18 results on '"Kollén L"'
Search Results
2. Examination of differences in backward walking within a young and an old population: A quantitative cross-sectional survey
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Lindskog, F., primary, Axelson, H., additional, Tranberg, R., additional, Kollén, L., additional, Tullberg, M., additional, and Zügner, R., additional
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- 2020
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3. Aerobic fitness in overweight/obese children with congenital heart disease: Benefit of adapted VO2 reference values
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Gavotto, A. and Kollen, L.
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- 2022
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4. Functional gait assessment : Reliability and validity in people with peripheral vestibular disorders
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Nilsagård, Ylva, Kollén, L., Axelsson, H., Bjerlemo, B., Forsberg, Anette, Nilsagård, Ylva, Kollén, L., Axelsson, H., Bjerlemo, B., and Forsberg, Anette
- Abstract
Background/aim: Reliable and valid measures evaluating imbalance during walking are important for targeting rehabilitation efforts. This study aimed to investigate the reliability and validity of the Functional Gait Assessment (FGA) in people with peripheral vestibular disorder. Methods: This study used a cross-sectional design and tested the reliability and validity of the FGA in 43 participants with peripheral vestibular disorder. The participants' performance on the FGA was filmed. To test intra-rater reliability, three raters reassessed 39 of these participants using the video uptakes. Interrater reliability was assessed by five raters analysing the video uptakes. Concurrent validity was investigated using timed measures of dynamic balance and the Activities-specific Balance Confidence scale. Results: The intra-rater reliability for the FGA score was high, with a intraclass correlation coefficient (ICC) (model 2,1)=0.94 (95% CI=0.85; 0.97). The intra-rater percentage of agreement for all raters for separate items was moderate to high, and weighted kappa was good to very good, ranging from 0.61 for change in speed to 0.95 for stair climbing. The inter-rater reliability was ICC (model 2,1)=0.73 (95% CI=0.49; 0.86). Agreement for two random raters was 45-92%. Weighted kappa was fair to very good, ranging from 0.27 for change in speed to 0.87 for walking with a narrow base of support. The internal consistency was high (α=0.88). Gait with eyes closed had the lowest item-to-total (0.33) and item-to-item (<0.30) correlation. Concurrent validity was moderate to strong (rho=0.50-0.76) with the highest correlation coefficient for the Timed Up and Go test. Conclusions: The FGA is a reliable and valid measure in people with peripheral vestibular disorder. For improving internal consistency, removal of the item 'gait with eyes closed' may be considered. more...
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- 2014
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5. Evaluation of treatment in benign paroxysmal positional vertigo (BPPV)
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Kollén L, Bjerlemo B, and Möller C
- Abstract
Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo. The prognosis is good, usually with spontaneous remission within three months, but symptoms may last. Patients were consecutively evaluated before and 1, 6 and 12 months after treatment, to evaluate the long-term effects of the Semont manoeuvre and Brandt & Daroff exercises. The subjects were 17 patients (13 women and four men, mean age 52 years) who had suffered from BPPV for more than three months. The Semont manoeuvre was performed. Patients with vertigo after two Semont manoeuvres were instructed to perform Brandt & Daroff exercises. Follow-up was done by the Dix-Hallpike test, measurement of static/dynamic balance and a health questionnaire; for the vertigo, a visual analogue scale (VAS) was used. Three of 17 patients still suffered from vertigo after 12 months but the nystagmus during the Dix-Hallpike test was significantly decreased. At the end of the study, nine of 17 patients still experienced unsteadiness during standing and walking. It is of importance to perform not only manoeuvres and Brandt & Daroff exercises but also to instruct the patient in vestibular rehabilitation including static/dynamic balance exercises in order to reduce unsteadiness. [ABSTRACT FROM AUTHOR] more...
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- 2006
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6. Symptoms and signs did not predict outcome after surgery: a prospective study of 143 patients with idiopathic normal pressure hydrocephalus.
