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 …

Do bone geometric properties of the proximal femoral diaphysis reflect loading history, muscle properties, or body dimensions?

Abstract Objectives: The aim of this study was to investigate activity‐induced effects from bone geometric properties of the proximal femur in athletic vs nonathletic healthy females by statistically controlling for variation in body size, lower limb isometric, and dynamic muscle strength, and cross‐sectional area of Musculus gluteus maximus. Methods: The material consists of hip and proximal thigh magnetic resonance images of Finnish female athletes (N = 91) engaged in either high jump, triple jump, soccer, squash, powerlifting, endurance running or swimming, and a group of physically active nonathletic women (N = 20). Cross‐sectional bone geometric properties were calculated for the lesse…

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 …

Effects of exercise frequency and training volume on bone changes following a multi-component exercise intervention in middle aged and older men: Secondary analysis of an 18-month randomized controlled trial.

Progressive resistance training (PRT) combined with weight-bearing impact exercise are recommended to optimize bone health, but the optimal frequency and dose of training remains uncertain. This study, which is a secondary analysis of an 18-month intervention in men aged 50–79 years, examined the association between exercise frequency and the volume of training with changes in DXA and QCT-derived femoral neck (FN) and lumbar spine (LS) bone outcomes, respectively. Men were allocated to either thrice-weekly PRT plus impact exercise training (n = 87) or a non-exercising (n = 85) group. Average weekly exercise frequency (ExFreq) and training volume per session [PRT volume (weight lifted, kg), …

sj-docx-2-cre-10.1177_02692155231170687 - Supplemental material for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Supplemental material, sj-docx-2-cre-10.1177_02692155231170687 for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial by Marjo Rinne, Sanna Garam and Katriina Kukkonen-Harjula, Kari Tokola, Arja Häkkinen, Jari Ylinen, Riku Nikander in Clinical Rehabilitation

The relationship between loading history and proximal femoral diaphysis cross-sectional geometry

Objectives We investigated the relationship between loading history and bone biomechanical properties used in physical activity reconstructions. These bone properties included bone bending and torsional strength (J), cortical area (CA), the direction of the major axis (theta angle), and element shape ratios determined from cross sections of standardized bone length. In addition, we explored the applicability of anatomically determined cross sections. Methods Our material consisted of hip and proximal thigh magnetic resonance images of Finnish female athletes (N = 91) engaged in high-jump, triple-jump, endurance running, swimming, power-lifting, soccer and squash; along with a group of activ…

CareACT - internet-based intervention for enhancing the psychological well-being of elderly caregivers – a study protocol of a controlled trial

Abstract Background The rapid increase in the number of elderly family caregivers underlines the need for new support systems. Internet-delivered psychological interventions are a potential approach, as they are easy to access for family caregivers who are often homebound with their care recipient. This study examines the relative effectiveness of an internet-based acceptance and commitment therapy (ACT) intervention or a standardized institutional rehabilitation program, first, in reducing depressive symptoms, and second, in improving the well-being and quality of life of elderly family caregivers compared to a control group receiving support from voluntary family caregiver associations. M…

Neuromuscular performance and body mass as indices of bone loading in premenopausal and postmenopausal women.

The strong association between body mass and skeletal robusticity has been attributed to increasing skeletal loading with increasing mass. However, it is unclear whether body mass is merely a coarse substitute for bone loading rather than a true independent predictor of bone strength. As indices of neuromuscular performance, impulse and peak power were determined from vertical ground reaction force during a maximal counter movement jump test in 221 premenopausal and 82 postmenopausal women. Bone compressive (BSI(d) g(2)/cm(4)) and bending (SSImax(mid) mm(3)) strength indices were measured with peripheral quantitative computed tomography (pQCT) at the distal ((d)) and midshaft ((mid)) sites …

Supplemental_figure_2 – Supplemental material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial

Supplemental material, Supplemental_figure_2 for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial by Katri M Turunen, Laura Aaltonen-Määttä, Timo Törmäkangas, Timo Rantalainen, Erja Portegijs, Sirkka Keikkala, Marja-Liisa Kinnunen, Taija Finni, Sarianna Sipilä and Riku Nikander in Clinical Rehabilitation

The cross-sectional area of the gluteus maximus muscle varies according to habitual exercise loading: Implications for activity-related and evolutionary studies.

