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  • 51.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Fysisk träning förbättrar balans och muskelstyrka hos äldre2006Inngår i: Fysioterapi, ISSN 1653-5804, nr 2, s. 40-43Artikkel i tidsskrift (Annet vitenskapelig)
  • 52. Nyberg, Lars
    et al.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Fall prediction index for patients in stroke1997Inngår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 28, nr 4, s. 716-21Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: The identification of stroke patients who are prone to falls is essential to the development of prevention strategies. This study aimed at developing an easily administered fall risk index for patients in stroke rehabilitation. METHODS: A consecutive series of 135 patients in geriatric stroke rehabilitation was studied. Patient characteristics viewed as potential fall predictor variables were assessed at admission. Univariate and multiple Cox regression analyses of these variables were used in the development of a fall prediction index. RESULTS: The final index included the following items: male sex, poor performance of activities of daily living, urinary incontinence, impaired postural stability, bilateral motor impairment, presence of bilateral cortical or white matter lesions, visuospatial hemineglect, and use of diuretics, antidepressants, or sedatives. The index score correlated significantly with the fall risk (odds ratio, 1.46; 95% confidence interval, 1.26 to 1.69). The score was also used to classify individuals into low-, intermediate-, and high-risk groups, among which the fall rates differed significantly (log rank statistics, 29.86; P < .001). CONCLUSIONS: An easily administered fall risk index is suggested, which might serve as a basis for prevention strategies among patients in stroke rehabilitation.

  • 53. Nyberg, Lars
    et al.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Patient falls in stroke rehabilitation: A challenge to rehabilitation strategies1995Inngår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 26, nr 5, s. 838-42Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: The risk of falls is very high among stroke patients, and falling is a major complication in stroke rehabilitation. This study aimed to investigate the incidence, characteristics, and consequences of falls in an inpatient stroke rehabilitation setting. METHODS: One hundred sixty-one patients consecutively admitted to a geriatric stroke rehabilitation unit were studied. Falls that occurred during their rehabilitation stay were prospectively registered and analyzed. RESULTS: Sixty-two of the patients (39%) suffered falls. The total number of falls was 153, which corresponds to an incidence rate of 159 falls per 10,000 patient-days. Most falls occurred during transfers or from sitting in a wheelchair or on some other kind of furniture. Seventeen falls (11%) were classified as the result of extrinsic mechanisms, 49 (32%) were intrinsic falls, 39 (25%) occurred in a nonbipedal position (while sitting or lying), and 48 falls (31%) remained unclassified. No injury was observed in 109 of 153 incidents (71%), whereas 6 falls (4%) involved fractures or other serious injury. CONCLUSIONS: Since falls are so frequent, they must be considered a significant problem in stroke rehabilitation. Fall prevention strategies should therefore be developed and included in rehabilitation programs.

  • 54. Nyberg, Lars
    et al.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Using the Downton index to predict those prone to falls in stroke rehabilitation1996Inngår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 17, nr 10, s. 1821-4Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: Falls are a major complication in inpatient stroke rehabilitation. An important issue in preventive strategies is the early identification of those at risk. This study aimed at assessing the fall-prediction accuracy of an easily administered fall risk index in stroke rehabilitation. METHODS: A consecutive series of 135 patients admitted to a geriatric stroke rehabilitation unit was studied. A score on the Downton fall risk index was obtained from the admission assessment data and used as a predictive indicator of the risk of falls. The patients' falls were prospectively recorded during their rehabilitation stay. The correlation between falls and the predicted risk was assessed by means of survival analysis and a multiple regression analysis, adjusting for the time of observation. RESULTS: The risk of falls as a function of the time observed was significantly greater among those predicted to be at high risk (index score > or = 3) than among the others (P = .009, log-rank test; odds ratio, 2.9). Furthermore, the number of falls during rehabilitation stay was moderately correlated (R = .57) with the fall risk index sum when adjusted as for the time of observation. The sensitivity of the fall prediction as to outcome was 91%, whereas the specificity was limited to 27%. CONCLUSIONS: A moderately high correlation was found between the predicted and the observed risk of falls in stroke rehabilitation when the Downton fall risk index was used. However, a low specificity rate limits the accuracy of the prediction