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Andrén K, Wikkelsø C, Laurell K, Kollén L, Hellström P, and Tullberg M
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- Humans, Female, Male, Aged, Prospective Studies, Aged, 80 and over, Treatment Outcome, Neuropsychological Tests, Middle Aged, Hydrocephalus, Normal Pressure surgery, Hydrocephalus, Normal Pressure diagnosis
- Abstract
Objective: To determine the utility of symptoms, signs, comorbidities and background variables for the prediction of outcome of treatment in iNPH., Methods: A prospective observational study of consecutively included iNPH patients, who underwent neurological, physiotherapeutic and neuropsychological assessments before and after shunt surgery. The primary outcome measure was the total change on the iNPH scale, and patients were defined as improved postoperatively if they had improved by at least five points on that scale., Results: 143 iNPH patients were included, and 73% of those were improved after surgery. None of the examined symptoms or signs could predict which patients would improve after shunt surgery. A dominant subjective complaint of memory problems at baseline was predictive of non-improvement. The reported comorbidities, duration of symptoms and BMI were the same in improved and non-improved patients. Each of the symptom domains (gait, neuropsychology, balance, and continence) as well as the total iNPH scale score improved significantly (from median 53 to 69, p < 0.001). The proportions of patients with shuffling gait, broad-based gait, paratonic rigidity and retropulsion all decreased significantly., Discussion: This study confirms that the recorded clinical signs, symptoms, and impairments in the adopted clinical tests are characteristic findings in iNPH, based on that most of them improved after shunt surgery. However, our clinical data did not enable predictions of whether patients would respond to shunt surgery, indicating that the phenotype is unrelated to the reversibility of the iNPH state and should mainly support diagnosis. Absence of specific signs should not be used to exclude patients from treatment., (© 2024. The Author(s).) more...
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- 2024
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7. Dizziness Symptoms, Balance Confidence, and Vestibular Function in Older Women Reporting Dizziness and Unsteadiness.
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Lindell E, Kollén L, and Finizia C
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- Aged, Benign Paroxysmal Positional Vertigo diagnosis, Cross-Sectional Studies, Female, Humans, Postural Balance, Walking, Dizziness diagnosis, Vestibule, Labyrinth
- Abstract
Objective: The aim of this article is to evaluate older women who report dizziness on a daily or weekly basis, but not seeking medical care for their problems, for levels of patient-reported outcome measures related to dizziness, balance confidence, vestibular impairment, benign paroxysmal positional vertigo walking speed, Timed Up and Go (TUG), balance confidence, depression, and anxiety., Study Design: Cross-sectional survey., Setting: Secondary referral center., Patients: Patients coming for bone density measurements answered questions regarding occurrence of dizziness. Women reporting dizziness on a daily or weekly basis were considered eligible and invited for investigation at the Ear, Nose, and Throat clinic at Södra Älvsborg Hospital, Sweden., Main Outcome Measure: Patients completed the Dizziness Handicap Inventory (DHI), Activities-specific Balance Confidence Scale, and Hospital Anxiety and Depression Scale and were investigated with the video Head Impulse Test, for benign paroxysmal positional vertigo, walking speed, and TUG test., Results: Fifty-two female patients were enrolled. Associations were found between high levels of DHI and high distress due to dizziness, and low levels of balance confidence and reduced walking speed and TUG test time. Participants with higher DHI levels reported higher levels of both depression and anxiety. No associations were found between levels of DHI and results on vestibular tests., Conclusion: Women reporting higher levels of distress due to dizziness had reduced walking speed and reported less balance confidence and higher levels of anxiety and depression. The findings support the theory that DHI captures aspects of overall self-rated wellbeing and function rather than structural vestibular deficits., Competing Interests: The authors disclose no conflicts of interest., (Copyright © 2022, Otology & Neurotology, Inc.) more...
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- 2022
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8. Physical Capacity and Activity in Patients With Idiopathic Normal Pressure Hydrocephalus.