Greater size of the gluteus maximus muscle in humans compared to non-human primates has been considered an indication of its function in bipedal posture and gait, especially running capabilities. Our aim was to find out how the size of the gluteus maximus muscle varies according to sports while controlling for variation in muscle strength and body weight. Data on gluteus maximus muscle cross-sectional area (MCA) were acquired from magnetic resonance images of the hip region of female athletes (N=91), and physically active controls (N=20). Dynamic muscle force was measured as counter movement jump and isometric knee extension force as leg press. Five exercise loading groups were created: hig…

A tailored counseling and home-based rehabilitation program to increase physical activity and improve mobility among community-dwelling older people after hospitalization: protocol of a randomized controlled trial

Physical activity (PA) decreases during hospitalization. In particular, the amount of PA engaged in by older people who are hospitalized following musculoskeletal injury is likely to be limited for months after discharge home. Given the importance of an active lifestyle for their recovery and the prevention of future adverse outcomes, there is clearly a need for interventions to increase PA. This article describes the protocol of a randomized controlled trial set up to investigate the effects of a physical activity oriented home rehabilitation program (ProPA) on PA and the restoration of mobility in community-dwelling older people. Men and women aged 60 years or older hospitalized due to a …

Fyysisen aktiivisuuden merkitys niskan kuntoutuksessa : sokkoutettu, satunnaistettu, kontrolloitu tutkimus

Supported Web-Based Acceptance and Commitment Therapy for Older Family Caregivers (CareACT) Compared to Usual Care

Objectives: The objective of the present study was to investigate whether an acceptance and commitment therapy (ACT)-based web-intervention (Group 1, CareACT), or a standardized rehabilitation in a rehabilitation center (Group 2) was effective in enhancing the psychological well-being of family caregivers aged 60 and over compared to support provided by voluntary caregiver associations (Group 3). Methods: Altogether, 149 family caregivers participated in this quasi-experimental study. Primary outcome measure was depression. Secondary outcomes included anxiety, sense of coherence, quality of life, psychological flexibility, experiential avoidance, and thought suppression. The questionnaires …

sj-docx-2-cre-10.1177_02692155231170687 - Supplemental material for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Supplemental material, sj-docx-2-cre-10.1177_02692155231170687 for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial by Marjo Rinne, Sanna Garam and Katriina Kukkonen-Harjula, Kari Tokola, Arja Häkkinen, Jari Ylinen, Riku Nikander in Clinical Rehabilitation

Health-related Quality of Life of Breast Cancer Survivors Attending an Exercise Intervention Study : A Five-year Follow-up

Background/Aim: As the number of breast cancer survivors is increasing, their long-term health-related quality of life (HRQoL)has become an important issue. The aim of the study is to follow up the HRQoL of breast cancer survivors (BCS) in a prospectiverandomized exercise intervention study and to compare HRQoL to that of the age-matched general female population. Patients and Methods: Following adjuvant treatment, 537 patients aged 35-68 and capable of exercise training were randomized to a 12-monthexercise trial. In 182 of those patients, HRQoL was measured by the generic 15D at baseline and followed up for five years.Furthermore, the HRQoL of all BCS answering the 15D at five-year follow…

Kuntoutujan osallistaminen tavoitteenasettamisprosessiin ja tavoitteiden saavuttamisen arviointiin. Loppuraportti

Kuntoutujan osallisuus omassa kuntoutumisprosessissaan on ensiarvoisen tärkeää, jotta kuntoutumista edistävät toimet nivoutuvat osaksi kuntoutujan arkea ja kuntoutuja motivoituu ja sitoutuu muutokseen. Tässä Kelan rahoittamassa vuosina 2015 ja 2016 toteutetussa tutkimuksessa tarkasteltiin kuntoutujan osallistamista kuntoutumistavoitteiden asettamiseen ja tavoitteiden seurantaan Goal Attainment Scaling -menetelmällä (GAS). Tutkimuksen tavoitteena oli 1) tarkastella kuntoutujan osallisuutta ja siihen vaikuttavia tekijöitä tavoitteita asettaessa, 2) arvioida tavoitteiden saavuttamista ja siihen liittyviä tekijöitä sekä 3) vertailla kahden kuntoutujaryhmän yhtäläisyyksiä ja eroavaisuuksia tavoi…

Reliability and validity of the COPE Index among caregivers of disabled people.