  • 55.
    Nyberg, Lars
    et al.
    Umeå University, Department of Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Berggren, Diana
    Umeå University, Department of Anesthesia and Intensive Care.
    Brännström, Benny
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Bucht, Gösta
    Umeå University, Department of Community Medicine and Rehabilitation.
    Falls leading to femoral neck fractures in lucid older people1996Inngår i: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 44, nr 2, s. 156-60Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To analyze the mechanisms of falls that result in femoral neck fractures among lucid older people. DESIGN: A cross-sectional study. SETTING: An orthopedic university hospital department. PARTICIPANTS: A consecutive series of 123 lucid patients, 65 years of age or more, who were admitted for femoral neck fractures. MEASUREMENTS: On admission, the subjects were interviewed about fracture accident characteristics, and falling mechanisms were classified. An arterial blood gas sample was taken from each patient soon after admission. Based on data regarding drug consumption and social and medical characteristics, a fall-risk index was calculated for each subject. RESULTS: It was ascertained that 95% of the fractures were caused by falls and < 2% were spontaneous. Most accidents (68%) took place indoors, 47% of the falls were classified as extrinsic, 24% as intrinsic, 7% as nonbipedal, and 22% remained unclassified. Almost all outdoor falls were extrinsic; however, intrinsic falls were as common as extrinsic falls indoors (P < .001). Extrinsic fallers presented a significantly lower fall-risk index score than subjects with fractures caused by intrinsic, nonbipedal, and unclassifiable falls. A large proportion of subjects (24%) wre hypoxemic (pO2 < 8 kPa) on admission, and patients who sustained fractures at night had lower oxygen tension than that of daytime fallers (P = .006). CONCLUSIONS: Accidental falls are the primary cause of femoral neck fractures. Preventive actions should be directed toward intrinsic, as well as extrinsic, risk factors for falls. Hypoxemia might be a risk factor for falls, especially those falls that occur at night

  • 56. Nyberg, Lars
    et al.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Janson, A.
    Umeå university.
    Sandman, Per-Olof
    Umeå University, Department of Nursing.
    Eriksson, S.
    Umeå university.
    Incidence of falls in three different types of geriatric care: A Swedish prospective study1997Inngår i: Scandinavian Journal of Social Medicine, ISSN 0300-8037, Vol. 25, nr 1, s. 8-13Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The incidence and consequences of falls were investigated in three different types of Swedish geriatric care clinics: a geriatric rehabilitation clinic, a psychogeriatric clinic and a nursing home. Falls were prospectively registered by the nursing staff. The incidence rate (and 95% confidence interval) of falls per 10,000 patient days of the psychogeriatric clinic was 171 (146-196), compared with 92 (72-112) at the geriatric rehabilitation clinic, and 31 (22-41) at the nursing home. Most falls (62%) did not result in injury, while major injuries occurred in 5%. We conclude that accidental falls are a major problem in geriatric care in Sweden, but there is a considerable difference in incidence rates between different types of institutions

  • 57. Nyberg, Lars
    et al.
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Jensen, Jane
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Fall-olyckor kan förebyggas1999Inngår i: Sjukgymnasten, ISSN 0037-6019, nr 2, s. 18-24Artikkel i tidsskrift (Annet vitenskapelig)
  • 58.
    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.
    The development of a virtual reality system to stud tendency of falling among older people2004Inngår i: The 5th International Conference on Disability, Virtual Reality and Associated Technologies: Proceedings : ICDVRAT, September 20-22 Oxford UK / [ed] Paul Sharkey; Rachel McCrindle; David Brown, Reading: University of Reading , 2004, s. 315-320Konferansepaper (Fagfellevurdert)
  • 59.
    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.
    The development of a virtual reality system to study tendency of falling among older people2005Inngår i: International Journal on Disability and Human Development, ISSN 1565-012X, Vol. 4, nr 3, s. 239-243Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Injuries related to falls are a major threat to the health of older persons. A fall may result not only in an injury but also in a decreased sense of autonomy in the daily life. To be able to prevent such falls, a need to further understand the complex mechanisms involved in balance and walking is needed. Here we present an immersive virtual reality system, in which a person can move around while being subjected to various events, which may influence balance and walking