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Rydja J, Kollén L, Ulander M, Tullberg M, and Lundin F
- Abstract
Introduction: Most patients with idiopathic normal pressure hydrocephalus (iNPH) improve gait after surgery. However, knowledge on physical capacity and activity after shunt surgery is limited. One of the aims of this study was to evaluate the effect of shunt surgery in patients with iNPH on short-distance walking, functional exercise capacity, functional strength, and variables of activity and sleep, 3 and 6 months postoperatively. Another aim was to evaluate the effect of a physical exercise program. Additionally, we studied how changes in short-distance walking were correlated with functional exercise capacity and voluntary walking., Methods: In total, 127 patients were consecutively included and randomized to the exercise group ( n = 62) or the control group ( n = 65). Participants in the exercise group underwent the supervision of a 12-week exercise program. All patients were assessed before surgery, at 3 and 6 months postoperatively with the 10-m walk test (10MWT), the 6-min walk test (6MWT), 30-s chair stand test (30sCST), and with the actigraphic recordings of activity variables measured for a total of 24 h/day for at least 3 days., Results: All patients improved at 3 months postoperatively in the 10MWT ( p < 0.001), 6MWT ( p < 0.001), and 30sCST ( p < 0.001). These results were maintained after 6 months. Actigraphic recordings for voluntary walking (steps per minute) were improved and nighttime sleep (%) increased after 6 months ( p = 0.01, p = 0.04). There were no significant differences between the exercise group and the control group, except for the postoperative change in the proportion of daytime sleep after 3 months, which was slightly more reduced compared to baseline in the exercise group ( p = 0.04). Changes after 3 months in the 10MWT and 6MWT were moderately correlated (ρ= -0.49, p = 0.01) whereas the correlation between the 10MWT and voluntary walking was weak (ρ = -0.34, p = 0.01)., Conclusion: Shunt surgery improved short-distance walking, functional exercise capacity, functional strength, and voluntary walking. An exercise program did not affect these outcomes. Short-distance walking was weakly correlated with voluntary walking, indicating improved physical capacity does not directly translate to increased physical activity. Further research should address how interventions should be tailored to promote physical activity after shunt surgery., Trial Registration: clinicaltrials.gov, Id: NCT02659111., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rydja, Kollén, Ulander, Tullberg and Lundin.) more...
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- 2022
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9. The timed up and go test in idiopathic normal pressure hydrocephalus: a Nationwide Study of 1300 patients.
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Sundström N, Rydja J, Virhammar J, Kollén L, Lundin F, and Tullberg M
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- Aged, Aged, 80 and over, Exercise Test, Female, Gait Disorders, Neurologic etiology, Gait Disorders, Neurologic therapy, Humans, Hydrocephalus, Normal Pressure surgery, Male, Middle Aged, Sweden, Gait Disorders, Neurologic diagnosis, Hydrocephalus, Normal Pressure complications, Neurosurgical Procedures, Outcome Assessment, Health Care, Postural Balance, Registries
- Abstract
Background: The aim of this study was to describe the outcome measure timed up and go (TUG) in a large, nationwide cohort of patients with idiopathic normal pressure hydrocephalus (iNPH) pre- and post-operatively. Furthermore, to compare the TUG test to the 10-m walk test (10MWT), the iNPH scale, the modified Rankin scale (mRS) and the Mini Mental State Examination (MMSE), which are commonly applied in clinical assessment of iNPH., Methods: Patients with iNPH (n = 1300), registered in the Swedish Hydrocephalus Quality Registry (SHQR), were included. All data were retrieved from the SHQR except the 10MWT, which was collected from patient medical records. Clinical scales were examined pre- and 3 months post-operatively. Data were dichotomised by sex, age, and preoperative TUG time., Results: Preoperative TUG values were 19.0 [14.0-26.0] s (median [IQR]) and 23 [18-30] steps. Post-operatively, significant improvements to 14.0 [11.0-20.0] s and 19 [15-25] steps were seen. TUG time and steps were higher in women compared to men (p < 0.001) but there was no sex difference in improvement rate. Worse preoperative TUG and younger age favoured improvement. TUG was highly correlated to the 10MWT, but correlations of post-operative changes were only low to moderate between all scales (r = 0.22-0.61)., Conclusions: This study establishes the distribution of TUG in iNPH patients and shows that the test captures important clinical features that improve after surgery independent of sex and in all age groups, confirming the clinical value of the TUG test. TUG performance is associated with performance on the 10MWT pre- and post-operatively. However, the weak correlations in post-operative change to the 10MWT and other established outcome measures indicate an additional value of TUG when assessing the effects of shunt surgery., (© 2022. The Author(s).) more...
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- 2022
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10. Physical exercise and goal attainment after shunt surgery in idiopathic normal pressure hydrocephalus: a randomised clinical trial.