Aim To study the reliability and validity of the Carers of Older People in Europe (COPE) Index among caregivers of disabled people of different ages. Methods A cross-sectional design of Finnish caregivers (n = 1117). Exploratory factor analysis (EFA) was performed separately on samples of three different age groups, and the internal consistencies of the subscales were investigated. Results Three factors were identified; Cronbach's alpha was 0.83–0.86 for negative impact and 0.77–0.78 for quality of support, indicating good internal consistency. The third factor, positive value, was less consistent across the age groups (α < 0.66). Conclusions The COPE Index is a valid and reliable screening…

sj-pdf-1-cre-10.1177_02692155231170687 - Supplemental material for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Supplemental material, sj-pdf-1-cre-10.1177_02692155231170687 for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial by Marjo Rinne, Sanna Garam and Katriina Kukkonen-Harjula, Kari Tokola, Arja Häkkinen, Jari Ylinen, Riku Nikander in Clinical Rehabilitation

Exercise loading and bone structure

The objective of this dissertation was to determine the types of exercise loading that are associated with the strength of bones. Four cross-sectional studies were conducted between 2004 and 2008 including 378 athletes and their 62 referents. Sixteen different sports were classified into five specific categories for the lower extremities and three categories for the upper extremities according to the type of exercise loading.Besides planar DXA-derived hip structural analysis, pQCT, and MRI methods allowing the assessment of true bone cross-sections were used for the bone structure analyses of the tibia, proximal femur, radius, and humerus. At the lower extremity, the high-impact exercise lo…

Health-related Quality of Life of Breast Cancer Survivors Attending an Exercise Intervention Study: A Five-year Follow-up

Background/Aim: As the number of breast cancer survivors is increasing, their long-term health-related quality of life (HRQoL) has become an important issue. The aim of the study is to follow up the HRQoL of breast cancer survivors (BCS) in a prospective randomized exercise intervention study and to compare HRQoL to that of the age-matched general female population. Patients and Methods: Following adjuvant treatment, 537 patients aged 35-68 and capable of exercise training were randomized to a 12-month exercise trial. In 182 of those patients, HRQoL was measured by the generic 15D at baseline and followed up for five years. Furthermore, the HRQoL of all BCS answering the 15D at five-year fo…

Effects of high-impact training and detraining on femoral neck structure in premenopausal women: a hip structural analysis of an 18-month randomized controlled exercise intervention with 3.5-year follow-up.

Purpose: This study evaluated the training effects of an 18-month exercise intervention and subsequent 3.5-year follow-up on femoral neck structure in premenopausal women. Methods: Of 98 women who participated in this randomized controlled study, 84 (39 trainees and 45 controls) completed the 18-month intervention. At both 18 months and 3.5 years, dual-energy X-ray absorptiometry data on 22 trainees and 22 control participants (ages 35–45 y) were available for hip structural analysis. The section modulus (Z), cross-sectional area (CSA), and subperiosteal width at the femoral neck were analyzed. Lower-leg explosive power and estimated maximal oxygen uptake (Vo2max) were assessed by vertical…

Perceived Burden among Spouse, Adult Child and Parent Caregivers

Rehabilitees perspective on goal setting in rehabilitation : a phenomenological approach

Purpose: Setting meaningful goals for the rehabilitation process after acute illness is essential for rehabilitees recovery. The aim of this study was to understand the meanings of the goal setting situation with professionals from rehabilitees point of view. - Method: We included 20 acute stroke and back pain rehabilitees (mean age 66 y) who set goals with a multidisciplinary rehabilitation team. Data was collected by interviewing the rehabilitees after the goal setting situations. A qualitative analysis from a phenomenological perspective using Spiegelberg’s seven-phase meaning analysis was performed to reveal meanings. - Results: The five meanings were identified as: (i) “trust in the re…

Comment on "Effects of Elastic Resistance Band Exercise on Postural Balance, Estrogen, Bone Metabolism Index, and Muscle Strength of Perimenopausal Period Women".

