities of daily living performance at the 4- and 12-month follow-ups; odds ratios (95% confidence interval (CI) ) 2.51 (1.00-6.30) and 3.49 (1.31-9.23), respectively. More patients in the intervention group had also regained the ability to walk independently indoors without walking aids by the end of the study period, odds ratio (95% confidence interval) 3.01 (1.18-7.61). CONCLUSION: A multidisciplinary postoperative intervention programme enhances activities of daily living performance and mobility after hip fracture, from both a short-term and long-term perspective

  • 40.
    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 study2007Ingår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 19, nr 3, s. 178-86Artikel i tidskrift (Refereegranskat)
    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

  • 41.
    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 function2006Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 86, nr 4, s. 489-98Artikel i tidskrift (Refereegranskat)
    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.

  • 42.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Fysisk träning förbättrar balans och muskelstyrka hos äldre2006Ingår i: Fysioterapi, ISSN 1653-5804, nr 2, s. 40-43Artikel i tidskrift (Övrigt vetenskapligt)
  • 43.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lindelöf, Nina
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Littbrand, Håkan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Yifter-Lindgren, Elinor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Håglin, Lena
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in activities of daily living: a randomised controlled trial2006Ingår i: Australian Journal of Physiotherapy, ISSN 0004-9514, Vol. 52, nr 2, s. 105-13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims of this randomised controlled trial were to determine if a high-intensity functional exercise program improves balance, gait ability, and lower-limb strength in older persons dependent in activities of daily living and if an intake of protein-enriched energy supplement immediately after the exercises increases the effects of the training. One hundred and ninety-one older persons dependent in activities of daily living, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ? 10 participated. They were randomised to a high-intensity functional exercise program or a control activity, which included 29 sessions over 3 months, as well as to protein-enriched energy supplement or placebo. Berg Balance Scale, self-paced and maximum gait speed, and one-repetition maximum in lower-limb strength were followed-up at three and six months and analysed by 2 x 2 factorial ANCOVA, using the intention-to-treat principle. At three months, the exercise group had improved significantly in self-paced gait speed compared with the control group (mean difference 0.04 m/s, p = 0.02). At six months, there were significant improvements favouring the exercise group for Berg Balance Scale (1.9 points, p = 0.05), self-paced gait speed (0.05 m/s, p = 0.009), and lower-limb strength (10.8 kg, p = 0.03). No interaction effects were seen between the exercise and nutrition interventions. In conclusion, a high-intensity functional exercise program has positive long-term effects in balance, gait ability, and lower-limb strength for older persons dependent in activities of daily living. An intake of protein-enriched energy supplement immediately after the exercises does not appear to increase the effects of the training.

  • 44.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lindelöf, Nina
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Littbrand, Håkan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Yifter-Lindgren, Elinor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nordin, Ellinor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Håglin, Lena
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in ADL: A randomised controlled trial evaluating the effects on physical functions and falls2006Ingår i: 18th Nordic Congress of Gerontology: Innovations for an Ageing Society, 2006, s. 184-185Konferensbidrag (Övrigt vetenskapligt)
  • 45.
    Stenvall, Michael
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Olofsson, Birgitta
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Lundström, Maria
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Svensson, Olle
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Inpatient falls and injuries in older patients treated for femoral neck fracture2006Ingår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 43, nr 3, s. 389-99Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A prospective inpatient study was performed at the Orthopedic and Geriatric Departments at the Umea University Hospital, Sweden, to study inpatient falls, fall-related injuries, and risk factors for falls following femoral neck fracture surgery. Ninety-seven patients with femoral neck fracture aged 70 years or older were included, background characteristics, falls, injuries, and other postoperative complications were assessed and registered during the hospitalization. There were 60 postoperative falls among 26/97 patients (27%). The postoperative fall event rate was 16.3/1000 Days (95% CI 12.2-20.4). Thirty two percent of the falls resulted in injuries, 25% minor, and 7% serious ones. In multiple regression analyses, delirium after Day 7, HRR 4.62 (95% CI 1.24-16.37), male sex 3.92 (1.58-9.73), and sleeping disturbances 3.49 (1.24-9.86), were associated with inpatient falls. Forty-five percent of the patients were delirious the day they fell. Intervention programs, including prevention and treatment of delirium and sleeping disturbances, as well as better supervision of male patients, could be possible fall prevention strategies. Improvement of the quality of care and rehabilitation, with the focus on fall prevention based on these results, should be implemented in postoperative care of older people