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Rydja J, Kollén L, Hellström P, Owen K, Lundgren Nilsson Å, Wikkelsø C, Tullberg M, and Lundin F
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- Aged, Aged, 80 and over, Follow-Up Studies, Humans, Male, Outcome Assessment, Health Care, Single-Blind Method, Cerebrospinal Fluid Shunts, Exercise Therapy, Goals, Hydrocephalus, Normal Pressure rehabilitation, Hydrocephalus, Normal Pressure surgery, Neurological Rehabilitation
- Abstract
Background: Rehabilitation in iNPH is suggested to be an important factor to improve patients' functions but there are lack of clinical trials evaluating the effect of rehabilitation interventions after shunt surgery in iNPH. The objective of this study was to evaluate the effect of a physical exercise programme and goal attainment for patients with idiopathic normal pressure hydrocephalus (iNPH) after surgery compared to a control group., Methods: This was a dual centre randomised controlled trial with assessor blinding, intention-to-treat (ITT) and per protocol (PP) analysis. Individuals diagnosed with iNPH scheduled to undergo shunt surgery at the Linköping University Hospital in Linköping and Sahlgrenska University Hospital in Gothenburg, Sweden were consecutively eligible for inclusion. Inclusion was conducted between January 2016 and June 2018. The patients were randomised 1:1 using sequentially numbered sealed envelopes to receive either written exercise information (control group) or written information and an additional supervised high-intensity, functional exercise programme (HIFE) executed twice weekly over 12 weeks (exercise group). Preoperatively, the patients set individual goals. The primary outcome was change from baseline in the total iNPH scale score at the post-intervention follow-up. Secondary outcomes were goal attainment, and change in the separate scores of gait, balance, neuropsychology and continence and in the total score after 6 months., Results: In total, 127 participants were randomised to the exercise group (n = 62) and to the control group (n = 65). In the ITT population (exercise group, n = 50; control group, n = 59), there were no between-group differences in the primary outcome, but the attrition rate in the exercise group was high. The exercise group improved more than the control group in the balance domain scores after 6 months. Post-intervention, the PP exercise population achieved their set goals to a greater extent than the controls., Conclusions: An additional effect of the 12-week HIFE-programme on the overall improvement according to the iNPH-scale after shunt surgery in iNPH was not shown. This could be due to high attrition rate. However, the long-term effect on balance and higher goal achievement indicate beneficial influences of supervised physical exercise. Trial registration clinicaltrials.gov, NCT02659111. Registered 20 January 2016, https://clinicaltrials.gov/ct2/show/NCT02659111., (© 2021. The Author(s).) more...
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- 2021
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11. Dizziness and health-related quality of life among older adults in an urban population: a cross-sectional study.
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Lindell E, Kollén L, Johansson M, Karlsson T, Rydén L, Fässberg MM, Erhag HF, Skoog I, and Finizia C
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- Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Male, Surveys and Questionnaires, Urban Population, Dizziness epidemiology, Quality of Life
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Background: Dizziness is a common complaint among older adults and may affect quality of life in a negative way. The aim of this study was to assess health-related quality of life (HRQL), sense of coherence (SOC), self-rated health (SRH) and comorbidity in relation to dizziness, among older persons from an urban population., Methods: The study is part of the Gothenburg H70 Birth Cohort Studies (H70). A cross-sectional population-based sample including 662 79-years-olds (404 women, 258 men, 62% response rate) were surveyed with questions regarding dizziness, imbalance, comorbidities and general health. HRQL was assessed using the 36-item Short Form-36 Health Survey (SF-36) and SOC with the 13-items questionnaire Sense of Coherence (SOC-13)., Results: Half of the participants reported problems with dizziness (54%). Dizziness was negatively associated with HRQL, including after adjusting for comorbidities, especially in the physical domains of SF-36. Having dizziness was also associated with poorer SRH, tiredness and comorbidity among both men and women. SOC (mean total score), however, did not differ between dizzy and non-dizzy participants., Conclusions: Dizziness was negatively associated with HRQL, also after adjusting for comorbidities. Identification and treatment of dizziness, when possible, are important because reduction of dizziness symptoms may potentially help to enhance overall well-being in this age group., (© 2021. The Author(s).) more...
- Published
- 2021
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12. Benign paroxysmal positional vertigo and vestibular impairment among older adults with dizziness.