  • 60.
    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 study2006Inngår i: Cyberpsychology & Behavior, ISSN 1094-9313, E-ISSN 1557-8364, Vol. 9, nr 4, s. 388-95Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 61.
    Nyberg, Lars
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Pauelsen, Mascha
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Johansson, Viktor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The relation between fall-related concerns and mobility in older age may be explained by underlying physical capacity and psychological factors2019Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background:

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

    Aim:

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

    Method:

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

    Results:

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

    Conclusions:

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

  • 62.
    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 fractures2005Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 2, s. 119-27Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 63.
    Olsson, Eva
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Löfgren, Britta
    Umeå University, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Validation of a fall risk index in stroke rehabilitation2005Inngår i: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 14, nr 1, s. 23-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    fall risk index has previously been developed to identify fall-prone individuals in stroke rehabilitation. The purpose of this study was to validate the predictive accuracy of the index. The validation sample (n = 158) consisted of patients admitted to a specialized geriatric stroke rehabilitation ward. The index was scored for each subject, and the relationship between the score and falls was assessed. The index was then remodeled and cross-validated in the sample from which it was derived (model fit sample, n = 135). The total index score (0-11) was significantly connected with the time to first fall (hazard ratio, 1.22; confidence interval [CI], 1.03-1.44). However, the classification of subjects into groups with low, intermediate, and high risk of falling could not be correlated with the time to first fall. A remodeled index contained 3 of the separate original index items. Its relationship to fall risk in the model fit sample was (hazard ratio, 1.82; CI, 1.38-2.40). The fall risk index showed some correlation with the fall risk among patients in stroke rehabilitation, but the results indicate that it should be modified to reach acceptable accuracy. A remodeled index showed a higher association with fall risk.

  • 64.
    Pauelsen, Mascha
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Jafari, Hedyeh
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Using the frequency power spectrum to learn more about aging postural control and fall-related concerns2019Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Backgound:

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

    Aim:

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

    Method:

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

    Results:

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

    Conclusions:

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

  • 65.
    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 concerns2018Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 30, nr 9, s. 1079-1085Artikkel i tidsskrift (Fagfellevurdert)
    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. 

  • 66. 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 people2017Inngår i: WCPT 2017 congress proceedings, 2017Konferansepaper (Fagfellevurdert)
    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.

  • 67.
    Ramnemark, Anna
    et al.
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Borssén, Bengt
    Umeå University Hospital, Department of Orthopaedics.
    Olsson, T.
    Umeå University, Department of Internal Medicine.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Fractures after stroke1998Inngår i: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 8, nr 1, s. 92-5Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fractures are a serious complication after stroke. Among patients with femoral neck fractures, a large subgroup have had a previous stroke. This study aimed to investigate the incidence of fractures after stroke. Included in the study were 1139 patients consecutively admitted for acute stroke. Fractures occurring from stroke onset until the end of the study or death were registered retrospectively. Hip fracture incidence was compared with corresponding rates from the general population. Patients were followed up for a total of 4132 patient-years (median 2.9 years). There were 154 fractures in 120 patients and median time between the onset of stroke and the first fracture was 24 months. Women had significantly more fractures than men (chi 2 = 15.6; p < 0.001). In patients with paresis most of the fractures affected the paretic side (chi 2 = 22.5; p < 0.001) and 84% of the fractures were caused by falls. Hip fracture was the most frequent fracture and the incidence was 2-4 times higher in stroke patients compared with the reference population. Fractures are thus a common complication after stroke. They are usually caused by falls and affect the paretic side. It is necessary to focus on the prevention of post-stroke fractures, including the prevention of both falls and osteoporosis.

