Effects of a Rehabilitation Program on Perceived Environmental Barriers in Older Patients Recovering from Hip Fracture: A Randomized Controlled Trial

Objectives. To study effects of a one-year multicomponent intervention on perceived environmental barriers in hip fracture patients.Design. Randomized controlled trial of a 12-month home-based rehabilitation aiming to improve mobility and function (ISRCTN53680197); secondary analyses.Subjects. Community-dwelling hip fracture patients on average 70 days after trauma (n=81).Methods. Assessments at baseline, 3, 6, and 12 months later included perceived entrance-related barriers (e.g., indoor/outdoor stairs, lighting, floor surfaces, and storage for mobility devices) and perceived barriers in the outdoor environment (poor street condition, hilly terrain, long-distances, and lack of resting plac…

Physical activity after a hip fracture : effect of a multicomponent home-based rehabilitation program - a secondary analysis of a randomized controlled trial

Objectives To investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over 1-year follow-up among older people recovering from a recent hip fracture. Design Secondary analysis of a randomized, controlled, parallel-group trial. Setting Home-based rehabilitation; measurements in university laboratory. Participants Community-dwelling people (N=81) aged ≥60 years recovering from a hip fracture. Participants were randomly assigned to an intervention (n=40) or a control (n=41) group, on average, 42±23 days after discharge from the hospital. Intervention A yearlong intervention included evaluation and …

Physical Activity After a Hip Fracture: Effect of a Multicomponent Home-Based Rehabilitation Program—A Secondary Analysis of a Randomized Controlled Trial

Objectives To investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over 1-year follow-up among older people recovering from a recent hip fracture. Design Secondary analysis of a randomized, controlled, parallel-group trial. Setting Home-based rehabilitation; measurements in university laboratory. Participants Community-dwelling people (N=81) aged ≥60 years recovering from a hip fracture. Participants were randomly assigned to an intervention (n=40) or a control (n=41) group, on average, 42±23 days after discharge from the hospital. Intervention A yearlong intervention included evaluation and …

Cardiovascular benefits and potential hazards of physical exercise in elderly people

66–85-vuotiaiden liikunnallisesti aktiivisten naisten suorituskyky sydämen ja verenkiertoelimistön kuntoa mittaavassa kuormituskokeessa oli keskimäärin 40 % parempi kuin vastaavanikäisten harjoittelemattomien naisten. 75-vuotiailla miehillä ja naisilla parempi kestävyyskunto ennusti pidempää ikää. 76–78-vuotiaiden naisten suorituskyky parani keskimäärin 4-9 % neljän kuukauden kestävyys- ja voimaharjoittelulla. Harjoittelemattomassa vertailuryhmässä suorituskyky laski 6 % vastaavassa ajassa. Suorituskyvyn muutokset vaihtelivat kuitenkin huomattavasti yksilöstä toiseen. Verenkiertoelimistöön liittyviä terveysongelmia esiintyi harjoitteluohjelman aikana, mutta ne eivät liittyneet suoraan fyysi…

Factors affecting the increased risk of physical inactivity among older people with depressive symptoms.

The purpose of this study was to investigate the association between depressive symptoms and physical inactivity, and whether motives for and barriers to exercise explain the potential association between depressive symptoms and physical inactivity in older people. The design of the study was cross-sectional. The study population comprised 645 people born between 1922 and 1928 who were residents in a city-center area of Jyväskylä in central Finland. Depressive symptoms were assessed using Center for the Epidemiologic Studies Depression Scale, physical activity using Grimby's (1986) validated scale, and motives for and barriers to exercise using a questionnaire and mobility limitation with a…

Health-related quality of life and physical activity in persons at high risk for type 2 diabetes

The aim of this study was to compare the health-related quality of life (HRQOL) of persons at risk for type 2 diabetes to that of the Finnish general population. In addition, the associations between physical activity and HRQOL at-risk persons were studied.One hundred thirty-two at-risk persons were recruited from health care centres in Central Finland. Participants filled out questionnaires including demographic characteristics, HRQOL (SF-36), frequency of vigorous physical activity (or =2 times a week, once a week, less than once a week) and comorbidities.HRQOL of at-risk persons differed significantly from that of the Finnish population in four of the eight dimensions of SF-36. Compared …

Neck semispinalis capitis muscle size in sitting and prone positions measured by real-time ultrasonography.