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Lindell E, Karlsson T, Kollén L, Johansson M, and Finizia C
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Objective: This article aimed to investigate older adults visiting a geriatric institution for a bone density measurement who reported dizziness on a daily or weekly basis (but who are not seeking care for dizziness), according to BPPV, vestibular function, walking abilities, and frequency of falls., Methods: Patients coming for a bone density measurement answered questions regarding occurrence of dizziness. Patients having dizziness on a daily or weekly basis were considered eligible for the study and invited for investigation at the Ear, Nose, and Throat clinic at Södra Älvsborg Hospital, Sweden. The patients answered questions about history of dizziness, medications, and comorbidities. They were also investigated for BPPV, vestibular deficits using the video head impulse test (vHIT), walking speed, Timed Up and Go test (TUG), and for perception of verticality and horizontality and Romberg test., Results: A total of 55 patients with dizziness were included. Fifteen (27%) were diagnosed with BPPV. Forty (73%) patients reported falling during the previous year, including 11 with BPPV. Dizziness when turning in bed was more common among patients with BPPV and increased the risk of BPPV 8-fold., Conclusion: BPPV is common among older adults with dizziness, including among those not seeking medical care. It is important to identify older adults with BPPV and treat the condition since BPPV may contribute to falls. Asking about dizziness when turning in bed can help to distinguish patients with increased risk for BPPV and older adults with dizziness should be investigated for BPPV even when typical history is lacking. Level of evidence : 4., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC. on behalf of The Triological Society.) more...
- Published
- 2021
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13. Benign paroxysmal positional vertigo, dizziness, and health-related quality of life among older adults in a population-based setting.
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Lindell E, Kollén L, Johansson M, Karlsson T, Rydén L, Falk Erhag H, Wetterberg H, Zettergren A, Skoog I, and Finizia C
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- Aged, Benign Paroxysmal Positional Vertigo epidemiology, Cross-Sectional Studies, Dizziness epidemiology, Female, Humans, Male, Nystagmus, Pathologic, Quality of Life
- Abstract
Purpose: Dizziness may affect quality of life in a negative way and contribute to falls. The aim of this study was to investigate and compare 75 years old with dizziness caused by benign paroxysmal positional vertigo (BPPV) to those with general dizziness/impaired balance (non-BPPV related) and to those reporting no dizziness, regarding health-related quality of life (HRQL), falls, tiredness, and walking speed in a population-based setting., Method: A cross-sectional population-based sample, including 671 75 years old (398 women, 273 men), was investigated for BPPV, dizziness symptoms, falls, and walking speed. HRQL was assessed using the 36-item Short Form-36 Health Survey (SF-36)., Result: A total of 67 persons (10%) had symptoms of BPPV with 11 (1.6%) having nystagmus when tested for BPPV. Having BPPV as well as general dizziness/impaired balance was associated with reduced HRQL, more tiredness, enhanced number of falls, and lower walking speed. Furthermore, the risk of having BPPV increased fourfold if symptoms of dizziness when turning in bed was reported., Conclusion: Having problems with dizziness is common among senior citizens where BPPV can be an unrecognized cause of dizziness that may impact HRQL and overall well-being. As BPPV is common among older adults, and is potentially curable through reposition maneuvers, it is important to liberally test for, and treat the condition. Information about dizziness when turning in bed can help to pinpoint persons with enhanced risk for BPPV also on a population-based level. more...
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- 2021
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14. What Happened with Muscle Force, Dynamic Stability And Falls? A 10-Year Longitudinal Follow-Up in Adults with Myotonic Dystrophy Type 1.
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Hammarén E and Kollén L
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- Adult, Cohort Studies, Exercise Test, Female, Follow-Up Studies, Humans, Leg physiopathology, Longitudinal Studies, Male, Middle Aged, Muscle Weakness physiopathology, Muscle, Skeletal physiopathology, Postural Balance physiology, Prospective Studies, Walking physiology, Accidental Falls statistics & numerical data, Muscle Strength physiology, Myotonic Dystrophy physiopathology
- Abstract
Background: Individuals with myotonic dystrophy type 1 (DM1) are known to stumble and fall, but knowledge is scarce regarding dynamic stability in this disorder., Objective: To describe disease progress regarding muscle force, dynamic stability and patient reported unintentional falls during a ten-year period, in individuals with DM1., Methods: Quantification of isometric muscle force in four leg muscle groups and assessment of Timed 10-meter-walk in maximum speed (T10max), Timed Up&Go (TUG) and Step test (STEP) were performed at three occasions in a DM1 cohort, together with self-reported falls., Results: Thirty-four people (m/f:11/23, age: 50.2 + /-9.4) participated. The muscle force loss after ten years was large in the distal ankle muscles. A steeper force decrease was seen in most muscles between year five and ten compared to the former five-year period. Males reported more falls than females, 91% vs 35% had fallen last year. A positive correlation, ρ= 0.633, p < 0.001, was shown between walking time (T10max) and number of falls. Frequent fallers were only seen among those with slower walk (T10max > 10seconds), and fewer steps in the STEP test (STEP≤5 steps)., Conclusions: A diminishing leg muscle strength and worse dynamic stability were seen in the group, with a steeper decrease in the latter five years. Weak ankle dorsiflexors, a slower walk and difficulties to lift the forefoot were related to frequent falls. more...