Conceptions of healthcare professionals about rehabilitees’ participation in goal setting in an acute hospital : a phenomenographic study

Purpose: In acute care, effective goal-setting is an essential phase of a successful rehabilitation process. However, professionals’ knowledge and skills in rehabilitee-centered practice may not always match the ways of implementing goal-setting. This study aimed to describe the variation in how acute hospital professionals perceive and comprehend rehabilitee participation in rehabilitation goal-setting. Methods: Data were collected by interviewing 27 multidisciplinary rehabilitation team members in small groups shortly after rehabilitation goal-setting sessions. A qualitative research design based on phenomenography was implemented. Results: We identified four conceptions of rehabilitee pa…

sj-pdf-1-cre-10.1177_02692155231170687 - Supplemental material for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Supplemental material, sj-pdf-1-cre-10.1177_02692155231170687 for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial by Marjo Rinne, Sanna Garam and Katriina Kukkonen-Harjula, Kari Tokola, Arja Häkkinen, Jari Ylinen, Riku Nikander in Clinical Rehabilitation

Effect of fall direction on the lower hip fracture risk in athletes with different loading histories : A finite element modeling study in multiple sideways fall configurations

Physical loading makes bones stronger through structural adaptation. Finding effective modes of exercise to improve proximal femur strength has the potential to decrease hip fracture risk. Previous proximal femur finite element (FE) modeling studies have indicated that the loading history comprising impact exercises is associated with substantially higher fracture load. However, those results were limited only to one specified fall direction. It remains thus unclear whether exercise-induced higher fracture load depends on the fall direction. To address this, using magnetic resonance images of proximal femora from 91 female athletes (mean age 24.7 years with >8 years competitive career) and …

supplement_material – Supplemental material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial

Supplemental material, supplement_material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial by Katri M Turunen, Laura Aaltonen-Määttä, Timo Törmäkangas, Timo Rantalainen, Erja Portegijs, Sirkka Keikkala, Marja-Liisa Kinnunen, Taija Finni, Sarianna Sipilä and Riku Nikander in Clinical Rehabilitation

Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

Over 90% of hip fractures are caused by falls. Due to a fall-induced impact on the greater trochanter, the posterior part of the thin superolateral cortex of the femoral neck is known to experience the highest stress, making it a fracture-prone region. Cortical geometry of the proximal femur, in turn, reflects a mechanically appropriate form with respect to habitual exercise loading. In this finite element (FE) modeling study, we investigated whether specific exercise loading history is associated with femoral neck structural strength and estimated fall-induced stresses along the femoral neck. One hundred and eleven three-dimensional (3D) proximal femur FE models for a sideways falling situ…

Ricci-flow based conformal mapping of the proximal femur to identify exercise loading effects.

AbstractThe causal relationship between habitual loading and adaptive response in bone morphology is commonly explored by analysing the spatial distribution of mechanically relevant features. In this study, 3D distribution of features in the proximal femur of 91 female athletes (5 exercise loading groups representing habitual loading) is contrasted with 20 controls. A femur specific Ricci-flow based conformal mapping procedure was developed for establishing correspondence among the periosteal surfaces. The procedure leverages the invariance of the conformal mapping method to isometric shape differences to align surfaces in the 2D parametric domain, to produce dense correspondences across an…

Association between long-term exercise loading and lumbar spine trabecular bone score (TBS) in different exercise loading groups

Objective: To examine whether different exercise loading is associated with lumbar vertebral texture as assessed with Trabecular Bone Score (TBS). Methods: Data from 88 Finnish female athletes and 19 habitually active women (reference group) were analyzed. Participants’mean age was 24.3 years(range 17-40 years).Athletes were divided into five specific exercise loading groups according to sport-specific training history: high-impact (triple jumpers and high jumpers), odd-impact (soccer players and squash players), high-magnitude (power lifters), repetitive impact (endurance runners), and repetitive non-impact (swimmers). TBS-values were determined from lumbar vertebral L1-L4 DXA images. Body…

Impact loading history modulates hip fracture load and location : A finite element simulation study of the proximal femur in female athletes

Sideways falls impose high stress on the thin superolateral cortical bone of the femoral neck, the region regarded as a fracture-prone region of the hip. Exercise training is a natural mode of mechanical loading to make bone more robust. Exercise-induced adaptation of cortical bone along the femoral neck has been previously demonstrated. However, it is unknown whether this adaption modulates hip fracture behavior. The purpose of this study was to investigate the influence of specific exercise loading history on fall-induced hip fracture behavior by estimating fracture load and location with proximal femur finite element (FE) models created from magnetic resonance images (MRI) of 111 women w…

Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial.