  • 46.
    Nyberg, Lars
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Sondell, Björn
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Backman, Anders
    Umeå universitet.
    Holmlund, Kenneth
    Umeå universitet, VRlab.
    Eriksson, Staffan
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Stenvall, Michael
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Rosendahl, Erik
    Maxhall, Marcus
    Umeå Center for Interaction Technology.
    Bucht, Gösta
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Using a virtual reality system to study balance and walking in a virtual outdoor environment: a pilot study2006Ingår i: Cyberpsychology & Behavior, ISSN 1094-9313, E-ISSN 1557-8364, Vol. 9, nr 4, s. 388-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Falls and fall-related injuries are a major problem for elderly persons. Most falls occur during walking and turning, and the risk of falling increases when attention is diverted to something besides walking. It is often difficult to standardize methods for testing balance and fall tendency in a clinically relevant setting. We describe the development of a system using a virtual environment (VE) to assess how attention demanding and unexpected events influence a person's capacity to control balance and movement. The hardware in the system consists of a head-mounted display (HMD), a magnetic tracker system, and two SGI computers. The software consists of the image generation of the VE and the management and visualization of motion tracking data. In a preliminary pilot study eight subjects (age 23-80) participated. Each subject walked on a normal floor and was visually presented a familiar outdoor environment in the HMD. They were exposed to different unexpected events, such as a virtual snowfall and tilting of the VE. Disturbances of balance and walking patterns such as changes in speed, stride length and balance reactions like slipping were observed. Two subjects experienced symptoms of cyber sickness with a SSQ score above 25 points. Walking with sensors only did not affect walking time, but in VE the subjects generally walked more slowly. Virtual tilting of the environment had an impact on balance performance during walking. This effect was not observed while the test subjects were walking in a virtual snowfall. The model needs further development but may hold a potential for clinical use.

  • 47.
    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.
    Wågert, Petra von Heideken
    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 fractures2005Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 12, nr 2, s. 51-8Artikel i tidskrift (Refereegranskat)
    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

  • 48.
    Olofsson, Birgitta
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundström, Maria
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Borssén, Bengt
    Umeå University Hospital, Department of Orthopaedics.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Delirium is associated with poor rehabilitation outcome in elderly patients treated for femoral neck fractures2005Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 2, s. 119-27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to describe risk factors for delirium and the impact of delirium on the rehabilitation outcome for patients operated for femoral neck fractures. Sixty-one patients, aged 70 years or older, consecutively admitted to the Department of Orthopaedic Surgery at Umea University Hospital, Sweden for femoral neck fractures were assessed and interviewed during hospitalization and at follow up 4 months after surgery. Delirium occurred in 38 (62%) patients and those who developed delirium were more often demented and/or depressed. Patients with delirium were longer hospitalized and they were more dependent in their activity of daily living (ADL) on discharge and after 4 months. They had poorer psychological well-being and more medical complications than the nondelirious. A large proportion of the patients who developed delirium did not regain their previous walking ability and could not return to their prefracture living accommodation. Delirium after hip fracture surgery is very common especially among patients with dementia or depression. This study shows that delirium has a serious impact on the rehabilitation outcome from both short- and long-term perspectives. Because delirium can be prevented and treated, it is important to improve the care of elderly patients with hip fractures.

  • 49.
    Stenvall, Michael
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Elinge, Eva
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Wågert, Petra von Heideken
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundström, Maria
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Having had a hip fracture: association with dependency among the oldest old2005Ingår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 34, nr 3, s. 294-297Artikel i tidskrift (Övrigt vetenskapligt)
  • 50.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lindelöf, Nina
    Umeå, Geriatrisk centrum.
    Yifter-Lindgren, Elinor
    Norrlands universitetssjukhus.
    Littbrand, Håkan
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Håglin, Lena
    Norrlands universitetssjukhus.
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Nyberg, Lars
    High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in ADL2005Ingår i: 18th World Congress of Gerontology: Active aging in the XXI century, participation, health and security, IAGG , 2005Konferensbidrag (Övrigt vetenskapligt)
12 1 - 50 av 96
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