  • 68.
    Ramnemark, Anna
    et al.
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Lorentzon, Ronny
    Umeå University, Department of Orthopedics, Sports Medicine Unit.
    Englund, U.
    Umeå University, Department of Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Progressive hemiosteoporosis on the paretic side and increased bone mineral density in the nonparetic arm the first year after severe stroke1999Inngår i: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 9, nr 3, s. 269-75Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fractures are a common and serious complication after stroke and the risk of hip fractures among stroke patients is 2 to 4 times greater than among other elderly people. The aim of this study was to investigate prospectively the change in bone mineral density (BMD) after severe stroke and to study the association between motor impairment, disability and the development of hemiosteoporosis. The study comprised 24 stroke patients, with no persistent paresis from previous strokes or previous osteoporotic fractures, included 1 month after stroke onset. BMD, motor function, ambulation and activities of daily living (ADL) were assessed at 1, 4, 7 and 12 months after stroke onset. At inclusion, the patients' BMD was normal for their age. During the study, there was a significant loss of BMD in the total body (-2.0%; p < 0.05), but not in the head or spine. BMD differed significantly between the paretic and the non-paretic arm at inclusion (-4.8%; p < 0.001). Decrease in BMD was most pronounced in the affected humerus (-17.4%; p < 0.001) and proximal femur (-12.2%; p < 0.01). BMD decreased significantly in both lower extremities during follow-up, but the losses were more pronounced on the paretic side (p < 0.01). In the nonaffected ultradistal radius there was a significant increase in BMD from inclusion to the end of the study (+5.8%; p < 0.01). There was no pattern in the bone losses correlating with presumptive risk factors for hemiosteoporosis such as motor function, ability to perform ADL or ambulation. Two patients had fractures at follow-up, both on the paretic side. Loss of bone mineral density in the paretic extremities is thus pronounced and progressive during the first year after stroke, indicating that loss of BMD is probably an important risk factor for post-stroke fractures. Surprisingly, BMD in the nonaffected arm increased significantly during the first year after stroke, most likely due to increased physical activity, and perhaps a redistribution of bone minerals from the paretic extremities.

  • 69.
    Ramnemark, Anna
    et al.
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Lortentzon, Ronny
    Umeå University, Department of Orthopedics, Sports Medicine Unit.
    Olsson, T.
    Umeå University, Department of Medicine.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Hemiosteoporosis after severe stroke, independent of changes in body composition and weight1999Inngår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 30, nr 4, s. 755-60Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: Fractures are a serious complication after stroke, and the risk of hip fractures among stroke patients is increased 2 to 4 times versus a reference population. Fractures after stroke are probably caused by the development of hemiosteoporosis and the high incidence of accidental falls. The aim of this study was to investigate the development of hemiosteoporosis in relation to other changes in body composition during the first year after severe stroke. METHODS: The study included 24 patients with extensive paresis after stroke. Bone mineral content (BMC) and fat and lean mass were assessed 1, 4, 7, and 12 months after stroke onset by a dual-energy x-ray absorptiometer. RESULTS: The loss of total body BMC was significant during the first year after stroke (-1.6%; P<0.05), but there were no significant changes in total lean or fat mass. At inclusion, there were no significant differences between sides in lean or fat mass or BMC, but during follow-up, BMC of the affected side decreased significantly compared with the same side at inclusion (-7.5%; P<0.01). Side differences in fat mass became significant between legs (9.3%; P<0.001) and whole sides (4. 8%; P<0.01). There were only minor side changes in lean mass. Loss of BMC was independent of weight changes. CONCLUSIONS: During the first year after severe stroke, patients developed pronounced hemiosteoporosis. This was not associated with general changes in lean or fat mass. The development of hemiosteoporosis was independent of weight changes after stroke.

  • 70.
    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 facilities2008Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 20, nr 1, s. 67-75Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 71.
    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 falls2008Konferansepaper (Annet vitenskapelig)
    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.