Objectives: The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital. Design: Randomized controlled trial. Setting: Home and community. Participants: Community-dwelling people aged ⩾60 years recovering from a lower limb or back musculoskeletal injury, surgery, or disorder were recruited from local health center hospitals and randomly assigned into an intervention ( n = 59) or a control (standard care, n = 58) group. Intervention: The six-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive hom…

Loading modalities and bone structures at nonweight-bearing upper extremity and weight-bearing lower extremity: a pQCT study of adult female athletes.

This cross-sectional study of adult female athletes assessed whether the apparent loading-related differences in bone structure are primarily associated with the loading type or the muscle performance-related joint moments. Several structural variables at shaft sites of the tibia, radius and humerus, and distal sites of the tibia and radius were measured with peripheral quantitative computed tomography (pQCT) among 113 female national level athletes (representing hurdling, volleyball, soccer, racket-sports and swimming) and their 30 nonathletic referents. For the weight-bearing lower extremities, the loading modalities of the above sports were classified into high-impact (hurdling, volleyba…

Detection of exercise load-associated differences in hip muscles by texture analysis

We examined whether specific physical exercise loading is associated with texture parameters from hip muscles scanned with magnetic resonance imaging (MRI). Ninety-one female athletes representing five distinct exercise-loading groups (high-impact, odd-impact, low-impact, nonimpact and high-magnitude) and 20 nonathletic female controls underwent MRI of the hip. Texture parameters were computed from the MRI images of four hip muscles (gluteus maximus, gluteus medius, iliopsoas and obturator internus). Differences in muscle texture between the athlete groups and the controls were evaluated using Mann-Whitney U-test. Significant (P < 0.05) textural differences were found between the high-impac…

Isometric endurance test of the cervical flexor muscles - Reliability and normative reference values.

Abstract Objective To obtain reference values for the isometric endurance test (IET) of the cervical flexor muscles, investigate its reproducibility, and compare the results with the maximal isometric strength test (MIST) of the cervical flexor muscles. Design Cross-sectional non-comparative study with single group repeated measurements. Methods Altogether 219 healthy females aged 20–59 years volunteered to participate in the study. The IET was performed in the supine position and MIST seated. The reproducibility was evaluated by the intraclass correlation coefficient (ICC) and an analysis described by Bland and Altman. The relationship between the two measuring methods was evaluated by Pea…

Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Objectives We investigated whether a specific exercise program for the neck–shoulder region reduces headache intensity, frequency, and duration, and how it influences neck disability among women with chronic headache compared to a control group. Design Two-center randomized controlled trial. Subjects 116 working-age women. Intervention The exercise group (n = 57) performed a home-based program with six progressive exercise modules, over 6 months. The control group (n = 59) underwent six placebo-dosed transcutaneous electrical nerve stimulation sessions. Both groups performed stretching exercises. Main measures The primary outcome was pain intensity of headache, assessed using the Numeric Pa…

Five-year follow-up results of aerobic and impact training on bone mineral density in early breast cancer patients

Summary A 12-month exercise program reversibly prevented hip bone loss in premenopausal women with early breast cancer. The bone-protective effect was maintained for 2 years after the end of the program but was lost thereafter. Purpose Breast cancer survivors are at an increased risk for osteoporosis and fracture. This 5-year follow-up of a randomized impact exercise intervention trial evaluated the maintenance of training effects on bone among breast cancer patients. Methods Five hundred seventy-three early breast cancer patients aged 35–68 years and treated with adjuvant therapy were allocated into a 12-month exercise program or a control group. Four hundred forty-four patients (77%) were…

"Ei tää hullumpi ole" : yli 60-vuotiaiden omaishoitajien etäkuntoutuksen vaikuttavuus ja kuntoutujien kokemukset

Hankkeen tavoitteena oli tutkia verkkopohjaisen, hyväksymis- ja omistautumisterapiamenetelmiin perustuvan etäkuntoutusohjelman vaikutuksia yli 60-vuotiaiden omaishoitajien psyykkiseen hyvinvointiin. Hanke toteutettiin näennäiskokeellisessa asetelmassa vertaamalla keskenään ryhmiä, joista yksi osallistui 12 viikon etäkuntoutusohjelmaan (n = 60), yksi omaishoitajien laitoskuntoutukseen (n = 52) ja yksi omaishoitoyhdistysten tarjoamiin toimintoihin (n = 39). Omaishoitajien psyykkistä hyvinvointia arvioitiin tutkimuksen alussa, etäkuntoutusohjelman jälkeen 4 kuukauden välimittauksissa sekä 10 kuukauden kuluttua tutkimuksen alusta. Tässä artikkelissa raportoidaan tuloksia ja kokemuksia hankkeen …