Objective: To examine the reliability of measurements of semispinalis capitis muscle (SECM) cross-sectional area (CSA) in prone and sitting positions, and to compare the muscle size in these two positions. Design: Semispinalis capitis CSA was measured twice a day on two successive days with a real-time ultrasound apparatus. Subjects: Eighteen males (aged 19–34 years) and 28 females (aged 19–34 years) were studied for the reliability test. Seven males and 12 females were randomly selected to compare SECM size in sitting and prone positions. Results: The intraclass correlation coefficient (ICC) for repeatability measurements was r = 0.98 for the two positions. The correlation of the CSA in s…

Type of surgery is associated with pain and walking difficulties among older people with previous hip fracture

Aim The aim was to assess the level of lower body pain among people with previous femoral neck fracture, and whether the type of surgery was associated with pain and physical function a mean of 2 years after surgery. Methods The study included 115 community-dwelling older adults aged 60 years and older with previous femoral neck fracture, and 31 reference subjects without previous lower limb injuries. A total of 30 patients had internal fixation surgery, 70 had hemiarthroplasty and 15 had total hip replacement. All patients had surgery in the same hospital and received typical inpatient rehabilitation. From 1.6 months to 7.5 years after the fracture, the patients underwent examination inclu…

Associations between the dimensions of perceived togetherness, loneliness, and depressive symptoms among older Finnish people

Objectives: We studied the associations between perceived togetherness, depressive symptoms, and loneliness over a six-month period among 222 people aged 75–79 who reported loneliness or depressive mood at baseline. Method: The present cross-lagged models utilized baseline and six-month follow-up data of a randomized controlled trial that examined the effects of a social intervention on loneliness and depression (ISRCTN78426775). Dimensions of perceived togetherness, i.e. attachment, social integration, guidance, alliance, nurturance, and reassurance of worth, were measured with the Social Provisions Scale, depressive symptoms with a short form of the Geriatric Depression Scale, and lonelin…

Cardiac adverse effects and acute exercise in elderly subjects

Cardiac arrhythmias, ST segment depressions and other cardiac adverse effects are occasionally seen in relation to physical exercise in elderly people. However, the magnitude, quality, and time-dependence of these events need to be clarified. During voluntary maximal cycle ergometer exercise (CEE), immediate cardiac disturbances as a reason for exercise termination were registered in a sample of 75-year-old men and women (N=203) (population group, PG). Any referrals to hospital following cardiac incidents within 24 hours post-CEE were obtained from patient records. Ambulatory ECG was recorded 24 hours before and after CEE in 23 elderly subjects (12 men, 11 women) capable of maximal effort (…

The predictive value of exercise testing for survival among 75-year-old men and women

All 75-year-olds born in 1914 and living in the city of Jyväskylä, central Finland (n=388) were invited to study the predictive value of exercise test for mortality. Subjects who entered the laboratory (n=295) were to have a standard pre-test evaluation and perform a cycle ergometer exercise test. Subjects with complete background, exercise-test status and mortality data (n=282) were divided into three groups according to exercise-test status: a non-exercise test group (n=79), an exercise-test termination group (n=95), and an exercise-test completion group (n=108). Mortality was followed up for 9 years. The multivariate hazard ratio (HR) for death among the non-exercise test group compared …

Factors associated with maximal walking speed among older community-living adults.

Background and aims: The relative contribution of different domains on walking speed is largely unknown. This study investigated the central factors associated with maximal walking speed among older people. Methods: Cross-sectional analyses of baseline data from the SCAMOB study (ISRCTN 07330512) involving 605 community-living ambulatory adults aged 75–81 years. Maximal walking speed, leg extensor power, standing balance and body mass index were measured at the research center. Physical activity, smoking, use of alcohol, chronic diseases and depressive symptoms were self-reported by standard questionnaires. Results: The mean maximal walking speed was 1.4 m/s (range 0.3–2.9). In linear regre…

Bilateral and Unilateral Neuromuscular Function and Muscle Cross-Sectional Area in Middle-Aged and Elderly Men and Women