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- 2021
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15. Dizziness and its association with walking speed and falls efficacy among older men and women in an urban population.
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Lindell E, Kollén L, Johansson M, Karlsson T, Rydén L, Zettergren A, Frändin K, Skoog I, and Finizia C
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- Accidental Falls, Aged, Cohort Studies, Fear, Female, Humans, Male, Risk Factors, Sweden epidemiology, Urban Population, Dizziness epidemiology, Walking Speed
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Background: Dizziness is common among older people and falling is a feared complication., Aim: The purpose of this study was to investigate the presence of dizziness and its association with falls, walking speed and fear of falling, including sex differences, among 79-year-olds. Secondary purposes were to describe the relationship between dizziness and falls to number of medications and diseases., Method: The study consisted of the fifth cohort of Gothenburg's H70 birth cohort studies. A sample of 662 79-year-olds (404 women, 258 men) were investigated with questions regarding dizziness, previous falls and falls efficacy [estimated according to the falls efficacy scale Swedish version (FES (S))]. Functional tests included self-selected and maximal walking speed over 20 m., Results: Dizziness was reported among 51% of the women and by 58% of the men (p = 0.12). Approximately, 40% had fallen during the past 12 months (41% women, 38% of the men, p = 0.48). Dizziness was related to a higher risk of falls among women (OR 2.63 (95% CI 1.67-4.14, p < 0.0001), but not among men (OR 1.07, 95% CI 0.63-1.82, p = 0.8). Dizzy individuals had lower scores on FES (S) (p < 0.01), more medications (p < 0.001) and diseases (p < 0.001) than those without dizziness. Participants who reported dizziness walked 10% slower than participants without dizziness (p < 0.001)., Conclusion: Women with dizziness more often reported falls compared to women without dizziness-a trend that was not seen among men. Persons with dizziness walked slower. Many medications increased risk of falling; hence, number of medications alone might help pinpoint risk groups for falling. more...
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- 2020
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16. The phenotype of idiopathic normal pressure hydrocephalus-a single center study of 429 patients.
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Agerskov S, Hellström P, Andrén K, Kollén L, Wikkelsö C, and Tullberg M
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- Aged, Cognition, Female, Gait, Humans, Hydrocephalus, Normal Pressure physiopathology, Hydrocephalus, Normal Pressure psychology, Male, Phenotype, Postural Balance, Retrospective Studies, Severity of Illness Index, Treatment Outcome, Urinary Incontinence, Hydrocephalus, Normal Pressure diagnosis, Hydrocephalus, Normal Pressure surgery
- Abstract
Introduction: Idiopathic Normal Pressure Hydrocephlaus (iNPH) is, despite a vastly improved knowledge of the disorder since its first description still underdiagnosed and undertreated. Because of this, there is a need for further large studies describing the typical symptomatology and reversibility of symptoms in iNPH, which was the aim of this study., Methods: In all, 429 patients (mean age 71 years) were included. Detailed pre- and postoperative examinations of symptoms and signs were analyzed. A composite outcome measure was constructed., Results: Sixty-eight % improved after surgery. Preoperatively, 72% exhibited symptoms from three or four of the assessed domains (gait, balance, neuropsychology and continence) while 41% had symptoms from all four domains. Ninety % had gait disturbances, of which 75% had broad-based gait, 65% shuffling gait and 30% freezing of gait. These disturbances coexisted in most patients preoperatively, but were more likely to appear as isolated findings after surgery. Impaired balance was seen in 53% and retropulsion in 46%. MMSE <25 was seen in 53% and impaired continence in 86%. Improvements were seen in all symptom domains postoperatively., Conclusions: The iNPH phenotype is characterized by a disturbance in at least 3/4 symptom domains in most patients, with improvements in all domains after shunt surgery. Most patients present with a broad-based and shuffling gait as well as paratonia. Present symptoms in all domains and a shuffling gait at the time of diagnosis seem to predict a favorable postoperative outcome, whereas symptom severity does not., (Copyright © 2018 Elsevier B.V. All rights reserved.) more...
