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  • 1.
    Strauch, Stefanie
    et al.
    Sahlgrens Univ Hosp, Sweden.
    Hagstromer, Maria
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Bäck, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
    Objectively Assessed Physical Activity in the Oldest Old Persons With Coronary Artery Disease2019In: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895, Vol. 42, no 4, p. E69-E76Article in journal (Refereed)
    Abstract [en]

    Background and Purpose: Accelerometer threshold values to detect physical activity intensity in the oldest old persons with coronary artery disease (CAD) are lacking as well as knowledge about their free-living physical activity behavior. The purpose of this study was 2-fold. (1) To assess the sensitivity and specificity of 3 existing intensity threshold values for Acti-Graph accelerometers for the oldest old persons with CAD. (2) To assess free-living physical activity, applying the threshold values with the highest sensitivity and specificity for assessing at least moderate intensity, among these persons. Methods: In a cross-sectional design, a total of 24 persons with CAD, mean age 87.5 (3.7) years, participated in the study at a university hospital in Sweden. To assess the sensitivity and specificity of the existing threshold values, the participants walked at different speeds wearing the accelerometer at a pace corresponding to individualized perceived exertion at light, moderate, and high intensity according to the Borg Rating of Perceived Exertion Scale. For the free-living physical activity assessment, the persons wore the accelerometer for 7 consecutive days. The percentage agreement for light-, moderate-, and high-intensity threshold values, as well as receiver operating characteristic curves, was used to identify the sensitivity and specificity of the existing threshold values for moderate intensity. Results and Discussion: The threshold values for at least moderate intensity at 1041 counts per minute according to Copeland had the highest sensitivity (0.739) and specificity (0.609) to identify at least moderate intensity for the ActiGraph GT3X+ accelerometer. In a free-living setting, the oldest old persons with CAD spent 11 of 13.5 (81%) waking hours in a sedentary position and, of the 2.5 hours of being active, 19 minutes (2%) were at least at moderate intensity. Nine of 24 persons (38%) reached 20 minutes of moderate- to vigorous-intensity physical activity 3 days a week, according to guidelines for exercise-based cardiac rehabilitation. Conclusions: The existing threshold values according to Copeland had the highest sensitivity and specificity to identify at least moderate intensity and are valid for use in the oldest old persons with CAD. Using accelerometry as an objective measurement for physical activity can help further improve our understanding of free-living physical activity behavior and to assess relationships between free-living physical activity and health outcomes among the oldest old persons with CAD.

  • 2.
    Åhlund, Kristina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. NU Hosp Grp, Sweden.
    Ekerstad, Niklas
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. NU Hosp Grp, Sweden.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Bäck, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Sahlgrens Univ Hosp, Sweden.
    Physical Performance Impairments and Limitations Among Hospitalized Frail Older Adults2018In: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895, Vol. 41, no 4, p. 230-235Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Early rehabilitation is important for frail older adults due to reduced reserve capacity and physical fitness. To facilitate individualized rehabilitation programs, we need tools to make it possible to assess physical fitness in relation to frailty, instead of chronological age. The purpose of this study was, in a Swedish context, to describe measures of physical fitness in hospitalized frail older adults in relation to their degree of frailty. Methods: This was a cross-sectional study. A total of 408 frail older adults, mean age 86.6 years (75-99 years), in need of emergency medical inpatient care, were included in the NAL-Uddevalla (NU) hospital group in Sweden. During the hospital stay, physical fitness was assessed using 4 different tests: hand-grip strength, the Timed Up and Go Test, 5-time sit-to-stand test, and 6-minute walk test. In the analyses, the physical fitness outcomes were related to the degree of frailty using the FRail Elderly Support ResearcH group screening instrument and previously used cutoffs or age-related reference values for older adults. Results and Discussion: This study showed that most hospitalized frail older adults perform far lower than previously described age-related reference values relating to physical fitness. An increased degree of frailty contributes to reduced physical fitness in tests assessing strength and endurance. Conclusions: A frail-related screening instrument may be useful in the evaluation of physical fitness in hospitalized frail older adults and may facilitate the development of realistic, individualized rehabilitation programs beneficial to an early start on the emergency medical ward.

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