Forty-eight healthy men (M) and women (W), divided into two different age groups, i.e., M50 yrs (range 44-57; n = 12), W50 yrs (range 43-57; n = 12), M70 yrs (range 59-75; n = 12), and W70 yrs (range 62-75; n = 12), volunteered as subjects for examination of muscle cross-sectional area (CSA), maximal voluntary forces, force-time curves, and electromyographic activity of the knee extensor muscles during bilateral and unilateral isometric contractions. The maximal bilateral knee extension force and the average CSA values in M50 were greater (p < .05) than in M70 and in W50 were greater (p < .05-.001) than those recorded for W70. The early forces in the force-time curve were greater (p < .05) …

Walking recovery after a hip fracture: A prospective follow-up study among community-dwelling over 60-year old men and women

Purpose. Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture.Methods. A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery), and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes dur…

Muscle loading and activation of the shoulder joint during humeral external rotation by pulley and variable resistance.

The aim of the study was to evaluate differences in the loading of glenohumeral joint muscles between a cable pulley machine (CP) and variable resistance machine (VR) during axial humeral external rotation.Eleven healthy male subjects took part in the study. Intramuscular electromyography from five muscles of the shoulder (medial deltoid, supraspinatus, infraspinatus and upper part of the trapezius), torque and power output was measured at different rotation angles and with different loads (10%, 50% and 100% of 1RM). Also the compressive and shear force in the glenohumeral joint was analyzed at the horizontal level at angles of rotation. External rotation was performed with a self-selected …

Neuromuscular adaptations during bilateral versus unilateral strength training in middle-aged and elderly men and women.

Twelve middle-aged men and 12 middle-aged women in the 50-year-old age group (M50; range 44-57 years; W50; 43-57), and 12 elderly men and 12 elderly women in the 70-year-old age group (M70; 59-75; W70; 62-75) volunteered as subjects in order to examine effects of 12-week progressive heavy resistance strength training on electromyographic activity (EMG), muscle cross-sectional area (CSA) of the quadriceps femoris and maximal concentric force in a one repetition maximum (1 RM) test of the knee extensor muscles. One half of the subjects in each group performed the knee extension (and flexion) exercises only bilaterally (BIL), while another half performed the exercises only unilaterally (UNIL).…

Impaired geometric properties of tibia in older women with hip fracture history.

This study evaluated side-to-side differences in tibial mineral mass and geometry in women with previous hip fracture sustained on average 3.5 years earlier. Both tibial mineral mass and geometry were found to be reduced in the fractured leg. INTRODUCTION: The purpose of this study was to evaluate side-to-side differences in tibial mineral mass and geometry after hip fracture and to assess the determinants of such differences. METHODS: Thirty-eight 60- to 85-year-old women with a previous hip fracture and 22 same-aged control women without fractures participated in the study. Bone characteristics of the distal tibia and tibial shaft of both legs were assessed using pQCT in order to compare …

Effects of resistance training on lower-extremity impairments in older people with hip fracture

Abstract Portegijs E, Kallinen M, Rantanen T, Heinonen A, Sihvonen S, Alen M, Kiviranta I, Sipila S. Effects of resistance training on lower-extremity impairments in older people with hip fracture. Objective To study the effects of resistance training on muscle strength parameters, mobility, and balance. Design Randomized controlled trial. Setting Research laboratory and senior gym. Participants Population-based sample of eligible 60- to 85-year-old community-dwelling men and women 0.5 to 7.0 years after hip fracture. Forty-six people had no contraindications and were willing to participate in the exercise trial. Intervention Twelve-week intensive progressive strength-power training (n=24),…

EFFECTS OF A HOME-BASED REHABILITATION PROGRAM ON HEALTH-RELATED QUALITY OF LIFE

Health-Related Quality of life (HRQoL) decreases after a hip fracture (HF) and may remain low for a long time. Knowledge is needed on effective rehabilitation strategies after HF. Purpose of this study was to investigate the effects of individualized home-based rehabilitation on HRQoL among community-dwelling older people after HF.

Effect of bicycle ergometer test on intraocular pressure in elderly athletes and controls.

To evaluate the effect of intensive physical exercise on intraocular pressure (IOP) in 66- to 85-year-old subjects IOP was measured before and after a maximal bicycle ergometer test. The non-glaucomatous subjects comprised 85 males and 36 female athletes and 16 male and 22 female controls of corresponding age drawn from a population register. IOP was measured using a non-contact tonometer. The results indicated a decrease (> or = 2 mmHg) in 34% of the subjects, no change in 57% and an increase in 9%. The decrease was more pronounced in subjects with higher pre-test values. In all four subjects with a pre-test value above 22 mmHg a reduction from 4 to 11 mmHg was observed. The change in IOP …

Effect of a social intervention of choice vs. control on depressive symptoms, melancholy, feeling of loneliness, and perceived togetherness in older Finnish people: a randomized controlled trial.