  • 72.
    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 trial2006Inngår i: Australian Journal of Physiotherapy, ISSN 0004-9514, Vol. 52, nr 2, s. 105-13Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 73.
    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 falls2006Inngår i: 18th Nordic Congress of Gerontology: Innovations for an Ageing Society, 2006, s. 184-185Konferansepaper (Annet vitenskapelig)
  • 74.
    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 falls2007Inngår i: 15th International Congress of The World Confederation for Physical Therapy: 2-6 June 2007, Vancouver, Canada, WCPT , 2007Konferansepaper (Annet vitenskapelig)
  • 75.
    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 ADL2005Inngår i: 18th World Congress of Gerontology: Active aging in the XXI century, participation, health and security, IAGG , 2005Konferansepaper (Annet vitenskapelig)
  • 76.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lindgren, Elinor Yifter
    Norrlands universitetssjukhus.
    Lindelöf, Nina
    Umeå, Gerontologiskt centrum.
    Littbrand, Håkan
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Håglin, Lena
    Norrlands universitetssjukhus.
    Lundin-Olsson, Lillemor
    Institutionen för samhällsmedicin och rehabilitering, sjukgymnastik, Umeå universitet.
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Nyberg, Lars
    Effekten på fysisk funktion av ett högintensivt funktionellt träningsprogram och nutritionstillskott med protein för äldre ADL-beroende personer vid särskilda boenden: en randomiserad kontrollerad studie2004Inngår i: Svenska läkaresällskapets riksstämma 24-26 november 2004, Stockholm: Svenska läkaresällskapet , 2004, s. 54-Konferansepaper (Annet vitenskapelig)
  • 77.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Littbrand, Håkan
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Lindelöf, Nina
    Umeå, Gerontologiskt centrum.
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Nyberg, Lars
    Functional physical exercise program for frail older people2003Inngår i: Advanced health care sciences of tomorrow, The Swedish institute for health sciences , 2003, s. 24-Konferansepaper (Annet vitenskapelig)
  • 78.
    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 impairment2007Inngår i: Research and practice in Alzheimer's disease, Paris: Serdi publisher , 2007, s. 212-215Kapittel i bok, del av antologi (Annet vitenskapelig)
    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.

  • 79.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Littbrand, Håkan
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Lindelöf, Nina
    Umeå, Gerontologiskt centrum.
    Nyberg, Lars
    Functional exercise program for frail older people2003Inngår i: 14th International Congress of the World Confederation for Physical Therapy, WCPT , 2003Konferansepaper (Annet vitenskapelig)
  • 80. Rosendahl, Erik
    et al.
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Eriksson, Staffan
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Jensen, Jane
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Effekten av fysisk träning på fallriskfaktorer bland sköra äldre2001Inngår i: Abstractbok för sjukgymnastdagarna 2001, Stockholm: Legitimerade sjukgymnasters riksförbund , 2001, s. 63-Konferansepaper (Annet vitenskapelig)
  • 81.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundin-Olsson, Lillemor
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Eriksson, Staffan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Jensen, Jane
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafson, Yngve
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Lars
    Exercise improves physical performance among older people with high fall risk in residential care facilities2003Inngår i: 14th International Congress of the World Confederation for Physical Therapy, WCPT , 2003Konferansepaper (Annet vitenskapelig)
  • 82.
    Rosendahl, Erik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Kallin, Kristina
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Jensen, Jane
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Nyberg, Lars
    Prediction of falls among older people in residential care facilities by the Downton index2003Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 15, nr 2, s. 142-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND AIMS: Falls are frequent among older people living in residential care facilities. The aim of this study was to investigate the prediction accuracy of the Downton fall risk index among older people living in residential care facilities at 3, 6 and 12 months, and with two different definitions of falls. METHODS: Seventy-eight residents in one residential care facility, 56 women and 22 men, mean +/- SD age 81 +/- 6 years, participated in this study. Forty-seven percent of participants had dementia, 45% depression, and 32% previous stroke. Forty-one percent of participants used a walking device indoors, and the median score of the Barthel ADL Index was 16. At baseline, the Downton fall risk index was scored for each individual. A score of 3 or more was taken to indicate high risk of falls. Participants were followed up prospectively for 12 months, with regard to falls indoors. RESULTS: At 3, 6 and 12 months, and using a fall definition including all indoor falls, sensitivity ranged from 81 to 95% with the highest value at 3 months, and specificity ranged from 35 to 40%. The prognostic separation values ranged from 0.26 to 0.37. Within 3 months, the risk of falling was 36% in the high-risk group (index score > or = 3) and 5% in the low-risk group. The accuracy of predictions did not improve when applying a fall definition in which falls precipitated by acute illness, acute disease, or drug side-effects were excluded. CONCLUSIONS: Already after 3 months, the Downton fall risk index appears to be a useful tool for predicting falls, irrespective of their cause, among older people in residential care facilities