- Published
- 2018
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17. Physical functioning in older persons with dizziness: a population-based study.
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Kollén L, Hörder H, Möller C, and Frändin K
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- Activities of Daily Living, Aged, Cross-Sectional Studies, Female, Geriatric Assessment methods, Humans, Male, Prevalence, Sex Factors, Surveys and Questionnaires, Sweden epidemiology, Accidental Falls prevention & control, Accidental Falls statistics & numerical data, Dizziness diagnosis, Dizziness epidemiology, Dizziness physiopathology, Postural Balance physiology, Walking physiology
- Abstract
Background: Dizziness is one of the most prevalent symptoms in old age and tends to increase with age., Aims: To report physical functioning, health-related aspects and gender differences in elderly persons with and without dizziness in a population-based sample of 75-year-olds., Methods: A cross-sectional sample of 75-year-olds from Gothenburg, Sweden (n = 675, 398 women and 277 men) was examined by means of questionnaires and functional tests. The questions concerned dizziness/imbalance, physical activity level, walking habits, falls efficacy, number of falls, subjective health or general fatigue and medication. The tests included were self-selected and maximum gait speed, stair climbing capacity, one leg stance and grip strength., Results: More women than men reported dizziness/imbalance (40 vs 30 %, p < 0.001). Persons with dizziness, compared to those without dizziness, less often regularly exercised at a moderate intensity level (summer: 62 vs 74 %, p < 0.001; winter: 41 vs 51 %, p < 0.001), less often took a daily walk (p < 0.05), had lower scores on the FES(S) (p < 0.001), more often reported general fatigue (p < 0.001), more often had fallen in the previous year (40 vs 23 %, p < 0.001) and had a higher intake of medical drugs (4.6 vs 3.3, p < 0.001). They also performed worse regarding gait speed, stair climbing and one leg stance (p < 0.001), but there was no difference in grip strength., Conclusion: Older persons with dizziness are less physically active, have worse lower extremity function, are more often fallers and report lower self-rated health than persons without dizziness. more...
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- 2017
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18. Benign paroxysmal positional vertigo is a common cause of dizziness and unsteadiness in a large population of 75-year-olds.
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Kollén L, Frändin K, Möller M, Fagevik Olsén M, and Möller C
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- Age Factors, Aged, Benign Paroxysmal Positional Vertigo, Cross-Sectional Studies, Dizziness diagnosis, Dizziness etiology, Dizziness physiopathology, Female, Humans, Longitudinal Studies, Male, Postural Balance physiology, Posture physiology, Semicircular Canals physiopathology, Sex Factors, Surveys and Questionnaires, Sweden epidemiology, Vertigo complications, Walking physiology, Dizziness epidemiology, Vertigo epidemiology
- Abstract
Background and Aims: Studies have shown that 65% of people with dizziness may have a vestibular etiologic diagnosis, possibly benign paroxysmal positional vertigo (BPPV). The diagnosis of BPPV is based on medical history and findings after the Dix-Hallpike test. It is sometimes difficult to perform the Dix-Hallpike test in elderly persons, due to the limited range of motion when extending the neck. In this study, we used a side-lying test to stimulate the posterior semicircular canal, while the head and neck were fully supported on the examination table. The aims of this study were to investigate the prevalence of dizziness and/or impaired balance and BPPV in a population of 75-year-olds by means of a questionnaire and clinical tests, and to compare elderly persons with and without BPPV., Methods: A representative population sample of 675 persons completed a questionnaire about dizziness and 571 persons underwent side-lying, static balance and dynamic walking tests., Results: Subjective dizziness and/or impaired balance were found in 36% of subjects, especially when walking outdoors. A significant gender difference was found, with a higher prevalence in women (40%) compared with men (30%) (p<0.01). BPPV was found in 11% and was significantly more common in women (p<0.01). Elderly individuals with BPPV also displayed significantly impaired balance in static and dynamic balance tests compared with persons without BPPV (p<0.01). Persons with BPPV reported significantly more sub- jective problems with dizziness and balance compared with persons without BPPV (p<0.001)., Conclusions: Subjective and objective unsteadiness, dizziness and BP- PV are common in the elderly. more...
- Published
- 2012
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