Objectives: This study examined effects of a social intervention on depressive symptoms, melancholy, loneliness, and perceived togetherness in community-dwelling Finnish older people. Method: Promotion of mental well-being in older people (GoodMood; ISRCTN78426775) was a single-blinded randomized control trial lasting 1.5 years. Two hundred and twenty-three persons aged 75–79 years reporting symptoms of loneliness or melancholy were randomized into intervention and control groups. The intervention group was allowed to choose among supervised exercise, social activity, or personal counseling. Follow-up measurements were conducted at the end of 6-month intervention, and at 3, 6, and 12 months…

The effects of muscle strength and power training on mobility among older hip fracture patients

The incidence of hip fractures is growing in all Western societies. The mobility of hip fracture patients does not return to the pre-fracture level even 2 years after fracture. One reason for mobility limitation may be the persistent muscle weakness on the fractured leg. The purpose of this randomized controlled study was to examine whether 12-week muscle strength and power training twice a week has an effect on mobility in 60–85-year-old hip fracture patients. Forty-three persons were randomly assigned to an intervention (n=23) and a control (n=20) group. The intervention comprised 12-week supervised intensive progressive strength–power training twice per week. All the measurers were blind…

Promoting mobility after hip fracture (ProMo): study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people

Abstract Background To cope at their homes, community-dwelling older people surviving a hip fracture need a sufficient amount of functional ability and mobility. There is a lack of evidence on the best practices supporting recovery after hip fracture. The purpose of this article is to describe the design, intervention and demographic baseline results of a study investigating the effects of a rehabilitation program aiming to restore mobility and functional capacity among community-dwelling participants after hip fracture. Methods/Design Population-based sample of over 60-year-old community-dwelling men and women operated for hip fracture (n = 81, mean age 79 years, 78% were women) participat…

Underlying Factors in the Association between Depressed Mood and Mobility Limitation in Older People

&lt;i&gt;Background:&lt;/i&gt; Depressed mood may either precede mobility limitation or follow from mobility limitation. &lt;i&gt;Objective:&lt;/i&gt; To compare mood status among people with manifestmobility limitation, those with preclinical mobility limitation and those without mobility limitation and investigate factors explaining the association between depressed mood and mobility limitation. &lt;i&gt;Design:&lt;/i&gt; Cross-sectional. Subjects: 645 community-living 75- to 81-year-old people. &lt;i&gt;Methods:&lt;/i&gt; Depressed mood was assessed using the Centre for Epidemiologic Studies Depression Scale (CES-D, cut-off score 16); difficulty walking 500 m was assessed by self-report.…

EMG, heart rate, and accelerometer as estimators of energy expenditure in locomotion.

AB Purpose: Precise measures of energy expenditure (EE) during everyday activities are needed. This study assessed the validity of novel shorts measuring EMG and compared this method with HR and accelerometry (ACC) when estimating EE. Methods: Fifty-four volunteers (39.4 +/- 13.9 yr) performed a maximal treadmill test (3-min loads) including walking with different speeds uphill, downhill, and on level ground and one running load. The data were categorized into all, low, and level loads. EE was measured by indirect calorimetry, whereas HR, ACC, and EMG were measured continuously. EMG from quadriceps (Q) and hamstrings (H) was measured using shorts with textile electrodes. Validity of the met…

Effects of intensive strength-power training on sense of coherence among 60-85-year-old people with hip fracture: A randomized controlled trial

Background and aims: Older people with disabilities are at increased risk of psychological health decline. There are no earlier studies on the effects of resistance training on sense of coherence (SOC) among older people with a history of hip fracture. The aim of this study is to test the effects of intensive 12-week strength-power training on SOC among older adults after hip fracture. Methods: A clinical sample of 60-85-year-old community-dwelling men and women was studied, 0.5. to 7.0 years after hip fracture. Forty-six had no contraindications for participation and were randomized into training (n=24) and control groups (n=22). The training group participated in a 12-week, individually t…

Long-term effect of physical activity counseling on mobility limitation among older people: a randomized controlled study.