The role of thought suppression and psychological inflexibility in older family caregivers’ psychological symptoms and quality of life

Abstract Background Family caregivers often report high levels of distress, including depressive symptoms, anxiety, and reduced quality of life. There is a need for a greater understanding of the factors influencing, explaining, and maintaining psychological distress in family caregivers. Aim The aim of this study was to examine whether avoidance strategies such as thought suppression (WBSI), psychological inflexibility (AAQ-II), and, and caregiver experiential avoidance (EACQ) predict psychological distress (BDI-II, GAD-7) and quality of life (WHOQOL) in family caregivers aged 60 and over. We hypothesized that these avoidance strategies would explain elevated levels of psychological sympto…

Long-term health-related quality of life of breast cancer survivors remains impaired compared to the age-matched general population especially in young women. Results from the prospective controlled BREX exercise study.

Objective To investigate long-term health-related quality of life (HRQoL) changes over time in younger compared to older disease-free breast cancer survivors who participated in a prospective randomized exercise trial. Methods Survivors (aged 35–68 years) were randomized to a 12-month exercise trial after adjuvant treatment and followed up for ten years. HRQoL was assessed with the generic 15D instrument during follow-up and the younger (baseline age ≤ 50) and older (age >50) survivors’ HRQoL was compared to that of the age-matched general female population (n = 892). The analysis included 342 survivors. Results The decline of HRQoL compared to the population was steeper and recovery slower…

Counselling for physical activity, life-space mobility and falls prevention in old age (COSMOS): protocol of a randomised controlled trial.

IntroductionThe most promising way to promote active life years in old age is to promote regular participation in physical activity (PA). Maintaining lower extremity muscle function with good balance has been associated with fewer falls and the need of help from others. This article describes the design and intervention of a randomised controlled trial (RCT) investigating the effectiveness of a health and PA counselling programme on life-space mobility and falls rates in community-dwelling older adults at the Health Kiosk and/or Service Centre.Methods and analysisCommunity-dwelling men and women (n=450) aged 65 years and over with early phase mobility limitation will be recruited to a 24-mo…

Perceived Burden among Spouse, Adult Child and Parent Caregivers

Aims To identify what factors are associated with the caregiver burden of spouse caregivers, adult child caregivers, and parent caregivers. Background Caregivers often feel stressed and perceive caregiving as a burden. The caregiver burden has been little studied from the perspective of the personal relationship between caregiver and care recipient. Design Cross-sectional study. Methods A random sample of 4,000 caregivers in Finland was drawn in 2014 and those who remained either spouse, adult child, or parent caregivers at data collection were included in the analysis (N = 1,062). Data collection included recipients' characteristics. Caregivers' perceived burden was measured using the Care…

Influence of exercise loading on magnetic resonance image texture of thigh soft tissues.

Adaptation to exercise training can affect bone marrow adiposity; muscle-fat distribution; and muscle volume, strength and architecture. The objective of this study was to identify exercise-load-associated differences in magnetic resonance image textures of thigh soft tissues between various athlete groups and non-athletes. Ninety female athletes representing five differently loading sport types (high impact, odd impact, high magnitude, repetitive low impact and repetitive non-impact), and 20 non-athletic clinically healthy female controls underwent magnetic resonance imaging. Five thigh muscles, subcutaneous fat and femoral bone marrow were analysed with co-occurrence matrix-based quantita…

Targeted exercise against osteoporosis: A systematic review and meta-analysis for optimising bone strength throughout life

Background. Exercise is widely recommended to reduce osteoporosis, falls and related fragility fractures, but its effect on whole bone strength has remained inconclusive. The primary purpose of this systematic review and meta-analysis was to evaluate the effects of long-term supervised exercise (≥6 months) on estimates of lower-extremity bone strength from childhood to older age. Methods. We searched four databases (PubMed, Sport Discus, Physical Education Index, and Embase) up to October 2009 and included 10 randomised controlled trials (RCTs) that assessed the effects of exercise training on whole bone strength. We analysed the results by age groups (childhood, adolescence, and young and …