  • 83.
    Rosendahl, Erik
    et al.
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering.
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Kallin, Kristina
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Jensen, Jane
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering. Sjukgymnastik.
    Gustafson, Yngve
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering, Geriatrik.
    Nyberg, Lars
    Predictions of falls among old people in residential care facilities by the Downton index2001Inngår i: 17th World congress of gerontology, IAGG , 2001, s. 499-Konferansepaper (Annet vitenskapelig)
  • 84.
    Rutberg, Stina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Castelli, Darla
    Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA.
    Lindqvist, Anna-Karin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Grit as Perseverance in Physical Activity Participation2020Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, nr 3, artikkel-id 807Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Childhood is a critical period for the acquisition of healthy behaviors, and the promotion of sustainable healthy behavior among children is greatly important. Therefore, an increased understanding of the relationship between grit and physical activity in a school context is needed. The purpose of this study is to describe and develop an understanding of students’ and teachers’ awareness and experiences concerning grit as a health-promoting factor. Fifty-five students and three teachers participated in the study. Data were collected through the Short Grit Scale and focus group interviews. There were weak to non-significant correlations between the three teachers’ ratings of their students’ grit and the children’s own ratings. The qualitative results show that children and teachers understood the construct of grit but had slightly different perceptions of it and that grit is not considered to be set in stone. The participants made an association between grit, motivation, meaningfulness, and setting goals. The findings indicate that grit might be an ideal target for making physical activity interventions sustainable.

  • 85.
    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 Conference2014Inngår i: Medical problems of performing artists, ISSN 0885-1158, E-ISSN 1938-2766, Vol. 29, nr 4, s. 243-245Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 86.
    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 stroke2018Inngår i: International Journal of Therapy and Rehabilitation, ISSN 1741-1645, E-ISSN 1759-779X, Vol. 25, nr 11, s. 576-586Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 87.
    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 stroke2019Inngår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, nr 1, artikkel-id e1744Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 88.
    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 old2005Inngår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 34, nr 3, s. 294-297Artikkel i tidsskrift (Annet vitenskapelig)
  • 89.
    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 fracture2007Inngår i: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 18, nr 2, s. 167-75Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 90.
    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 fracture2006Inngår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 43, nr 3, s. 389-99Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 91.
    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-up2007Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 3, s. 232-8Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 92.
    Sterky, Elisabet
    et al.
    Örnsköldsviks sjukhus.
    Lundin-Olsson, Lillemor
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Nyberg, Lars
    Balans, förflyttningsförmåga och fall hos äldre gångare på servicehus1997Inngår i: Nordisk fysioterapi, ISSN 1402-3024, Vol. 1, nr 3, s. 104-108Artikkel i tidsskrift (Annet vitenskapelig)
  • 93.
    Strandkvist, Viktor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Norrbotten County Council.
    Pauelsen, Mascha
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lindberg, Anne
    Umeå University.
    Gustafsson, Thomas
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Signaler och system.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Hand grip strength is strongly associated with lower limb strength but only weakly with postural control in community-dwelling older adultsManuskript (preprint) (Annet vitenskapelig)
  • 94.
    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 services2008Konferansepaper (Annet vitenskapelig)
  • 95.
    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 municipality2009Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 13, nr 6, Suppl. 1, s. S428-Artikkel i tidsskrift (Annet vitenskapelig)
    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.

  • 96.
    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 Sweden2011Inngår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 70, nr 2, s. 195-204Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 97.
    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 Sweden2013Inngår i: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 12, nr 1, s. 36-43Artikkel i tidsskrift (Fagfellevurdert)
  • 98.
    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 applications2013Konferansepaper (Fagfellevurdert)
  • 99.
    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 Swedes2013Inngår i: International Journal of Telemedicine and Applications, ISSN 1687-6415, E-ISSN 1687-6423, ISSN 1687-6415, artikkel-id 509198Artikkel i tidsskrift (Fagfellevurdert)
    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.

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