Background. Physical activity counseling increases physical activity among older people, but its effectiveness on mobility, that is, maintaining the ability to move independently, is unknown. We studied the effect of physical activity counseling on mobility among older people and evaluated whether counseling-induced benefi ts persist after cessation of the intervention. Methods. In a 2-year, single-blinded, randomized controlled study, 632 sedentary participants aged 75 – 81 years were randomly assigned into the intervention ( n = 318) or control ( n = 314) group. The intervention group received a single individualized physical activity counseling session with a supportive telephone contact…

Balance confidence and functional balance are associated with physical disability after hip fracture.

Abstract Background This cross-sectional study investigated the associations between balance confidence, functional balance, and physical disability among older people after hip fracture. Material and methods The study utilizes baseline data of two randomized controlled trials (ISRCTN34271567 and ISRCTN53680197). The participants were 159 community-dwelling over 60-year-old people. Health, fracture status, the date and type of surgery, and contraindications for participation were assessed in a clinical examination. Balance confidence was assessed by the Activities-specific Balance Confidence Scale (ABC) and functional balance by the Berg Balance Scale. Physical disability was assessed by a …

Customer-oriented counseling for physical activity in older people: study protocol and selected baseline results of a randomized-controlled trial (ISRCTN 07330512)

The objective of this study is to describe the rationale, design and selected baseline results of a 2-year randomized-controlled trial (RCT) on the effects of physical activity counseling in community-living older people. After a four-phase screening and data-collection process targeting all independently living people in the city center of Jyvaskyla, Finland, six hundred and thirty-two 75–81-year-old cognitively intact, sedentary persons who were able to move independently outdoors at least minimally and willing to take part in the RCT were randomized into intervention and control groups. At baseline, over half of the subjects exercised less than two to three times a month and two-thirds w…

Neuromuscular adaptation during prolonged strength training, detraining and re-strength-training in middle-aged and elderly people.

Effects of a 24-week strength training performed twice weekly (24 ST) (combined with explosive exercises) followed by either a 3-week detraining (3 DT) and a 21-week re-strength-training (21 RST) (experiment A) or by a 24-week detraining (24 DT) (experiment B) on neural activation of the agonist and antagonist leg extensors, muscle cross-sectional area (CSA) of the quadriceps femoris, maximal isometric and one repetition maximum (1-RM) strength and jumping (J) and walking (W) performances were examined. A group of middle-aged (M, 37–44 years, n=12) and elderly (E, 62–77, n=10) and another group of M (35–45, n=7) and E (63–78, n=7) served as subjects. In experiment A, the 1-RM increased subs…

Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women

The separate effects of 18 weeks of intensive strength and endurance training on isometric knee extension (KE) and flexion (KF) strength and walking speed were studied in 76- to 78- year-old women. Maximal voluntary isometric force for both KE and KF was measured in a sitting position on a custom-made dynamometer chair at a knee angle of 60 degrees from full extension. Maximal walking speed was measured over a distance of 10 m. The endurance-trained women increased KE torque and KE torque/body mass after the first 9 weeks of training when compared with the controls. when comparing the baseline, 9 week and 18 week measurements within the groups separately, both the endurance- and strength-tr…

Changes in agonist-antagonist EMG, muscle CSA, and force during strength training in middle-aged and older people

Effects of 6 mo of heavy-resistance training combined with explosive exercises on neural activation of the agonist and antagonist leg extensors, muscle cross-sectional area (CSA) of the quadriceps femoris, as well as maximal and explosive strength were examined in 10 middle-aged men (M40; 42 ± 2 yr), 11 middle-aged women (W40; 39 ± 3 yr), 11 elderly men (M70; 72 ± 3 yr) and 10 elderly women (W70; 67 ± 3 yr). Maximal and explosive strength remained unaltered during a 1-mo control period with no strength training. After the 6 mo of training, maximal isometric and dynamic leg-extension strength increased by 36 ± 4 and 22 ± 2% ( P &lt; 0.001) in M40, by 36 ± 3 and 21 ± 3% ( P &lt; 0.001) in M7…

Sports-related injuries in elderly men still active in sports.

