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Gunnar Akner

Publications and source records attributed to Gunnar Akner.

14 recordsLinked to original sources
PubMed2006

The effect of exercise of the affected foot in stroke patients--a randomized controlled pilot trial.

OBJECTIVE: To evaluate the effect of treatment with a portable device called Stimulo on range of motion, muscle strength and spasticity in the ankle joint and its effect on walking ability, balance, activities of daily living (ADL) and health-related quality of life in stroke patients. DESIGN: A randomized controlled pilot study. SETTING: A research centre. SUBJECTS: Ambulatory or partly ambulatory chronic stroke patients with remaining spasticity and/or decreased range of motion in the hemiparetic leg/ankle. INTERVENTIONS: Standardized and individualized programme including active and passive range of motion of the ankle with a portable device (Stimulo), performed three times a week for 30 min, over a six-week period. MAIN MEASURES: Range of motion, muscle strength, spasticity, gait variables, balance, ADL and health-related quality of life. RESULTS: Eighteen subjects were included in the study with a mean age of 75 years. The compliance rate was 94-99%. There were no significant differences between the groups. CONCLUSION: The study showed no significant effect of an ankle-exercise intervention programme with Stimulo. Further studies with a larger sample size are of importance before any further conclusions can be drawn.

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PubMed2004

Geriatric medicine in Sweden: a study of the organisation, staffing and care production in 2000-2001.

OBJECTIVE: the organisation of long-term medicine and geriatric medicine has undergone many changes during the last 15 years. The aim of this study is to gain an overall perspective of the present organisation of geriatric medicine in Sweden. DESIGN: questionnaire survey. METHODS: The Swedish Society for Geriatric Medicine and Gerontology, in collaboration with the Federation of County Councils and the Swedish Association of Local Authorities, sent out a survey to people in all county councils in Sweden. The subject of the survey was the speciality of geriatric medicine in the Swedish healthcare system, with regard to healthcare organisation, staffing and care production in 2000/2001. RESULTS: there were 52 separate geriatric units, 41 independent 'clinics' and 11 'sections' within other departments. There were a total of 3,101 geriatric inpatient beds. On average, there was one geriatric bed for every 799 individuals within the local population aged 65 years and over, with a 10-fold variation between counties. Four counties had no geriatric provision. The 'geriatric clinics' were mainly located in university towns and averaged 85 beds per clinic, again with a 10-fold variation. There were 604 established positions for doctors within geriatrics, of which 63% were at geriatric clinics. On average, the clinics had 16 positions each (of which 75% were filled with geriatric specialists) with 7 beds per doctor. The corresponding averages for nurses and paramedics could not be summarised due to organisational differences between the county councils. In general, there were very few nurses with specialist training in geriatric medicine. CONCLUSIONS: the field of geriatric medicine in Sweden is very heterogeneous regarding terminology, designations, structure, staffing and care production. There is no overall structural plan for the role of geriatric medicine in Swedish healthcare, with the desired close connection between content and dimensioning of geriatric specialist training and the practical organisation of the activities. The county councils designate geriatric medicine so differently that it is hardly possible to compare different geriatric facilities today. Considering how many patients at hospitals today are elderly and suffer from multiple illnesses, it is a major quality issue to ensure that these patients have access to geriatric specialists.

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PubMed2004

Effects of physical training on physical performance in institutionalised elderly patients (70+) with multiple diagnoses.

OBJECTIVE: the positive effect of physical training in healthy elderly people is well documented. The aim of this systematic review was to describe the effect of physical training on physical performance in institutionalised elderly patients with multiple diagnoses. DESIGN: systematic literature review of randomised controlled trials regarding effects of physical training of elderly (70+) subjects. METHODS: the randomised controlled trials were evaluated using a modified version of an evaluation form originally developed by the Cochrane Collaboration. It is based on a weighted scale of 0-100 points, and ranks the studies as high, moderate or low methodological quality. A total of 16 randomised controlled trials were included in the review. RESULTS: six studies scored as high quality, eight as moderate and two as low. There was a large heterogeneity in the studies concerning sample size, types of interventions and types of assessments. There is strong evidence for a positive effect of physical training on muscle strength and mobility; moderate evidence for an effect on range of motion; and contradictory evidence regarding gait, activities of daily living, balance and endurance. CONCLUSION: more studies are required, with larger sample sizes, higher specificity as to the types of interventions and assessments, greater focus on clinically relevant outcomes such as endurance and activities of daily living, and also, for example, quality of life and mortality.

Activities of Daily Living↗
PubMedDate not supplied

Physical training in institutionalized elderly people with multiple diagnoses--a controlled pilot study.

Reduction in muscle mass and physical function depends on a variety of interacting factors: age, physical activity level, nutritional state and the type and impact of disease. The aim of this study was to investigate the effect of an individualized moderate intensity physical training program on muscle strength, balance, mobility, ambulation and activities of daily living (ADL) in institutionalized elderly people aged 65 and over with multiple diagnoses. Baseline assessments consisted of strength, balance, mobility/ambulation, and ADL. Twenty-one subjects were included in the intervention program. A control group (21 subjects) was first matched in pairs according to gender, age, ADL and mobility, and then by balance, ambulation and strength. The intervention program was individualized and included strength, mobility, balance and endurance training. Follow-up measures were conducted directly after the intervention and 10 weeks later. After drop-out, 20 subjects in the intervention group and 15 subjects in the control group remained for analyses. Balance and mobility improved significantly in the intervention group while declining in the control group. This pilot study indicates that a physical training program may improve functional capacity for institutionalized elderly persons with multiple diagnoses.

Activities of Daily Living↗