[Rehabilitation needs remain after discharge from somatic emergency departments].
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Biomedical subjects
Publications and source records attributed to B Lundgren-Lindquist.
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The author describes Swedish experience with an increasingly large elderly population, concentrating on problems relating to ADL, hygiene, housing and locomotion.
A study of functional ability--in relation to joint impairment and disability--in 79-year-olds was performed on representative subsamples by interview (n = 134) and physical examination of joints (n = 89) as well as interview and functional tests regarding activities of daily living (ADL) (n = 84). Joint complaints of the lower extremities were more frequent than complaints of the upper extremities. Restricted knee motion had the highest correlation to disability of entering public transports. Previous sedentary workers were more disabled in ADL functions than those with a previous strenuous physical work. Correlation was found between low physical activity in the leisure time and impaired ADL functions. Low physical activity in the group with no definable disease was also correlated with greater social assistance. The reasons for commitment to institutional care were usually complex and, generally, not caused by joint impairment. Although disability had increased within the sample since age 70, at age 79 sixty per cent of the probands could still manage household tasks and personal care, and 69% did not require walking aids. The 79-year-olds thus display a high degree of musculoskeletal ability.
In the longitudinal population study "70-year-old people in Göteborg" (H 70) at the second follow-up in 1980-81, 112 women and 93 men were examined concerning their hygiene abilities such as visiting the toilet and taking a bath. These elderly people were interviewed about their locomotor function, needs of technical aids and personal assistance available at home. An examination of their functional ability was performed in accordance with a standardized test in two bathrooms, one with a bathtub and the other one with a shower area. Recordings of heart rate and subjectively perceived exertion were made during the test. Almost all were able to stand in front of the washbasin when washing themselves. Climbing in, sitting down and getting out of the bathtub required relatively high levels of effort, and almost one in five had difficulties. Only a few subjects needed personal assistance for getting out of the bathtub. There were large intraindividual variations of heart rate and perceived exertion in the various tasks. More than three of four took advantage of the handrails next to the bathtub during the test compared to one third of the subjects having handrails at home. Two thirds of the subjects had at least one technical aid in the bathroom, the most common technical aid in the bathroom was a "non-slip" mat in the bathtub. The importance of designing products and adapting the environment corresponding to the functional capacity of the elderly is emphasized.
As part of the Gerontological and Geriatric Population Study of 79-year-old people in Göteborg, a representative subsample comprising 112 women and 93 men took part in a study of upper extremity function. Thirty-eight per cent of the women and 37% of the men had disorders in the upper extremities. The investigation included tests of co-ordination, static strength in the key-grip and the transversal volar grip, power capacity in opening jars and a bottle, basal movements in the upper extremities in personal hygiene and dressing activities, function in the kitchen e.g. reaching shelves, manual tasks including tests of pronation and supination of the forearm. In the key-grip as well as in the transversal volar grip men showed a generally larger decrease in strength with age than women compared to 70-year-olds in a previous population study. Significant correlations were found between strength in the key-grip and the performance time in the test of co-ordination. Women produced about 66% of the muscular force of the men when opening jars. Significant correlations were found between strength in the transversal volar grip and the maximal torque for opening the jars. Female and male subjects who were not capable of handling the electric plug in the manual ability test had significantly weaker strength in the key-grip. The importance of designing products and adapting the environment so as to correspond to the functional capacity of the elderly, is emphasized.
Walking speed and the ability to climbing steps were studied in a subsample of 112 women and 93 men of the longitudinal population study "70-year-old people in Göteborg", in order to evaluate the functional capacity of the lower extremities. No women or men of this age achieved, when walking comfortably, a speed of maximum 1.4 m/s which is recommended in Sweden as a norm for pedestrians at signalized intersections. At their maximum walking speed only 32% of the women and 72% of the men reached 1.4 m/s. In comfortable walking women on an average used 78% and men 70% of their maximal walking speed. All subjects could climb up and down a 20 cm step when using a handrail. Less than half of the women but almost all the men were able to climb up and down a 50 cm high step using a handrail. Subjects having handicap transport service choose significantly lower walking speed than the rest of the subjects. Correlations were found between step test results and walking speed. It is concluded that both traffic vehicles and the rythm at signalized intersections are not in accordance with the functional capacity of older persons.
This paper draws on a unique longitudinal study, '70-year-old people in Gothenburg, Sweden', to augment available knowledge of the incidence of physical disability in an ageing cohort. Among women the incidence of mobility disability was 0.12 between age 70 and 75 years, and 0.19 from age 75 to 79 years. One in 10 males became mobility disabled from age 70 to 75 years while the risk increased to 0.18 between age 75 and 79 years. Cohort members disabled at age 70 years were at significantly increased risk of dying by age 79 years compared with their non-disabled counterparts. The data were consistent with other research revealing a substantial annual risk of disability or death for people in their eighth decade of life.