By means of a questionnaire with a complementary interview and physical examination, the site and nature of sports injuries were investigated over a 10-year period (1977-1987) in 97 elderly athletes (age range 70-81 years). The athletes were still active in training and competition with a mean competition background of 15 years. Of the subjects studied 30 were strength/power athletes and the remaining 67 endurance athletes. Altogether we found 273 sports-related injuries (169 acute and 104 overuse injuries). Of the injuries 75% had occurred in the lower extremities. The most commonly injured part of the body was the knee (20% of all cases). Sprains of the thigh and knee were the most freque…

Walking Training and Functioning Among Elderly Persons With Stroke: Results of a Prospective Cohort Study.

Abstract Objective To determine if 65- to 85-year-old persons who had a stroke within the previous 3-36 months can improve functioning and quality of life during walking rehabilitation. Design Prospective cohort study with 6-month follow-up. Setting Three inpatient rehabilitation centers and one outpatient rehabilitation center. Participants A total of 147 persons who had sustained a stroke. Intervention The multidisciplinary rehabilitation intervention consisted of inpatient (20 days) or outpatient (18 days) rehabilitation with follow-up. Rehabilitation included walking exercises with and without body-weight support and conventional physiotherapy. After the rehabilitation period, participa…

Effects of a Home-Based Physical Rehabilitation Program on Physical Disability After Hip Fracture: A Randomized Controlled Trial

Abstract Objective Fewer than half of the patients with hip fracture will regain the prefracture level of physical functioning. This secondary analysis of a randomized controlled trial investigated the effects of a multicomponent home-based rehabilitation program (ProMo) on physical disability after hip fracture. Design Randomized, controlled, parallel-group trial. Setting Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital. Participants Population-based clinical sample of community-dwelling people older than 60 years (n = 81) operated for hip fracture were randomized into intervention and control groups. Intervention The year-long intervent…

Effects of progressive resistance training on physical disability among older community-dwelling people with history of hip fracture

Background and aims: Hip fracture is a common trauma in older people, and often leads to decreased muscle strength and increased physical disability. This randomized controlled trial examined whether three months of progressive resistance training (PRT) can reduce physical disability among older people with a history of hip fracture. Methods: A population-based sample of 60-85-year-old community-dwelling persons, with hip fractures sustained on average three years earlier, were enrolled in the study. Of 78 people participating in laboratory assessments, those without contraindications for participation in resistance training were randomly assigned to a training group (TG, n=22) or a control…

Physical inactivity and pain in older men and women with hip fracture history

Hip fracture patients often suffer from pain for several months after surgery. This may lead to physical inactivity and subsequent mobility limitation and disability. The purpose of this study was to investigate the association between severe musculoskeletal pain and the level of physical activity in older people with a history of hip fracture. Data were collected from 60- to 85-year-old (n = 78) community-dwelling people, 0.7–7.5 years after hip fracture. Physical activity was assessed with the Yale Physical Activity Survey (YPAS). According to the YPAS summary index distribution, the participants were divided into the physically inactive and physically active groups. Musculoskeletal pain …

Balance Confidence Was Associated With Mobility and Balance Performance in Older People With Fall-Related Hip Fracture: A Cross-Sectional Study

Abstract Portegijs E, Edgren J, Salpakoski A, Kallinen M, Rantanen T, Alen M, Kiviranta I, Sihvonen S, Sipila S. Balance confidence was associated with mobility and balance performance in older people with fall-related hip fracture: a cross-sectional study. Objective To study the relationship between balance confidence, a concept closely related to fear of falling, mobility and balance performance, and perceived mobility limitation in older people after a fall-related hip fracture. Design Cross-sectional analyses of pretrial data of 2 randomized controlled trials of physical rehabilitation. Setting University research center. Participants Community-dwelling people aged over 60 years, 6 week…

Effects of a multicomponent home-based physical rehabilitation program on mobility recovery after hip fracture: a randomized controlled trial.

To investigate whether a home-based rehabilitation program for community-dwelling older people with recent hip fracture is more effective than standard care in improving mobility recovery and reducing disability.Randomized, controlled, parallel-group trial.Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital.Clinical population of community-dwelling men and women (aged 60+) recovering from hip fracture. Participants were randomly assigned into control (n = 41) or intervention (n = 40) groups on average 42 ± 23 days after discharge home.A yearlong multicomponent home-based rehabilitation aimed at promoting mobility recovery and physical functi…

Lower-Limb Pain, Disease, and Injury Burden as Determinants of Muscle Strength Deficit After Hip Fracture

Background: Hip fracture may result in an asymmetrical lower-limb strength deficit. The deficit may be related to the trauma, surgical treatment, pain, or disuse of the fractured limb. However, disease and injury burden or musculoskeletal pain in the other limb may reduce muscle strength on that side, reducing the asymmetrical deficit. The aim of our study was to explore the asymmetrical strength deficit and to determine the potential underlying factors in patients from six months to seven years after a hip fracture. Methods: The asymmetrical deficit was calculated ([fractured limb/sum of both lower limbs] x 100%) for isometric knee extension torque, rate of force development during isometr…

Sense of coherence: effect on adherence and response to resistance training in older people with hip fracture history.

Our aim was to study the effects of sense of coherence (SOC) on training adherence and interindividual changes in muscle strength, mobility, and balance after resistance training in older people with hip fracture history. These are secondary analyses of a 12-week randomized controlled trial of progressive resistance training in 60- to 85-year-old community-dwelling people 0.5–7 years after hip fracture (n = 45; ISRCTN34271567). Pre- and posttrial assessments included SOC, knee extension strength, walking speed, timed up-and-go (TUG), and Berg Balance Scale (BBS). Group-by-SOC interaction effects (repeated-measures ANOVA) were statistically significant for TUG (p = .005) and BBS (p = .040), …

Balance Confidence and Functional Balance in Relation to Falls in Older Persons with Hip Fracture History

PURPOSE: To investigate whether self-assessed balance confidence and functional balance are associated with falls in older persons with hip fracture history. METHODS: This study is a part of a larger study on functional capacity and exercise rehabilitation in hip fracture patients. Seventy-nine patients, operated at the local hospital for collum or trochanter fracture within one-half to 7 years, participated in the laboratory measurements. Balance confidence was assessed with Activities-specific Balance Confidence scale (ABC) and functional balance using the Berg Balance Scale (BBS). According to self-reported number of falls during the previous 6 months participants were classified as thos…

Feasibility and acceptability of the pelvic floor muscle and bladder training programme

Pelvic floor muscle training (PFMT) is the most commonly used physical therapy treatment for urinary incontinence, and it is more effective when combined with bladder training (BT) than alone. However, to our knowledge, there are no earlier intervention studies of the user feasibility and acceptability of the pelvic floor muscle and BT programme. The aim of this study was to pilot test the feasibility and acceptability and follow the compliance of the 8-week pelvic floor muscle and BT programme. Pre–post intervention study among 11 community-dwelling women born in 1936 with self-reported urinary incontinence and without current PFMT was practised. Primary outcomes were the feasibility, acce…

Recovery of Lower Extremity Performance After Hip Fracture Depends on Prefracture and Postdischarge Mobility : A Subgroup Analysis of a Randomized Rehabilitation Trial

Physical function and lean body mass as predictors of bone loss after hip fracture: a prospective follow-up study

Abstract Background: Predictors of bone deterioration after hip fracture have not been well characterized. The aim of this study was to examine the associations of physical function and lean body mass (LBM) with loss of bone density and strength in older people recovering from a hip fracture. Methods: A total of 81 over 60-year-old, community-dwelling men and women operated for a hip fracture participated in this 1-year prospective follow-up study. Distal tibia total volumetric bone mineral density (vBMDTOT, mg/cm³) and compressive strength index (BSI, g²/cm⁴) and mid-tibia cortical vBMD (vBMDCO, mg/cm³) and bending strength index (SSI, mm³) were assessed in both legs by peripheral quantita…

Effects of a Home‐Based Physical Rehabilitation Program on Tibial Bone Structure, Density, and Strength After Hip Fracture: A Secondary Analysis of a Randomized Controlled Trial

Abstract Weight‐bearing physical activity may decrease or prevent bone deterioration after hip fracture. This study investigated the effects of a home‐based physical rehabilitation program on tibial bone traits in older hip fracture patients. A population‐based clinical sample of men and women operated for hip fracture (mean age 80 years, 78% women) was randomly assigned into an intervention (n = 40) and a standard care control group (n = 41) on average 10 weeks postfracture. The intervention group participated in a 12‐month home‐based rehabilitation intervention, including evaluation and modification of environmental hazards, guidance for safe walking, nonpharmacological pain management, m…